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  • Writer's pictureAgnieszka Kosinska

Is Rounded Shoulders And Forwarded Head Causing Pain?



Rounded shoulders are one of the most common postural problems that I see with my patients and yes, poor body posture can cause serious problems. In this article, I explain to you why this is causing an issue and how you can prevent it. The term rounded shoulders is used to describe hyperkyphosis.

HYPERKYPHOSIS (above 40 degrees) is a spinal deformity where the normal curvature of the thoracic spine is exaggerated that the back becomes rounded and the head and neck are protruded forward. Although 20-40 degrees of kyphosis is normal, functional “S” curve of the spine.


What cause rounded shoulders?


This shoulder 'abnormality' usually develops when you are sitting in prolonged poor posture. While at work, you slouch in your chair, when you get home, you want to unwind so you slouch on a couch to watch your favourite programme. Here are some of the daily activities that may contribute to rounded shoulders:

  • using a smartphone or tablet

  • using a computer or laptop

  • sitting for long periods

  • driving, cycling

  • bending over repeatedly

  • carrying or lifting heavy objects




You may do not have pain after sitting with poor posture for a few hours, but over time the stress that poor posture places on your spine can lead to anatomical changes in your spine. When your head moves forward the muscles in your neck have to tighten to fight the pull of gravity and hold your head up. The more your head is forward of the centreline, the more the muscles have to work against the force of gravity.

Over time, forward head posture can lead to muscles imbalances as the body tries to adapt to hold the head up. Some muscles become elongated and weakened, whereas other muscles become shorter and tighter.

Forward head posture can cause serious issues including neck and back strain, headaches, jaw pain, shoulder dysfunction, cervical radiculopathy, disc and/or joints degeneration.


Tight muscles:

  • Suboccipital muscles

  • Pectoralis major/minor

  • Upper trapezius

  • Levator scapulae, Subscapularis, Teres major

Weak muscles:

  • Mid/lower trapezius

  • Rhomboid

  • Posterior deltoid

  • Rotator cuff muscles (supraspinatus, infraspinatus, teres minor)


Check if you have rounded shoulders


What I want you to do is stand with your arms by your side. Don’t try to fix your posture. Just stand how you feel comfortable. Now, without rotating your hands, extend your thumbs. If they point forward, your shoulders are ok. If they point towards each other and the palms facing backwards, that means your shoulders are slouched, and your arms have started to rotate in front of you.


Guide to good posture


If poor posture can lead to back pain, it logically follows that good posture can help you avoid back pain. The good news is, that a mixture of stretches and strengthening exercises can often help to correct a poor posture. Here’s how to maintain good posture:


Walk tall

While walking, it's important to look straight ahead of you and to keep your head balanced straight above your spine. Additionally, remain tall (avoid drooping your shoulders) while you are walking.


Sit with support

If you’re like most people, you sit for at least eight hours every day. With so much of your life spent sitting down, it is imperative that you sit with proper posture. Make sure you have a good chair and don’t hunch forward to reach the computer screen.


Lift carefully

Improper lifting techniques can cause injury to the muscles, joints, and discs in your back. Keep the object you are lifting as close to your body as possible.


Exercise

Just as the muscles and joints have been trained to hunch forward, they can be retrained to find the correct resting position. Exercise 20 – 30 min a day, at least 3x a week can help improve your posture and alleviate any associated symptoms.


1. Chin Tuck

This exercise can be done sitting or standing. While looking straight ahead, place two fingers on your chin, slightly tuck your chin and move your head back. Hold for 5-8 seconds and then release. Repeat 10 times.

2. Doorway Stretch

Standing in a doorway, lift your arm, bend at the elbow (90 ) so your fingers point toward the ceiling. Place your hand on the doorjamb. Slowly lean into your raised arm and push against the doorjamb for 7-10 seconds. Relax and repeat again. Repeat this stretch 4 to 5 times on each side.

3. Handclasp

Standing up straight, reach your hands behind the back and cross your fingers. Then gently pull the shoulders back, do not allow the neck to push forward. The shoulders should be pulled back until the chest opens and a deep stretch is felt. Hold for 20-30 seconds. Repeat 10 times.

4. Wall Angel

Stand with your back against a flat wall. Maintain a slight bend in your knees. Your glutes, spine and head should all be against the wall. Bring your arms up with elbows bent so your upper arms are parallel to the floor and squeeze your shoulder blades together, forming a letter "W". Hold for 3 seconds. Next, straighten your elbows to raise your arms up to form the letter “Y.” Make sure not to shrug your shoulders to your ears. Repeat this 10 times, starting at “W,” holding for 3 seconds and then raising your arms into a “Y.” Do 2-3 sets.

5. Scapular wall hold

Stand with your back against the wall and arms straight at your sides and elbows bent to 90 degrees. Then lean back and push your elbows back into the wall as you press your chest out and open toward the ceiling. Hold for 6 seconds, and then relax. Repeat 10 times.

6. Scapula Setting

Lie on your stomach with your arms by your sides. Place a small pillow under your forehead for comfort, if required. Lift your arms up and draw your shoulder blades together and down your back as far as possible. Hold for 10 seconds. Relax and repeat 10 times.

7. Hip Flexor Stretch

Kneel onto your right knee with toes down, and place your left foot flat on the floor in front of you. Place both hands on your left thigh and press your hips forward until you feel a good stretch in the hip flexors. Hold this pose for 20-30 seconds, and then switch sides. Repeat each side 5 times.


 

References:

1. Tae-Woon Kim, PhD, Da-In An, Hye-Yun Lee, Ho-Young Jeong, Dong-Hyun Kim, PhD, Yun-Hee Sung, PhD "Effects of elastic band exercise on subjects with rounded shoulder posture and forward head posture"; J Phys Ther Sci. 2016 Jun; 28(6)

2. Rodrigo M. Ruivo, Pedro Pezarat-Correia, Ana I. Carita "Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain"; Braz J Phys Ther. 2014 Jul-Aug; 18(4)

3. Jung-Ho Kang, M.D., Rae-Young Park, M.D., Su-Jin Lee, M.D., Ja-Young Kim, M.D., Seo-Ra Yoon, M.D., Kwang-Ik Jung, M.D. "The Effect of The Forward Head Posture on Postural Balance in Long Time Computer Based Worker"; Ann Rehabil Med. 2012 Feb; 36(1)

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