How to fix a Dowager’s hump

“What is that unsightly bump at the base of your neck!?”

That is what we call the Dowager’s Hump.

Dowager's hump

Image courtesy of stockimages at FreeDigitalPhotos.net


This article will cover:


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// Dowager’s hump definition

It is an enlarged prominence that is formed at the lower region of the neck.

… in other words – it’s a big bump that sits at the base of your neck!

 

// Features of a Dowager’s hump

bump

As you can see in the picture above, there is:

  • Enlarged prominence (…that’s the Dowager’s hump!)
  • Forward rounding at the base of the neck
  • Fatty deposit tissue
  • Hyper extension of the middle neck region
  • Loss of natural spinal curve in the neck
  • Forward head posture

// The main cause of a Dowager’s hump

Bad posture.

… Or more specifically, a forward head posture.

poked necdk vs normal

… is this your posture?

Think about how your posture looks like when you are sitting throughout the day.

If I were to guess, I’d say you spend a long time sitting down either in front of the computer, television and/or driving (… and probably with the above posture).

This is a lot of time in your bad posture.

Did you know… that for every inch  that your head protrudes forward from it;s normal alignment, you add ~10 extra pounds of force on your neck.

 


“How does my bad posture cause a Dowager’s hump?”

The problem – The more forward your head sits, the more stress is placed on the base of your neck.

The result – To cater for the extra stress, the body:

a) lays on thick connective tissue and

b) thickens the bone/joint at the base of your neck.

This is the body’s attempt to support your heavy head (…which gets even heavier the more forward it is!)

After a long period of time, the thick connective tissue accumulates to an extent where a hump forms – the Dowager’s hump.


** Note: There are certain conditions (namely Osteoporosis and Cushing’s Syndrome) that can also cause a bump at the base of the neck.

 

 

// Implications of having a Dowager’s hump

  • Aesthetics. Let’s be honest. It’s not the most appealing thing to have… But hey, at least now we can start to do something about it.
  • It can give the appearance of having a squashed neck (or lack of neck). It might even make you shorter!
  • Neck pain: As the head is in a sub-optimal position, there is more stress placed on the muscles and joints of the neck.
  • Higher risk to conditions like arthritis, disc bulges, nerve impingement, muscle spasm and headaches.

// How long will to take to fix?

It really depends. How long have you had your Dowager’s hump for?

The problem is… the longer you have had the Dowager’s hump, the more difficult it will become to improve it.

Your posture will not be fixed over night. But with the right corrective strategy and a bit of persistence, you will see gradual improvements. Every bit counts! Small changes add up over time.

So, the sooner you recognise you have it, the sooner we can help you fix it!

Note: If your joints have already fused together, it is unlikely that they can “un-fuse”. 

// How to test if you have a dowager’s hump

 

1. Take a side profile shot of yourself:

dowager's hump

If you can see an obvious bump around the base of your neck, then you most likely have it!

 

2. Feel it:

Place your hand at the base of your neck. Can you feel a significant bump?

 

3. Get an X-ray:

If you really wanted to know the structural alignment of your neck, go to your general practitioner and request for an X-ray.

 

NOTE: It is normal to have slightly enlarged bones at the base of your neck area. Do not mistake this for having a Dowager’s hump! You’re looking/feeling for a significant bump.

How to fix your Dowager’s hump:

Image courtesy of stockimages at FreeDigitalPhotos.net


Warning: These exercise are designed to be gentle and pain-free. If in doubt, please see a medical professional before commencing these exercises.


To fix your Dowager’s hump, you will need to:

  1. Release the tight muscles
  2. Stretch the tight muscles
  3. Loosen up stiff joints
  4. Strengthen the weak muscles
  5. Address other areas

1. Release the tight muscles

These tight muscles are responsible for pulling the head into the incorrect head position.

a) Sub-occipital

SuboccipitalSub Occipital massage

Instructions:

  • Rest your head on a massage ball.
  • Make sure the ball is pressing on the target areas (see X target areas as above).
  • Gently rock your head from side to side.
  • Remember – If it hurts, it’s probably a tight spot!
  • Do both sides.
  • Duration: 1 minute per side.

b) Sternocleidomastoid

scm release

Instructions:

  • Locate the target areas. (see above)
  • You should be able to feel a prominent band of muscle on each side of the neck.
  • Do not to press too deep as you may hit other sensitive structures of the neck.
  • Gently massage these muscles with a pinch grip.
  • Duration: 1 minute each side.

2. Stretch the muscles

Now that you have released the tight muscles, it is time to stretch them!

a) Sub-occipital

neck stretch back

Instructions:

  • Tuck your chin in.
  • Whilst keeping your chin tucked in, gently pull your head downwards.
  • Aim to feel a stretch at the back of your neck.
  • Hold for 30 seconds.
  • Repeat 3 times.

 

b) Sternocleidomastoid

scm stretches

Instructions:

  • Gently tuck your chin in.
  • Look to your left and upwards.
  • Tilt your head to the right side.You should feel a stretch on the left side of the neck.
  • To increase stretch: With your right hand, apply pressure to left side of head and pull down.
  • Hold for at least 30 second. Repeat for opposite side.
  • Repeat 3 times.

 

3. Loosen up the stiff joints

With the Dowager’s hump, the joints in the neck will be stiff. Let’s loosen them up!

a) Head slides


Video from HowCast

Instructions:

  • Keep your face forward and chin parallel with the ground throughout the movement.
  • Slide your head from side to side.
  • Aim to feel a strong stretch on the side that you are sliding towards.
  • Repeat 20 times.

b) Chin tuck with over pressure

retractoverpressure

Instructions:

  • Lie on the floor with your knees bent.
  • Tuck your chin in.
  • Place your hands on your chin (see above) and apply a downward pressure
  • Hold for 5 seconds. Repeat 10 times.

c) Chin retraction with extension


Video from McKenzie Institute International.

Instructions:

  • Tuck your chin. (think about the movement as a book sliding back into the shelf)
  • Whilst maintaining this position, proceed to look up/down.
  • Ensure that you do not poke your chin out excessively during the movement.
  • Repeat 30 times.

d) Self neck traction

Video from Integrative Movement Specialists.

Instructions:

  • Lie on the floor with your knees bent.
  • Place one hand on the top of your chest, and the other hand behind your neck.
  • Proceed to pull down (towards your feet) with the hand on your chest as you pull up with the hand under your neck.
  • Aim to feel a pulling sensation at the back of your neck.
  • Hold for 10-15 seconds. Repeat 10 times.
  • Make sure that your neck muscles are completely relaxed whilst performing this exercise.

4. Strengthening exercises

If you have a Dowager’s hump, then I can guaranty that these deep muscles will be weak! (… namely the neck retractors and deep neck flexors)

deep neck flexors

If your muscles are weak, then it will very difficult to fix your Dowager’s hump.

I’ve organised these strengthening exercises in order of difficulty.

Please do not skip any exercises! (… unless you find the exercise very easy)

a) Chin tucks (lying down position)

Chin nod

Instructions:

  • Whilst lying down, tuck your chin in.
  • Try to get the back of your neck to touch the floor.
  • Hold for 5-10 seconds.
  • Repeat 20 times.

 

b) Chin tucks (up right position)

chintuck

Instructions:

  • Gently tuck your chin in.
  • Keep your eyes horizontal as you tuck your chin in. (Tip: Think about this movement as the sliding of a book back into the shelf)
  • Hold for 5-10 seconds.
  • Repeat 20 times.

c) Chin tucks (with neck flexion holds)

dnfresistance

Instructions:

  • Gently tuck your chin in.
  • Keep your eyes horizontal as you tuck your chin in. (Tip: Think about sliding a book back into the shelf)
  • Whilst applying a resistance to the bottom of your chin in an upward direction, press down your closed fist.
  • Hold for 5-10 seconds.
  • Repeat 20 times.

d) Chin tucks (against gravity)

chin tuck against gravity

Instructions:

  • Lie on your stomach with your head over the edge of the bed.
  • Gently tuck your chin in.
  • Hold for 30 seconds.
  • Repeat 5 times.

e) Chin tucks (with neck flexion against gravity)

neckretractionDNF

Instructions:

  • Lie on your back with your head over the edge of the bed.
  • Tuck your chin in.
  • Keep your neck in a neutral position.
  • Hold for 5-10 seconds.
  • Repeat 20 times.

 

Want more exercises? For a more comprehensive list of other neck exercises, check out this post:  Neck strengthening exercises.

5. Addressing your posture

“So… I just do the exercises mentioned above and my Dowager’s hump will disappear?”

No!… I wish it was that simple.

Although the exercises that I have mentioned above will definitely help address your Dowager’s hump, there are other factors that we must consider!

You see… your Dowager’s hump is a part of a bigger issue… and that’s your posture as a whole.

There are reasons why you have formed that Dowager’s hump. And to completely address this issue, we need to look at all other factors as well.

kyphosis

There are 3 main problems (but not limited to) in your posture that predispose you to developing the Dowager’s hump.

They are:

  1. Forward head posture
  2. Hunched back
  3. Rounded shoulders

Collectively, they place excessive amounts of stress to the base of your neck.

Problem 1: Forward head posture

Head over to this post: Forward head posture correction for an extensive list of exercises that will correct the position of your head.

 

Problem 2: Hunched back

Exercise to fix: Thoracic extension

Chest stretch

Instructions:

  • Place your outstretched hands onto a wall.
  • Lean into your hands.
  • Squeeze your shoulder blades back together
  • You should feel a) a stretch in your chest and b) the muscles between your shoulder blades contract.
  • Hold for 30 seconds.
  • Repeat 3 times.

… DON’T CHEAT! Make sure that do NOT over arch your lower back.

Head over to this post for an extensive guide to completely eliminate your hunch back posture.

 

Problem 3: Rounded shoulders

Exercise to fix: Retraction

scapulatretraction

Instructions:

  • Set yourself into the starting position. (as above)
  • Pull your elbows as far backwards as you can. (end position)
  • Hold at the end range for 10 seconds.
  • Repeat 20 times.

Head over here if you want an extensive guide on how to fix your Rounded shoulders.

Suggestions:


Any questions? I’ve got you covered…

Please leave me a comment down below and I’ll get back to you.

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About

I am a physiotherapist who has personally experienced the pain as a result of bad posture. I would like to offer you some of the solutions that I and my patients have greatly benefited from.

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45 thoughts on “How to fix a Dowager’s hump

  1. Mark, I appreciate very much the valuable information and advice in this website. I am upset seeing young people and adults of various ages suffered from bad postures without knowing it. I looked up this issue with a view to convincing my family member to take care of the problem. The exercises certainly will help.

  2. Hi Mark,
    You have said ‘ If your joints have already fused together, it is unlikely that they can “un-fuse”.’
    I have dowager’s hump. How do I know if it can’t be fixed ? I have cervical radiculapthy. Does the hump mean I can never fix my neck pain ?
    Thanks

    1. If your joints have fused together, there’s unfortunately too much we can do about that.

      HOWEVER – you just have to focus on areas where you can improve.

      The presence of a dowager’s hump does not completely mean that you will have pain for the rest of your life

      Mark.

      1. Thanks Mark. From the 10 yrs of computer job and my poor posture I have neck pain and shoulder and upper back pain ( for the past 3 years). I have forward head posture, rounded shoulders, a small Dowager’s hump.
        To reduce my pain, what should I begin with ? Will I have to do the exercises for all the above mentioned conditions or just forward head posture correction exercises will give me some relief to begin with. With a 6 month old to care for I can manage put in only 2 hrs everyday to exercise.

        1. Hi Lakshmi,

          Focus on the Releases and Stretches to begin with. This will help reduce your pain.

          On top of that, you need to identify ANY activity/movement/position that makes your symptoms worse.

          Either a) Modify it so you can do it without symptom reproduction, b) minimise your exposure to it OR c) don’t do it all.

          For you specifically, this may involve workstation modification, frequent breaks for the prolonged sitting position, being careful how you hold/nurse/lift/bath etc your 6 month old, regular stretches.

          Once your pain has subsided, you can focus a bit more on the strengthening side.

          Mark

          1. Thank you so much Mark. I will go with your advice. I know that road to recovery could be a very long one, nevertheless I am not going to give up.
            Thanks for your help !

  3. Thanks so much for your website! I think I have researched and read every website on the subject of forward neck posture and dowager’s humps out there, and this is by far the BEST!

  4. I was wandering if at some point you could make a video of all these exercises? I have looked online a lot to find a way to correct my posture and this is the most helpful information but I have printed it all to follow and its so hard to stop, read, try throughout the day. I think its going to take a lot of repetition to see results. A video would be so useful, especially since its the first time I have done any of the exercises and I am not sure if I am doing them correctly. 🙂

    1. Hi Lee,

      It depends on how long ago that you had your surgery. I would ask clearance from your surgeon if it has been within 12 weeks.

      Other than that, the exercises should be fine providing that you are not over doing it.Listen to your body. If it hurts, feels uncomfortable and/or increases your pain, do not do the exercise.

      Mark

  5. This is really great. I would love to try this. And i hope to get results soon once ive started it. Its really frowning to have this little hump on my neck.:(

  6. Hi Mark,
    I am 14 years old and I’ve had this dowagers hump for about 3 years how would you k ow if your joints fused? And to help correct it could I just focus on correcting my posture?

  7. Can the problems you addressed be hereditary? My great grandmother, my aunt and several cousins have this problem. I, too suffer from it. I feel very self conscious all the time, get negative comments, etc. I am 68 yrs old and actually just recently had a name put to it by a chiropractor who said”you have forehead posture which is most unattractive”. Needless to say I signed up for appointments but became too expensive. My pain subsided but still have the problem.

    1. Hi Maggie,

      There definitely can be a genetic predisposition to developing this condition.

      However – I can almost guaranty you that you did not have it when you were born.

      Usually – it is caused by postural factors over the years.

      Mark

  8. i’m 18 i’ve been suffering from major depression. i have been super active my entire life but the past year i have been lying on the couch ins ball. starting in june i felt the humor and it has gotten 10 times worse. is it fixable and how can you tell if your joints have fused?

    1. Hi Sammy,

      Good thing you are only 18 which means it is very likely you can fix the hump on your neck!

      Persist with these exercises and you will see a difference.

      Usually joints tend to fuse with conditions like arthritis. At your age (unless you have history of spine issues), it is very unlikely that they are fused.

      Hope this answers your question.

      Mark

    1. It can feel better even after 1 session.

      However – in terms of seeing a significant visual change, it can take a couple of months! (It really depends on how bad it is in the first place)

      Mark

  9. Hi Mark, I have had weak neck muscles for years from previous jaw surgeries. I’v also struggled with posture but somehow did not connect the two. I started your exercies but I can only do about half of the repititions before it starts hurting and is sore afterwards. I would think this is normal with muscles that have not been worked for a long time. I’m wondering if it would be better to start slow? and would some heat afterwards help?

    1. Hi Pamela,

      Start with an amount of repetitions that you can comfortably handle. This will be your baseline.

      From here, aim to progress to higher reps when appropriate.

      The suggested repetitions are just an outline, but you can change it to cater for your level of ability.

      And yes, heat is awesome for relaxing the muscles afterwards 🙂

      Mark

  10. Hello Mark,
    I recently noticed my dowager’s hump and it is very unattractive. I am 50 so have my joints fused at this age? I have no issues with arthritis or spine. I feel mine is due to many many years on the computer and this has probably been progressively worsening all these years. I have been doing one particular exercise for forward head position for about 2 wks and I see some progress. Just wondering if at my current age, this can still be reversed. I am going to begin your other strategies today.

    1. Hello Mark,

      I have a the same questions as Niki above. However, I am older at 55 this year and pray that my joints have not fused and I will have this permanently. I never noticed this hump till about 2-3 years ago. I sit at a computer for 8-10 hours a day and am sure this is what caused it. My daughter is a Yoga Instructor and advised me to start Yoga asap along with the exercises you suggest here. Any other suggestions? Should I start using one of those desk that rise up to stand and work? Would that help at all? Thank you!

      1. Hi Sharron,

        The best thing (besides from the exercises list above) is to take REGULAR breaks from the computer.

        This might mean to use a standing desk, get up for a coffee, go to the toilet, even standing up for only 10 seconds.

        The importance is to keep moving. Change positions. And not to stay in the one spot for too long.

        All the best!

        Mark

  11. Thanks Mark. this is very informative. My dad has poor posture and I figured i suffered it also. I have a the hump at the back of my neck and I will try to use to do every excise in an effort to change this . Any other info i would be glad to try.

  12. Hi Mark! Thank you so much for this! I have just started noticing the formation of a hump at the back of my neck and do exhibit all 3 posture misalignments. How frequently would you recommend doing the stretching and strengthening exercises listed here?

  13. Thank you for this info!! I’ve had a dowagers hump for years! Although I didn’t know that’s what it was. I’m extremely self-conscious about but didn’t realize it was caused by my posture and could possibly be fixed! I’m 27 I’m not sure how long I’ve had it. I don’t remember when it was that I first started noticing I would say its been probable about 4 years. Do you think its been too long? What’s a realistic time frame to see real results? I’m getting married in August and it would be great if it was better by then! Again Thank you!

  14. Hi Mark, I’m so glad I just happened to stumble across your blog. Its been a godsend to my terrible posture ways. I did have a question about releasing tense muscles on the back of your neck, the sub occipital. Can I roll a ball using my hand against my head sitting upright, or does it have to be lying down and putting your head against the ball? I’ve tried your way and the sitting upright and I feel like sitting upright targetted the painful areas better than lying down. Thanks!

    1. Hi Sharranya,

      If you feel the release better when sitting upright, then do it that way.

      As long as you are hitting the right areas, it’s all good!

      Mark

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