How to fix Rounded shoulders

qasiAs a physiotherapist, Rounded shoulders is one of the most common postural problems that I see with my patients.

… and yet, it is so easy to fix!

Rounded shoulders WILL LEAD TO BAD POSTURE! …

Not perhaps… Not maybe… It WILL.

(… and if you care anything about your posture, this is a post that you must not miss out on!)

 


What this article will cover:


// What are Rounded shoulders?

rounded shoulders

Simply put… It’s part of your bad posture!

Having Rounded shoulders is when the resting shoulder position has moved forward from it’s ideal alignment. (see picture above)

For those who like those anatomical big words – it involves scapula protraction/anterior tilt/elevation, anterior translation of the humeral head and/or internal rotation of the humerus.

Note: Remember to check out the post: The ideal sitting posture to learn more about what the correct postural alignment is.

 

 

// What are the causes?

 

Rounder shoulders are part of a bigger problem… and that is bad posture.

Your posture becomes the shape you decide to position your body throughout the day.

Hands up if you do any of these tasks:

  • Sit down all day
  • Use the computer/laptop
  • Use a smart phone/tablet
  • Look down for prolonged periods
  • Drive
  • Bend, lift or carry
  • Sleep on your side

I am willing to bet that you have rounded shoulders in most (…if not all) of these positions! … Am I right?

These positions you adopt throughout the day disrupts the normal balance of muscular activity that is responsible for maintaining your ideal posture.

 

 

// What’s happening with the muscles?

upper cross syndome

In Rounded shoulders, there are:

a) Tight muscles:

These muscles are PULLING the shoulders forward.

  • Pec major/minor
  • Subscapularis
  • Latissimus dorsi
  • Anterior deltoid
  • Biceps
  • Posterior capsule (pushes shoulder forward)
  • Upper trapezius
  • Serratus anterior

b) Weak muscles:

These muscles ARE NOT pulling the shoulder backwards. (as they should be!)

  • Mid/lower trapezius
  • Rhomboids
  • Posterior deltoids
  • Rotator cuff

Think about it this way. There’s a tug-of-war battle between the muscles at the front and back of the shoulders… And the wrong team is winning!

 

 

// Common painful regions

AREAS OF PAIN

Yes, I know… It’s pretty much the whole back!

 

 

// Test to determine if you have Rounded shoulders

 

a) Position of palms in standing:

20160725_162304

Stand up. Keep your arms relaxed by your side.

Have a quick glance at your hands.

… Which way are your palms facing?

You may have Rounded shoulders if…: Your palms are facing behind you.

 

b) Lying down test:

rounded shoulders floor test

Lie down with your back flat against the floor and arms by your side.

Do the back of you shoulders naturally rest on the floor? Or do they appear to be floating forward?

DON’T CHEAT! Make sure that you are not ARCHING your lower back!

You may have Rounded shoulders if…: Your shoulders do not come in contact with the floor.

 

 

// What is the correct shoulder position?

Let me teach you how to quickly re-set the position of your shoulders.

shoulder position reset

  • Reach out your hands as far to the side as possible, (see above)
  • Slightly bring your arms backwards
    • make sure you can feel a gentle contraction between your shoulder blades
  • Turn your palms upwards
  • Take note of your shoulder position. Keep this position! And gently lower your arms by your side.

 


Is your work station causing you to have bad posture? Check out my FREE ebook – How to set up your workstation.


How to fix your Rounded shoulders

What is expected of you:

// Dedicate a solid 20-30 minutes doing these exercises. Don’t rush through it. Take your time. It’s not a race. You may need to spend more time on the more challenging exercises.

// Commit to these shoulder exercises for a frequency of twice a week. It’ll take as long as it will take.  And that’s fine. 


Mark Wong

Note: These exercises are designed to be gentle and should not aggravate your pain. If any doubts, consult your health practitioner prior to commencing these exercises. Or… You can just contact me and I’ll try my best to help  you out!


Quick navigation:

  1. Releases
  2. Stretches
  3. Mobilisations
  4. Strengthening/Endurance

1. Releases

Tight structures will keep the shoulders in the forward rounded position. It is important that these tight structures are released to enable the shoulders to be re-positioned correctly.

// What you’ll need: A massage ball.

// How to perform release:

  • Place the ball on the target area.
  • Use your body weight to press into the ball.
  • Circle around any areas of tightness.
    • If it hurts… you are probably on the right area!
  • Spend 1-2 minutes on each area.
    • … or as long as you need to loosen it up
  • Note: Some of these spot are going to be real tender when you start to do the releases. Don’t hold your breath! Make sure you can breathe comfortably throughout. If you find that you need to hold your breath, back off on the pressure being applied.

 

// Target areas:

a) Pec major/minor:

Video from RehabMyPatient

 

b) Front shoulder:

  • Anterior capsule, Anterior deltoid, Long head biceps, Subscapularis

Video from PowerTubePro

 

c) Latissimus dorsi:

Video from RehabMyPatient

 

d)  Posterior deltoid/capsule:

Video from PowerTubePro

 

e) Between the shoulder blades:

Video from PowerTubePro

f) Serratus Anterior:

latfoamserratus anterior

 

 

2. Shoulder stretches

Hold for 30-60 seconds each. Make sure you feel the stretch where you are meant to feel it.

Note: Stretching is all about a game of angles. If you can’t feel a stretch, then you probably aren’t doing a whole lot of stretching. Move around the stretch. Find that magic position where you feel a deep stretch.

a) Chest stretch

Chest stretch

Instructions:

  • Place both hands on the door frame. (see above)
  • Lunge forward.
  • You should feel a stretch in the front part of your shoulder/chest region.

b) Posterior (back) stretch

posterior capsule stretch

Instructions:

  • Place your arm across your body.
  • Using the other arm, pull the arm being stretched across the body.
  • You should feel a stretch at the back of your shoulder.
  • Repeat on other side.

c) Lateral (side) stretch

latstretch

Instructions:

  • Whilst holding onto something, assume the position as above.
  • You should feel a stretch on the side of your body.
  • Repeat on other side.

d) Front shoulder stretch

Front shoulder stretch

Instructions:

  • With both hands on a bench, let your body sink down as low as possible. (see above)
  • Keep your shoulder blades squeezed together.
  • Keep your elbows in. Don’t let them flare out.
  • You should feel a stretch at the front of your shoulders.

e) Upper limb fascial/nerve stretch:

ULTT stretches

Instructions:

  • Place your palm (facing down) onto a wall.
  • Keep your arm completely straight.
  • Tilt your head to the opposite side.
  • You may feel the stretch in the fingers, forearm, bicep and/or side neck region.
  • Repeat on other side.

f) Upper trapezius stretch

neck side stretch

Instructions:

  • Tilt  your head to the side.
  • To increase stretch: Place your hand on the side of your head. Pull the head further to the side.

 

3. Shoulder mobilisation

a) Hand behind back

hbb retraction

Instructions:

  • Place both hands behind your back. (see above)
  • Hold onto your hand/wrist.
  • Gentle pull your should blades together.
  • Hold for 30 seconds.
  • Repeat at least 5 times.

 

b) External rotation in supine

Instructions:

  • (Watch video)

c) Flexion + External rotation with pipe

Instructions:

  • Grab onto a long object. With both hands, grip as far apart as possible. (with palms facing you)
  • Kneel in front of a bench. Whilst maintaining grip, place elbows on bench and squeeze them together.
  • Lean body forward.
  • If possible – straighten your arms in this position.
  • Hold for 30-60 seconds.

d) Thoracic extension

Thoracic extension

Instructions:

  • Position yourself over a foam roller. (see above)
  • Arch backwards.
  • Make sure you do not flare your lower rib cage out.
  • Hold for 30 seconds.
  • Repeat at least 5 times.

4. Strengthening

Congratulations! If you have completed the above exercises, your shoulders should be feeling much more flexible.

But this is only half of the journey… Having the flexibility in your shoulder merely allows the potential to have them in a better position. The real question is: Can you make sure they stay in the correct position?


*** READ THIS ***: All of the exercises below will require you to maintain this contraction throughout. Learn this movement FIRST! ***

Scapula retraction/Posterior tilt

Retraction

Instructions:

  • Pull your shoulder blades BACK and DOWN.
  • Feel the contraction between the mid to lower portion between the shoulder blades.
  • Aim to relax every other muscle.
  • Do NOT over squeeze your shoulder blades together!

Make sure that you FEEL the contraction. It is not simply just about the movement.


a) Elbows flares

elbow flares

Instructions:

  • Place both hands (elbows forward) on the sides of your head. (see Start position)
  • Bring your elbows all the back. (see End position)
  • Perform Scapula retraction/Posterior tilt whilst pulling elbows backwards.
  • Hold for 5 seconds.
  • Repeat 20 times.

 

b) Wall press and squeeze

wall squeeze

Instructions:

  • Place both hands high up on a wall in front of you.
  • Lean firmly into your hands.
  • Perform Scapula retraction/Posterior tilt.
  • Hold for 30 seconds.
  • Repeat 5 times.

c) Prone arm circles

arm circles

Instructions:

  • Support your chest on a stool. (as to keep your body parallel with the floor)
  • Place your hands out to the side. (see above)
  • Perform Scapula retraction/Posterior tilt throughout exercise.
  • Draw circles in a backwards direction whilst in this position.
  • Hold for 30-60 seconds.

 

d) Prone angel

horizontal retraction

Instructions:

  • Support your chest on a stool. (as to keep your body parallel with the floor)
  • Place your arms in the ‘W’ starting position.
  • Transition to ‘I’ position.
  • Remember to perform Scapula retraction/Posterior tilt throughout all movements.
  • 10 repetitions.

e) Wall angel

angel 1angel 2

Instructions:

  • Stand with your back to a wall.
  • Keep your back and arms pulled backwards as to remain in contact with the wall throughout movements.
  • Place your arms in the ‘W’ starting position.
  • Transition to ‘I’ position.
  • Remember to perform Scapula retraction/Posterior tilt throughout all movements.
  • 10 repetitions.

 

 

// Other areas to consider

Rounded shoulders is commonly linked with other postural issues.

Consider addressing these areas to completely optimise your posture!


What to do next?

Practice! Practice! Practice!

Make sure you have a look at this post: The ideal sitting posture to make sure that you know how to properly position your body in the right alignment.

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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31 thoughts on “How to fix Rounded shoulders

  1. Hi Mark,
    I have forward neck posture, Dowager’s hump and rounded shoulders, shoulder blade pain.
    Do I need to do all the exercises that you have mentioned in your blogs on these topics ?. They all put together are many number of exercises routine. Kindly let me know.
    Thanks

    1. Hi Laksmi,

      Essentially – I would do them all to begin with.

      As you become more familiar with the exercises and how you respond to them, you’ll find that you’ll have more of a response to certain exercises than others.

      You can then focus on those specific ones.

      Hope this answers your question.

      Mark

  2. Hi Mark! thanks for the great informations you provide.
    my question is it okay if i do further strengthening moves after these exercise?? (for example some kinda of HIIT workout for upper body). i guess my point is is okay at all to do further workout after these exercises?
    thanks again

    1. Hey Bob,

      You can most definitely do other exercises in conjunction with these exercises.

      Just make sure that you are doing your other exercises with good posture.

      Mark

  3. Hey Mark,

    What happens if you have rounded shoulders when you sit down but not when you lay on your back? Do both scenarios have to occur or if at least one occurs does that mean you have rounded shoulders?

    1. Hi Pree,

      If you do not have rounded shoulders when you lay on your back, then you may just have weak muscles that are not keeping your shoulders in the right position (as opposed to tight muscles pulling you forward)

      This means you should focus more on strengthening!

      Mark

  4. Hi Mark, thank you so much for your wonderful site filled with clear info, illustrations and most of all CARE. I’m a 48 yr old female… very thin, small framed with long limbs. Over time but most particularly in the past few years (had a baby at 41! Yay me! But hard on my body) I’ve experienced a total wreckage of my posture and such an increase in pain… mostly back but neck and knees, too. I just assumed it was because I was aging or arthritis, etc. I found your site and was floored. I have classic swayback posture (booo) that I can fix (yay!). Every exercise I’ve been doing FOR YEARS, has been wrong. So I have made a booklet of sorts with the exercises, stretches etc from your pages for swayback, forward neck, rounded shoulders and I just want to make sure that none of those things conflict. I am getting my @&& kicked by pain so much that I slump, tilt and generally do everything that makes it worse but I have confidence that by Christmas I will feel better thanks to you.

    1. Hi Elizabeth!

      Thanks for your comment.

      It sounds like you are motivated to fix your posture.. And that’s awesome!

      You can do both exercises for sway back posture and rounded shoulders at the same time 🙂 They do not conflict.

      Mark

      1. Thank you! You are AMAZING… and so quick to reply (again with the amazing). I stood straight with both hands to the very bottom of my abdomen or pelvis and pushed in and a bit up because I seem to tilt downward a little and was surprised to see my whole body change-my knees unlocked and my lower back pain eased, it also made it easier to straighten upper back and shoulders. Ummm, what does that mean muscle wise and pelvic tilt wise? Thanks again!

    1. Hi there,

      Since the lats attach to the front of your shoulder bone, it tends to pull your shoulders inwards/downwards at the insertion. (Internal rotation of your shoulder joint)

      This can lead to the Rounding of the shoulders.

      Mark

  5. Hi Mark, thanks for your great articles. just 2 things.
    1. lots of authors say the subscapularis pull the shoulders back, and the infraspinatus to front. you say exactly the opposit. here is one link of eric cressey saying that. http://ericcressey.com/posterior-capsule-tightness-subscapularis-dysfunction there are many others saying the same.. maybe you meant the subscapularis make the shoulders roll in and the xternal rotators roll out.. but you were talking about muscles that pull the shoulder forward and backward
    2. how can a tight post capsule pull the humeros to anterior as you said?

    thanks a lot. patrick

    1. Hey Patrick,

      Thanks for pointing that out.

      The Subscapularis will cause a rolling in of the humeral head when tight/facilitated (Internal rotation), which can see be seen in rounded shoulders.

      In regards to the anterior translation of the humeral head…

      The way I see it is that a tight posterior capsule will:
      1. Reduce true Internal rotation in the glenohumeral (shoulder) joint. This may cause the scapula to compensate the movement with an anterior tilt. In this scenario, the whole shoulder girdle tends to pop forward (and to a degree the humeral head).
      2. Instead of “pull”, it will “push” the humeral head forward (like a trampoline).

      Hope this answers your question!

      Mark

  6. Hi Mark
    Thank you so much for your tips
    I have a question : you said that we should do that twice a week , can I do that three times a week ?
    Thank you

  7. Hey Mark! Thanks for your advise! I have a question: if I perform the scapula retraction my lattimus Doris seems to take over. How can I prevent that from happening?

    Greetings from the Netherlands!

  8. Hi Mark,
    Thank you so much for posting this information about rounded shoulder. I have never understood why I get such severe headaches and back aches. I have seen so many specialists and never once have they mentioned about my shoulders. I have started doing some of these stretches and have also been modifying my work station. I am starting to feel the pain subside. I knew my posture was out but did not realise my shoulders were the main cause. Now that I am aware of this I can work on improving my shoulders and posture. I wish I saw this years ago.
    Thank you again, Traci (Vic, Australia)

    1. Hi Lauren,

      Do what you can to start off with.

      But make sure you progress with it later down the track.

      PS. Hope your psoas is getting better 😉

      Mark

      Mark

  9. Hi Mark,

    I just want to know that what should i do if there is no rounded shoulder when you sit down and lay on your back but while walking normally it occurs.
    My shoulder is normal while sitting or lay on my back but there is huge rounded shoulder appears while i am waliking.

    Please help me.

    1. Hi Ayush,

      The same exercises listed above can help you out.

      If you experience Rounded shoulders only when walking, you will likely need to focus on activating those muscles that pull you back into the right alignment.

      The posture you maintain whilst you are walking may also need to be addressed.

      Have a look at these different types of postures:
      Anterior Pelvic tilt
      Sway back posture
      Mark

  10. Thank you so much for these informative posts, these issues are not addressed by most GP’s and patients suffer and are probably overmedicated instead of learning the root of their problems! I’ve worked at my computer too many hours a day for years. Though I’ve always been a walker, the extra time spent writing a book the last year has taken a toll. My posture is awful, shouldered rounded (I have a small scoliosis anyway that’s not visible unless on x-ray) and I realize that I’ve begun standing with my knees slightly bent all the time. Seems like the weight of my body is projecting onto the balls of my feet and away from the heel entirely. Problems occasionally with plantar fasciitis and I’m not sure if that has contributed? We have hardwood floors and my feet stay tender, the chiropractor is trying to help me through neuropathy in my feet which seems to be worsening the more I sit!

    My chiropractor says I have problems in two neck discs and some low back disc degeneration but overall it’s not terrible. He’s urged me to walk EVERY DAY and I’m doing a brisk 30 minutes without pain.

    I’ll be working through your programs to help overcome the problems all this sitting has caused, any other tips to help with reversing my foot problem particularly?

    1. Hi Terry,

      Your foot pain sounds like it may be arising from the Anterior Pelvic tilt.

      In this posture your body shifts more onto the front of your foot which places more pressure on the plantarfascia, calf and quadriceps area. It also may cause your feet to roll inwards!

      So – addressing your anterior pelvic tilt should help de load that foot!

      Another thing you could do is strengthen your muscles underneath your foot. Check out this post here and look for the exercise called “Short foot”.

      Hope this helps!

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