Have you ever caught yourself with your shoulders hunching forward in the mirror? Or has someone ever said anything to you about standing up straight? Rounded shoulders occur when certain muscles become tight or weak. This often stems from poor postural habits, such as slouching over a desk or looking down at a smartphone for extended periods. This contributes to an imbalance in muscle strength and extensibility, affecting the neck, shoulders, upper back, and chest.
The effect of rounded shoulders over the lifespan may even compromise the health of your spine over time. Engaging in quick daily exercises, postural awareness, and ergonomic adjustments in your living and working environment can help in correcting your posture and relieving the tension caused by rounded shoulders. This post will address the biomechanics of poor vs. ideal posture, the causes of rounded shoulders, and changes you can make to improve your posture, including ergonomics, exercises, and daily habits to incorporate.
Take me straight to the postural exercises!
**This is not medical advice. Please consult your medical provider for more information.
The Importance of Good Posture
Maintaining good posture is not just about looking confident. It’s the foundation of our overall health. Poor posture is a common contributor to chronic pain throughout the body. When you keep your spine and joints aligned as they are intended, you’re not only preventing shoulder pain relief but are also warding off neck strain that can lead to chronic issues.
Good posture ensures that muscle balance around the spine, neck, and shoulders is maintained, reducing the risk of developing rounded shoulders. The vigilance of being aware of your posture helps prevent the onset of musculoskeletal issues, ensuring that your body remains strong and functional for years to come.
What is Ideal Posture?
From the ribs up, there should be a slight kyphotic curve of the thoracic spine. The shoulder blades should be neutral and no more than the anterior 1/3 of the shoulder should be in front of the ear. The head should be facing forward in a neutral position. The cervical spine shoulder have a natural lordotic curve. And the chin should not be jutting forward.
It is important to remember that posture will not be perfect. Our bodies are designed to move and not be sedentary. If we were to maintain perfect posture all the time, honestly, we would move looking like robots. There is fluidity in our movement and we should not feel stagnant simply trying to maintain perfect posture.
What you should be thinking about though is how long your body has been in one position and what does your alignment look like during that amount of time. When reviewing posture, it comes down to what position(s) are you in for extended amounts of time and is this contributing to stress to certain parts of body over time. Remember, just because you have the proper alignment and setup doesn’t mean you should stay in that particular position all day long.
If you want to learn more about this topic, read all about it here.
Poor Posture aka Upper Crossed Syndrome
Rounded shoulders is a term commonly associated with poor posture. Both “poor posture” and “rounded shoulders” can be lumped into a term known as “upper crossed syndrome.” Although rounded shoulders are just one component of upper crossed syndrome, the forward shoulders are most often accompanied with issues at the neck and upper back, hence the reference to this syndrome.
Simply put, upper crossed syndrome refers to muscular imbalances of the neck, upper back, and chest. The muscles in the chest, the pectoralis major and minor, become tight. This pulls the shoulders and shoulder blades forward. Muscles on the back of the neck also become tight, including the suboccipitals, upper trap, and levator scapulae. The opposing muscles that become weak are the deep neck flexors, which causes the chin to jut forward. The other muscles along the upper back that are weak are the rhomboids and lower trap.
This postural malalignment not only affects your shoulder alignment, but also affects the neck and upper back. Symptoms may appear in any of these areas. In order to alleviate the pain, regardless of where the pain or stiffness might be, the entire chain must be addressed. If you neglect just one portion of it, you will not get rid of the root cause of the problem, which is addressing posture.
Causes of Rounded Shoulders
When addressing the root cause of forward shoulders, it is crucial to understand the multifaceted nature of these postural impairments. There are common contributors to this issue, including daily practices and items we use. Understanding the root cause makes it easier to understand exactly how to fix the issue at hand.
Poor Ergonomics
If you have a poor workstation setup, you are setting yourself up for failure. Your foundation begins with a proper workstation setup to reduce chances of increasing stress on certain areas of the body. Not only will this help protect your neck and shoulders, but will also help reduce the chance of developing carpal tunnel and other issues.
While ergonomics does have a role in this, it doesn’t mean we should neglect actually paying attention to our posture. It is easy to slouch forward and slump as the day goes on. While we don’t expect perfect posture 100% of the time, being in an ideal posture a large majority of the time will safe your future self from possible injury and chronic stress. Ergonomics can help you achieve an ideal posture over a length a time compared to if you have a poor initial setup.
Different Body Types
While there is an ideal posture we all should aim for, it is important to understand that there might not be a one-size-fits-all solution for posture correction. The anatomy of each person’s body will have small influences over their posture.
For example, females who have a larger breast size commonly experience back pain. The weight of extra adipose tissue or large breast implants in the front of the chest naturally pulls forward and downward, making it harder for the muscles in the upper back to pull upright into an ideal posture. In extreme cases like this, I have witnessed women undergo breast reduction surgery to help alleviate their back pain. By no means is this the case for every person, but it may be something to consider if you find yourself in a situation like this. Speaking with your PCP can give you further insight. Another option is to make sure you have a very supportive and correctly-sized bra.
Another thing to consider would be the length of your torso. Individuals with longer torsos have to hold more weight upright and prevent the chest from wanting to collapse forward. Your postural muscles will have to work more compared to someone who has a smaller torso.
Social/Cultural Influences and Other Factors
Have you ever thought about how the items we use in our daily life affect our posture? Think about it: recliners, couches, and car seats all round our backs, shoulders, and necks forward. We hold our phones and tablets low so we have to flex our necks forward like we are staring at the ground. Think about how often we are using these different things and how much time out of our day adds up to being in this forward flexed postures. The answer: IT’S ALOT. On top of that, it primes us to crave being in these positions. So what happens is we find ourselves in these rounded positions even when we aren’t using said items above.
After we are done looking down at our phones, we put the phone away and continue keeping our head forward and looking down at the ground. A rounded seated posture becomes more comfortable, so we continue sitting like that at our work desk even after getting out of the car after being stuck in traffic. And this becomes a repeatable cycle that keeps us in these poor postures.
Other factors to consider are more social and cultural in nature. Even children when growing up can succumb to societal pressures in order to fit in. Kids who experience a growth spurt might slouch in order to feel like they fit in more with others around them who might be shorter. Females developing breast tissue earlier or at a faster rate than her peers might round the upper back and shoulders forward to hide their changing bodies.
As adults, we might even succumb to wanting to hide away in a crowd or prevent drawing attention in some manner, so we instinctually round the shoulders to “hide” in our own way. As you can see, there are multiple factors that contribute to our posture. Despite the reason for changes in our posture, the important thing is to understand how to fix it so we know what to address.
Initial Self-Assessment for Rounded Shoulders
To begin assessing whether you have rounded shoulders, stand in front of a mirror with your usual posture. Don’t try to straighten up. Just stand as you normally would throughout the day. Notice if your shoulders naturally roll forward. Next, turn to the side observe the alignment of your ears in relation to your shoulders. Ideally, they should align vertically with each other. More specifically, they should align within the anterior 1/3 of your shoulder. Also make note if your head juts forward.
Now that you know what your posture looks like, let’s try some movement to see how this relates to your posture. First, stand or sit up straight with your shoulders down and back and your head properly aligned above your shoulders. Lift your arms overhead as far as you can in the ideal posture. Then, slump and round your shoulder forward. Now try to lift your arms up overhead. What do you notice?
You should notice that you cannot lift your arms up as high. You might feel some pain or pinching somewhere. The point is that poor posture can lead to abnormalities with our mobility and movement, which can further lead to dysfunction.
How to Fix Rounded Shoulders
It’s essential to incorporate a combination of exercises, postural awareness, and ergonomic changes to correct posture. As discussed earlier, certain muscles become tight while others become weak. It is important to stretch and strengthen the correct muscles appropriately.
Below, you will find a combination of tools for you to try out to start working on correcting your posture.
Exercises to Fix Rounded Shoulders
To start working on fixing your posture, start with training the muscles that have become weak over time. You must train the postural muscles to have the strength and endurance to hold you upright for long periods of time. Start with these exercises:
Supine Scap Squeeze
Lie on your back with your knees bent. Squeeze your shoulder blades together like you are trying to pinch a pen between the shoulder blades. Your shoulders will move back towards the ground. Make sure you are not shrugging your shoulders upward towards your ear. A useful cue for this is to place your shoulder blades in your back pockets.
Hold this position for 5 seconds and repeat 20 times.
Supine Horizontal Abduction
Lie on your back with your knees bent. Extend your arms up towards the ceiling while holding a resistance band. Spread your arms as you pull the band apart. Remember to squeeze your shoulder blades together as you did in the first exercise. Slowly control your arms back to the starting position – do not let the band pull your arms back together.
Perform 3 sets of 10 reps.
Lacrosse Ball Pec Release
For this, you will use a lacrosse ball or other small firm ball. Place the ball in the front of your chest and use the wall to massage the pec region.
Do this for 1-3 minutes and repeat on the other side.
Ergonomic Adjustments at Work and Home
Regardless if you incorporated the exercises above into your daily routine, if you spend hours slouched over a desk, the exercises will most likely not provide you any relief. The point is that you have to work on maintaining the changes the exercises provide throughout the day. This means setting yourself up for success and this involves adapting your work environment. Ergonomic adjustments, whether at home or work, begins with assessing your chair and desk setup.
At first, you shouldn’t have to worry about making any purchases. Most changes can be made with objects around the house. If your chair has poor low back support, roll up a towel to create a natural curvature for lumbar support. Make sure your feet are able to touch the ground. If not, stack a few books so your feet are firmly in contact with something. Is your computer monitor too low? Again, you can use books or something similar to raise it so it is within eye level or just slightly below.
If you are interested in my personal recommendations for improving your posture through ergonomic adjustments and setup, contact me with your comments, concerns, or questions! You can leave a comment below and I will personally respond.
Incorporating Posture Checks into Daily Routine
Integrating frequent posture checks into your daily routine will further help with correcting your posture. This habit not only supplements postural awareness, but it reinforces the same exercises we implemented earlier. The more often you consciously work on being aware of your posture, the easier it becomes to notice when things are off.
Try this: any time you walk passed a mirror, stop and assess your alignment. This can make it easy for you to spot things that need to be worked on. It also becomes easier to notice when your posture is “off.” You’ll get more used to learning exactly how to hold your head, neck, shoulders, and upper back in proper alignment, relying less and less on the visual cues from the mirror.
Another option is to set a timer for every 30-60 minutes while you are working. When that timer goes off, move around a little bit, do a stretch that feels good, and/or check in with your current posture. This is a helpful way to implement the habit of checking in with yourself and moving every so often.
When to Seek Further Treatment
If you have tried the majority of the tools listed above and you recognize there is no change in your pain or discomfort, it might be time to seek professional help. A physical therapist is a movement expert and can determine what needs to be addressed after assessing posture, movement patterns, mobility, and strength. They will also be able to pick up on patterns throughout your day that could be contributing to your pain that you might not be aware of.
Final Notes On Posture
You have to retrain your brain. In this day and age, everything is meant to place us in poor postural positions without us even being aware of it. Cell phones are a constant struggle that pull us into forward head posture. The seats in our cars may feel comfortable but they push your shoulders forward where we do not want them to be. It is up to us to work on our posture and mobility to help counteract everything that is quite literally working against us.
Other Articles Related to Posture
- What is the Correct Sitting Posture?
- Thoracic Mobility Exercises: Unlock Your Body for Pain Relief
- What You Should Know About Tech Neck: Relieve the Pain
- A Complete Guide and Mobility Routine for Desk Workers
- Diaphragmatic Breathing: How to Breathe Correctly
- 7 Mobility Stretches so You Can Make it Through Your Day Pain Free
TL;DR
Rounded shoulders are caused by prolonged poor posture, leading to muscle imbalances. In this type of posture (upper crossed syndrome), the chest becomes overly tight and postural muscles that hold us upright become weak. Posture correction can be attained through exercises and corrective daily habits, which can alleviate and prevent shoulder and neck strain. Maintaining postural awareness is crucial for long term health and avoidance of chronic pain. This post reviews the biomechanics of poor vs. ideal posture, the causes of rounded shoulders, and changes you can make to improve your posture.
Tera Sandona is a licensed Doctor of Physical Therapy (DPT) and the founder of PT Complete. She helps high-achieving women break out of cycles of chronic pain, stress, and burnout through her Regulate and Rebuild Method, a sequenced approach that addresses the nervous system first and builds strength second. Her work focuses on helping women finally understand their bodies, rebuild strength, and create lasting resilience that fits real life.
