Am I destined to be the next Hunchback of Notre Dame…

I am referring to what is medically called the Dowager’s Hump (DH), this term can create a frenzy with images or something similar to the Hunchback of Notre Dame.  As a physiotherapist & Pilates educator, I commonly see clients complaining of neck problems, including pain and stiffness with varying stages of DH. Just the other day a client approached me with troubling neck pain and subsequently asked about her hump- wondering what on earth it was. Using “Google” to find the answers is not always the best approach and can in term provoke worry and concern; therefore I felt I should enlighten my clients to the truths as I see it.

I seem to have an obsession with posture, body alignment and trying to control the factors that influence how well we move. In my practice, posture seems to be the primary cause for the majority of neck & back pain clients that I see. Medically, this hump is the culmination of a tremendous amount of stress to the lower neck (cervical) vertebrae as the thoracic (middle back bones) spine perpetually flexes forward. A true DH is a subtle fracture of the spine, called a wedge fracture and is usually observed in older adults, people affected with osteoporosis or as a result of a trauma fall or injury.

However… If you are one to sit at a desk all day long, or you lean your head forward to read your screen; and let’s be honest most of us do. You are in fact compressing the front portion of your spinal bones which alters your posture without actually causing a fracture. Although you may attempt to straightenup with the very best intentions, if this posture is constant, your attempts may be just that – attempts, as you see the actual joints have adaptively changed and they just won’t close. This however is only half the story of what I would define as a Dowager’s Hump.

In my previously posted topics on posture, I talked about how a forward head posture can significantly increase the load on your spine. For every couple of centimeters that your head goes forward, the weight of your head with the gravity combine increases the force on your spine by 10! Yikes!!

If the body and brain are subject to these same pressures time and time again, it actually goes into survival mode, protecting oneself. You may be asking yourself, but how? Well how indeed, it actually starts laying down more and more fibrous material in the many layers of connective tissue. Think of it like a heavy traffic jam in a localized area; once they get in, they can’t get out. This allows for the body to continue laying down more fibers and sending more material, trapping the fat pad and other structures in its web or matrix around the bones. This increased activity for the body in ‘repair mode’ means this area is slowly deforming but at a faster rate, oh boy. Although your body is trying to repair itself the best way it knows how to protect your posture, it is actually causing you quite irreversible damage by laying down the extra fibers of tissue. This results in a stiff and grisly pad of scar tissue at the base of your neck – commonly referred to as postural Dowager’s Hump. On a plus, the body sees this repair as a stronger connection for the head and body.

Common symptoms for DH is that you may experience discomfort and aching around your lower neck, as if you feel a ‘thickness’ or ‘stiffening’ in this area.


So, I bet you are all asking, can I stop or prevent a Dowager’s hump from forming?


Well the answer is most definitely YES!

And with the trusty aid of your soft foam roller!

Repairing or preventing a Dowager’s hump can be no easy feat BUT the rewards are so worth it. Continual attention, repetition and knowing the exercises are the key. Just follow the simple guidelines below and you will reap the rewards:

1. Foam roller – with my guidance and support I will show you have to use your roller to its advantage.

2. Consistency – There is only so much we can do together, the results are in your hands and daily attention is the key

3. Postural changes – You must be willing to change your behavior and your posture when you sit at your desk and make some consideration of the fact that YOU are causing your Dowager’s hump.

4. Strength – You need to strengthen the imbalance that exists between the front and back of both your neck and back. Stretch the tight bits and strengthen the weak/long bits of your middle back and upper neck.


As previously mentioned, please remember that, a Dowager’s hump is not only the consequence of poor postural habits, it can also be caused by osteoporosis, fracture, traumatic injury and changes in the thoracic spine. If however you are noticing the formation of a hump at the base of your neck, it may be the beginnings of DH and could have been building up for years.


It won’t get any better if you do nothing and it will certainly not stop growing if you ignore it.


Get yourself a foam roller today and as always my ‘roller door’ is always open to share my knowledge, experience and provide a supportive environment at SP2Kinetics.



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