The Real Fix for Slouching Shoulders

Beyond Adjustments

 

Illustration comparing a slouched shoulder posture versus corrected, upright shoulder alignment.

We work hard caring for people with headaches, neck pain, shoulder pain and upper back pain. An important part of successful care is identifying, from the beginning, the elements of a person’s condition that could frustrate success. This is the great differentiator between someone getting adjusted, getting a treatment from the chiropractor that helps, and getting resolution for their problem so that the improvement from the treatment is lasting improvement.

Graphic highlighting muscular tension and imbalance around the shoulders and upper back.

The role of shoulder positioning

One of the most common considerations that defeats long term success in the care of headache and neck/upper back pain is dysfunctional bearing of the scapulae, which usually occurs as shoulders which have rounded forward. This is usually coupled with increased thoracic curvature and disturbed bearing of the neck and head which we described generally in our discussion of Scrolliosis. In this article, we would like to speak to the specifics of shoulder blades and particularly, one unique strategy for effectively changing the bearing of your shoulders.

Key muscle imbalances

Diagram showing pectoralis minor (tight) and rhomboid plus lower trapezius (weakened) muscle groups.
The two fundamental distortions that must be addressed in chronically rounded shoulders are short, tight pectoralis minor muscles which act to keep the shoulders pulled forward and weakened, dysfunctional rhomboid and lower trapezius muscles that fail to keep the shoulder blades back.

How to stretch the pectoralis minor

For some people stretches are enough for the tight muscles, but others will need help, such as tissue work or clarification of specific stretching techniques. There are several stretches that are very good to address the pectoralis minor among which is the cross-bench pullover. Additional stretches are easy to find with a quick YouTube or Google search for “stretches for the pectoralis minor.

How to strengthen the shoulder retractors

There are also several exercises that have enjoyed some popularity in the interest of strengthening the muscles that would hold the shoulder blades in a healthier, more neutral position. One of my favorites is the pre-exhaust horizontal row. We hope that for some our description here is adequate, but it might turn out that getting some instruction and clarification will be necessary for this to be effective for others. Attempting to expose muscles and tendons to work while they are harboring chronic injuries is a formula for frustration. There are people dealing with upper back issues that will need to have some treatment before they are in a place where they can use these movements successfully.

Equipment options for horizontal rowing

Performing a horizontal rowing movement usually requires equipment available at a gym where resistance is delivered through a cable and pulley arrangement such that a person, while seated, can row against resistance. If you do not have access to a gym, it is possible to achieve success with this movement by using resistance bands which are more likely to be available for a person at home. Rowing movements can also be performed bent over with either dumbbell or barbell but I think that this particular application benefits from the clarity that we get by doing the movement seated with horizontal resistance.

What is a row?

Adding a pre-exhaust component to the horizontal row makes more sense if we understand what we are trying to get out of the movement. At this point it is clear that we are trying to get strength into the muscles that pull the shoulder blades together. The rowing movement involves pulling the resistance to the body by bending the elbows using the biceps and pulling back with the rear deltoids and lats. It is not uncommon that this is the extent to which we engage the rowing movement. Being deliberate about engaging the shoulder blades is the difference in making this a successful movement.

How to perform a pre-exhaust row

With pre-exhaust, we go a step further. Performing the rowing movement fully to include the elbows, shoulders and shoulder blades is further enhanced in its impact on shoulder retractors if we first pre-exhaust the shoulder retractors (lower traps and rhomboids). We’re going to do this by shrugging our shoulders back and allowing them to be pulled forward with the resistance, effectively performing a horizontal shrug against the resistance of either the cable or the resistance bands. Performing 8 to 10 repetitions of this horizontal shrugging movement, deliberately engaging the shoulder blades and the muscles pulling the shoulder blades back and, at that point, taking a moment to stretch forward with the resistance and then complete another 8 to 10 or 12 repetitions of rowing movements, as fully as possible. With this last half of the row you’re doing a the movement with fresh biceps, lats and deltoids but with pre-exhausted rhomboids and lower traps. This can be very effective in getting improved engagement and responsiveness out of the muscles that are going to improve your posture and balance the musculature of your upper back.

What about getting adjusted?

Healed, fully moving and aligned segments are critical to the success of rehabilitation of any sort. Find someone that uses osseous adjusting.

Final thoughts

This is a deeper dive, and I know it’s not for everyone. There are people for whom we think this will be helpful and I don’t see any reason why it shouldn’t be shared with interested people who are trying to help themselves. We hope this has been of service.

Written by: Donaid Seals D.C

Dr. Seals is a practicing Doctor of Chiropractic with over 25 years of experience caring for people. His thinking is the product of his education, practice experience and many years in the natural foods and fitness industry. He has become living proof that old muscleheads don’t die-or fade away; sometimes they grow up to bring real-world expertise to the clinical picture. Traditional background information is available here.

Disclaimer: The entire contents of this website are based upon the opinions of Dr. Seals, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Seals and his community. Dr. Seals encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.