Are You Susceptible to Rounded Shoulder Posture (RSP)?
- davidwatts3
- Sep 10
- 6 min read
Updated: Sep 16
RSP refers to a postural condition where the shoulders are positioned forward, deviating from the ideal alignment with the spine and giving a person a hunched appearance.
What are the symptoms?
I often get clients complaining of neck pain, stiffness in the shoulders, and pain between the shoulder blades. These are all symptoms where RSP could be developing.
Other symptoms associated with RSP can include headaches, low back pain, reduced range of motion, muscle weakness, jaw pain, and respiratory issues. Where RSP is well set in there will be an obvious stooped appearance.
What activities cause RSP?
Rounded shoulders usually develop over time from repetitive activities or postures that encourage your shoulders to drift forward and your upper back to slouch. Here are some common causes:
Prolong sitting with poor posture
Examples: Slouching at a desk, leaning forward over a laptop, sitting without back support.
Working at a computer or desk job
Examples: Typing with elbows flared out, hunching over a keyboard, looking down at screens.
Using phones or tablets (tech neck)
Your head weighs around 12 pounds. When you bend it downwards it puts a large strain on the neck and upper back muscles.
Examples: Looking down at your phone, holding your device at waist level.
Weightlifting with imbalanced training
Examples: Overtraining chest (bench press, push-ups), neglecting back and rear shoulder exercises.
Driving for long periods
Examples: Sitting with arms forward on the steering wheel, leaning forward or rounding your back.
Hobbies and occupations that involve leaning forward
Examples: Drawing, painting, sewing, cycling (bikes with drop-down handlebars), cooking, doing dishes, dental, surgical, or assembly work.
Carrying heavy bags (especially one-sided)
Examples: Shoulder bags, backpacks, or purses on one shoulder, holding kids on one hip.
How do I know if I have RSP?
There are a few tests that you can do to see whether you suffer from rounded shoulders.
Wall Test (posture test)
Stand with your back against a wall or door, heels about 5-10 cm from it. Try to get your backside, upper back, and head to touch the wall. Let your arms hand naturally at your sides.
If your shoulders are not touching the wall or your palms are facing backward instead of toward your thighs you may have rounded shoulders. Palms facing backward is a sign of internal rotation of the shoulders.
Side Profile Check (mirror test)
Stand naturally side-on to a mirror (or get someone to take a photo of you side-on).
If your shoulders are forward of your ears, you may have rounded shoulders.
Other Checks
When a person is lying supine on a massage table another couple of methods can be used. The height of the shoulders can be compared (one may be higher than the other), and you can check whether the person's elbows can touch the table when they put their hands behind their head (if not, this could be an indication of rounded shoulders).
What happens to the body with RSP?
In a healthy person the shoulders are stablised by muscles in the front and back of the shoulders, the muscles counterbalancing each other. But when bad posture occurs, this counterbalancing mechanism is interfered with.
The bad posture causes the front muscles to tighten. This puts more strain on the back muscles which attempt to compensate, but eventually they may weaken from overuse. This extra strain causes pain between the shoulder blades and throughout the upper back.
In simple terms there is a tug-of-war between the muscles at the front and back of the shoulders and the front muscles are winning.
People with rounded shoulders do not have good stabilisation around their shoulder girdle. This means they are susceptible to injuries, for example when gym training and playing sports.
Which muscles are involved with RSP?
With RSP there are muscle imbalances. Some muscles become tight and overactive, while others become weak and underactive.
Tight/Overactive Muscles (muscles are shortened and pull shoulders forward)
Pectoralis Major and Minor (chest muscles)
Causes rounded shoulders when overactive.
Upper Trapezius (upper back muscle)
Often compensates for weak lower traps and contributes to poor posture.
Anterior Deltoid (shoulder muscle)
Overused in pushing movements, reinforcing the forward shoulder position.
Latissimus Dorsi (thoracic muscle)
Tight lats can limit shoulder mobility and encourage inward rotation.
Subscapularis (part of rotator cuff)
Overactive internal rotators can pull the shoulder forward.
Weak/Underactive Muscles (muscles are lengthened and fail to pull shoulders back)
Rhomboids Major and Minor (back muscles)
Weakness contributes to shoulder protraction.
Middle and Lower Trapezius (back muscles)
Weakness here leads to poor shoulder stabilisation.
Posterior Deltoid (shoulder muscle)
Often neglected in gym training, contributing to imbalance.
Teres Minor and Infraspinatus (rotator cuff)
Weakness leads to internal rotation dominance.
Serratus Anterior (side of chest muscle)
Poor activation results in shoulder instability.
How can massage help with rounded shoulders?
Massage is needed which targets the tight, overactive muscles that pull the shoulders forward. This will loosen the muscles, improving mobility, circulation, and muscle balance.
As with most upper body Raynor massages, I start with the hands and arms, focusing on the bands of tension (see blog 'Tension and Raynor Bands'). Tension anchored in the hands and present in the arms can contribute to tightness in the neck, shoulders, chest and back, so this needs to be reduced first.
Next is a neck massage. This includes the upper trapezius which is one of the tight RSP muscles.
Following the neck massage is an upper chest and shoulders massage. This addresses the tight chest and shoulder muscles, and further work is done on the upper trapezius muscles. The following photos depict a sample of strokes I use.
Then to finish, a back massage includes the lats and a search for any painful trigger points in the back (in particular between the shoulder blades).
What else is needed to recover from RSP?
Massage is not the full solution to RSP as it only addresses the tight muscles. The weak muscles (rhomboids, middle and lower trapezius muscles, rear deltoids) need to be strengthened to improve the muscle imbalance. Exercises can help with this.
In addition, posture habits need to be corrected. For example, making sure your desk setup is correct and not constantly looking down at your phone.
What can RSP do to long-term health?
Having rounded shoulders for a long period can affect your long-term health. Below are some possibilities.
Tightness and Pain: The most common side effect of rounded shoulders and one you might be already experiencing is tightness and pain. Rounded shoulders put a great deal of stress in the trapezoids, upper back, and neck muscles. This stress can cause long-term discomfort and pain.
Headaches: Tension from overused and tight shoulder and neck muscles can trigger tension headaches. These headaches can then become more severe, leading to migraine or cluster headaches.
Arthritis: Rounded shoulders and arthritis are involved in a vicious cycle. The wear and tear that comes as a part of the activities that promote rounded shoulders trigger the inflammation that causes arthritis. Once arthritis begins to set in and the inflammation worsens, you experience a dramatic decrease in the range of motion and usage of the shoulders. To counteract the pain associated with arthritis, you will remain in a hunched, rounded shoulders posture.
Disc Herniation: The muscles and vertebrae in the neck stabilise our heavy heads and allow them to move around easily. For those with rounded shoulders, a forward pull of the head can occur (due to the associated muscle imbalances) which overloads the neck. This can cause a disc herniation, where a disc is pushed out of alignment and on to a nerve. This results in severe pain that can become chronic.
Degenerative Disc Disease: The same mechanisms causing disc herniation can also lead to a condition known as degenerative disc disease. The extra weight on the spine can cause wear and tear on its discs, particularly the cervical spine (the neck part). This can result in severe pain, tingling, or numbness.
Degenerative Joint Disease: This is also called osteoarthritis. It is the result of overuse of the protective cartilage that surrounds the ends where two bones meet. Stiffness can give way to a limited range of movement and chronic pain. The extra strain put on muscles, vertebrae and joints can lead to high levels of inflammation which breaks down the cartilage at the ends of the bones and leads to degenerative joint disease.
Increased Risk of Serious Injury: RSP stresses muscles. If they are stressed for too long there is a high risk they become strained or torn.
Postural Distortions: Having RSP can have knock-on effects throughout the body. Examples include forward head posture, pelvic tilt, and knock-knee (inward facing knees).
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