Kyphosis (Rounded Upper Back) After 60: What Movement Can Help

Kyphosis is the natural forward curve of the upper back, the part of the spine that sits behind the shoulder blades. Everyone has some. It becomes a "rounded upper back" when the curve looks larger than usual.

Clinicians often point to a few common contributors. These include long periods of sitting, weaker upper-back muscles and changes in the bones and discs of the spine. Your own mix may differ, which is why an assessment helps.

A rounded upper back may pull the shoulders forward, which could change how the shoulder blade moves. Forward head posture is associated with neck pain [R27]. In adults over 60, strength, mobility and posture are each linked to shoulder pain and disability [R28]. These are associations. None of them proves the curve causes pain.

• Exercise can shift posture measures. Therapeutic exercise can improve forward-head angle, but the link between that change and pain change is still unsettled [R26].
• Exercise programs are the main studied approach. For forward head posture with neck pain, exercise-based programs, including stabilization work, are the main treatment studied [R27]. The studies show association, not that posture causes pain.
• Strength training supports older adults. Resistance training supports strength, function, mobility and independence in older adults. The position statement also says that fears and barriers should be addressed [R06].
• Evidence for kyphosis itself is limited. For forward head posture in older adults, evidence is limited and indirect [R28]. Evidence varies for kyphosis specifically, so ask your clinician.

Related reading: Shoulder blade exercises: strength, movement and control and Shoulder mobility exercises for seniors: seated, safe and short.

All of these are done seated in a sturdy chair. Move slowly and stop before any sharp pain.

1. Check in with a clinician first. If the curve is new, painful or changing, a doctor or physiotherapist should assess it before you start any routine.
2. Seated chest opening. Sit tall with your hands on your thighs. Let your shoulders roll back gently and your chest open a little. Hold briefly, then release.
3. Seated upper-back lift. Sit tall and lengthen up through the crown of your head, letting the chest rise slightly. Hold briefly, then relax.
4. Controlled arm reach. Reach both arms forward, then slowly out to the sides, keeping your ribs soft and your neck relaxed.
5. Bear-hug breathing. Cross your arms over your chest, hands on opposite shoulders. Breathe into the sides and back of your ribs, then let the shoulders drop.