Rounded shoulders
(Ref: Singla D., et al. Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature. J Chiropr Med 2017;16:220-229)
Rounded shoulder posture is one of the most common poor posture characteristics in physiotherapy clinics. In my experience, I see both cases of rounded shoulders accompanied with a forward head and only rounded shoulder alone. Chief complaint never talked about rounded shoulders; but, it is about muscle pain of neck, shoulder, upper back, and scapular.
Rounded shoulder posture refers to a posture characterized by acromion protraction in front of the line of gravity, shoulder protraction, and downward rotation as well as anterior tilt.
External cause factors, for example, computer and smartphone lifestyle, job characteristic, workstation, or temperature, ect. As internal cause factors reveal soft tissue impairment; include, weakness of scapular stabilizer muscles, upper back, rotator cuff, and shortening of chest muscle, upper arm muscle, some shoulder ligaments.
In this physiotherapy article presents shortening of front upper part soft tissue shortening; and, how to stretch them.
3 Major muscles involved rounded shoulders
1. Pectoralis major
The pectoralis major is a large, flat muscle of the pectoral girdle of the upper limb. It is a fan shaped that appears with 3 heads or portions: the clavicular, the sternocostal, and the abdominal head. This distinct tendon enters in contact towards the insertion on the humerus. Rounded shoulders is related to the shortening pectoralis major which pulls the humeral head anterior. It needs stretching and manual release from a physiotherapist to correct the posture.
Pectoralis major muscle
(Ref: https://link.springer.com/article/10.1007/s00064-021-00760-5)
2. Pectoralis minor
Pectoralis minor located between lateral 3rd, 4th, 5th rib to the coracoid process of scapular. When this muscle shortens, the scapular wiil be changed posture to be scapular anterior tilt, scapular internal rotation, and scapular downward rotation. It needs stretching and manual release from a physiotherapist as well.
Pectoralis minor muscle
(Ref: https://www.orthobullets.com/anatomy/10007/pectoralis-minor)
3. Biceps brachii
Biceps brachii affects the shoulder joint becasue there are 2 different attachments of muscle; include, long and short heads. The long head of the biceps brachii is attached from the supraglenoid tubercle of the scapular and passes through the bicipital groove, and the short head of this muscle is attached from the coracoid process of the scapular.
Biceps brachii
(Ref: https://fitmachtgesund.de/en/musculus-biceps-brachii/)
The rounded shoulder posture as a result of lower trapezius muscle, serratus anterior muscle, and rhomboid muscle is prolonged lengthening that develops weakness and pain. In my experience, stretching and massaging them cannot improve pain. I always massage and stretch all 3 muscles which we talked about above. To exercise scapular stabilizer muscle is one of crucial treatments; but, it is not my point in this article.
I prefer static stretching the most because it is more effective than dynamic stretching and easier than PNF stretching. The way to stretch is simple: stretch to the point where “tightness without pain” or “noticeable tension without pain” will hold at that point for 30 seconds of 3 - 4 repetitions in one muscle.
Remark: If you feel neck and head discomfort from these stretching, you should decrease stretching range of motion. While these 3 muscles are very tight, the scapular and neck muscles try to beat them to achieve a range of motion that increases stress on scapular and neck muscles. Therefore, start at a small tension point and go further gradually.
9 poses of stretching to improve rounded shoulders
Exercise #1: Horizontal doorway pectoral stretch
Exercise #2: High doorway pectoral stretch
Exercise #3: Double shoulder external rotation stretch
Exercise #4: Active anterior deltoid stretch
Exercise #5: Chair anterior deltoid stretch
Exercise #6: Single horizontal pectoral stretch
Exercise #7: Single shoulder external rotation stretch
Exercise #8: Half wall (chair) hang stretch
Exercise #9: Biceps brachii stretch
Reference:
https://he01.tci-thaijo.org/index.php/NurseNu/article/view/178634/143838
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