Dowager’s Hump: Why The Upper Back Rounds With Age, And How Yoga Changed It In A UCLA Trial
Dowager’s hump: the short answer
A dowager’s hump is the rounded hump that forms at the top of the back and base of the neck, with the head pushed forward. Doctors call a marked rounding hyperkyphosis (an over-rounded upper back). It is common after 60, and most people assume it is simply age. It is not only age, and it can be changed.
In a UCLA trial, older people with a rounded upper back did yoga three times a week for six months, and the rounding lessened. Here is the article in short form:
- A dowager’s hump is an upper back that has rounded and stayed there.
- Weak back muscles and thinning spine bones both feed it.
- UCLA trial, 118 people over 60: yoga lessened the rounding.
- Rounding the spine forward under load is the move to avoid.
- Back-arching work did far better in a Mayo Clinic study.
- Change comes over months of regular practice.
A quick word on Iyengar yoga. Iyengar yoga is the style developed by Mr BKS Iyengar. In the 20th century he did more than anyone to set down traditional Indian yoga, and he pioneered the use of props such as chairs, walls and belts, so that stiff and older bodies can do the poses safely. It is the style we teach at Flametree, in Darwin and live online.
A supported backbend over a chair takes the upper back the opposite way to a day of rounding.
What causes a dowager’s hump?
Usually several things at once. Years of sitting, driving and looking down at phones round the upper back forward. The muscles between and below the shoulder blades, which should hold the upper back up, go quiet. The head drifts forward, and every centimetre it moves adds load to the neck and upper back.
Thinning bones add the second part. When spine bones thin, the front edges of the bones in the upper back can slowly squash, and the curve deepens. That is why a dowager’s hump is more common in women after menopause, when bone loss speeds up.
And there is habit. Alison West, a senior Iyengar-trained teacher in New York, notices that some of her tallest, kindest men students hunch so they do not tower over people. Posture carries feeling as well as muscle, which is why it changes with practice, not with one good stretch.
Can you get rid of a dowager’s hump?
You can change it. A team at the University of California, Los Angeles, began with a small pilot of 21 women with a rounded upper back in 2002. The yoga was safe, and the early changes were promising enough to run a proper trial.
In that 2009 trial, 118 people aged 60 and over with a rounded upper back did yoga three times a week for six months, or went to a monthly talk. The yoga group’s rounding lessened, and the researchers called it a critical first step: a rounded upper back can be changed.
Vivian Vieritz, who still teaches a weekly Iyengar class in Queensland at 95, has osteoporosis. Her specialist expected someone with her bone density to arrive in a wheelchair. She sits tall, spine long and shoulders back, because “if you practise it every day, your body will stay straight and strong”.
Triangle Pose at the wall. The chest turns open and the spine lengthens, the opposite of a hunch.
What should I avoid with a dowager’s hump?
Rounding forward under load. In a 1984 Mayo Clinic study, Dr Mehrsheed Sinaki followed 59 women with thin spine bones after menopause. Of those given exercises that rounded the spine forward, 89% had a new spine fracture. Of those given exercises that arched the back, 16% did.
Doctors at the same clinic have also described people with thin bones whose spine bones crushed after strong forward bending with a rounded back. So sit-ups, toe touches with a curved back and deep rounded forward bends are out. Bend forward from the hips with a long spine instead. In a good class, that is built into every forward bend.
Which way the spine moves matters. Rounding forward under load did far worse than arching back.
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What exercises help a dowager’s hump?
Ones that work the back and open the front. An Iyengar class does both, every class.
- Standing poses with the arms working. Warrior 2 and Triangle hold the arms out and up for many breaths, strength work for the muscles a desk lets go.
- Shoulder blades in, chest broad. Cow Face Pose arms with a belt, and arms behind the back, move the shoulder blades in toward the chest.
- Supported backbends. Lying back over a bolster or a chair, done carefully, opens the front of the chest.
- Chin level. The head is drawn back over the shoulders, not poked forward.
Mr Iyengar’s own spine was famous for its lift. In 1992, the London teacher Maxine Tobias watched him practise backbends in Pune, in his seventies. The height of his spine took her breath away. He held the pose still for minutes.
Cow Face Pose arms with a belt. The shoulder blades move in and the front of the chest broadens.
How long does it take to improve a rounded upper back?
Months. The UCLA trial ran three times a week for six months. Many people feel the ache in the neck and between the shoulder blades ease within weeks, and stand a little taller in the mirror. The shape itself changes slowly, so this is a practice for months and years, not a quick fix.
See also our post on upper back pain and a rounded upper back, which covers the desk back and the ache between the shoulder blades.
Warrior 2. Arms held out for many breaths is strength work for the muscles that hold the upper back up.
Where can I get help with a dowager’s hump in Darwin?
For a dowager’s hump in Darwin, come to class at Flametree’s Woolner or Coolalinga studio, or join live online from anywhere in Australia. Our beginner classes all work the arms, shoulders and upper back, and every class is adjusted for people with thin bones. Tell your teacher before class so they can adapt the forward bends for you. Feel free to check with your professional advisers if you wish, but also give yoga a try.
See also Yoga For Posture, Osteopenia and Stiff Neck.
Strong Bones, Steady Feet, our free ebook on bones and balance after 50.
Your free copy of Strong Bones, Steady Feet is waiting. New to Flametree, or away for 3 months or more? You get 2 free classes + 2 ebooks, only available via this offer. Already coming to class? You can still get the book.
Frequently asked questions
What is a dowager’s hump?
It is a rounded hump at the top of the back and base of the neck, with the head pushed forward. Doctors call a marked rounding hyperkyphosis. It is common after 60, especially in women after menopause, and it can be changed with regular practice.
Can yoga reduce a dowager’s hump?
In a 2009 UCLA trial, 118 people aged 60 and over with a rounded upper back did yoga three times a week for six months, and their rounding lessened. The researchers called it a critical first step: a rounded upper back can be changed.
Are rounded shoulders the same as a dowager’s hump?
They often go together. Rounded shoulders are the shoulder blades sliding forward and apart; a dowager’s hump is the upper spine itself rounding. Long sitting and weak upper back muscles feed both, and the same yoga work helps both.
Do thin bones cause a hunched back?
They can add to it. When spine bones thin, their front edges can slowly squash and deepen the curve. That is why bending forward from the hips with a long spine, never rounding under load, matters so much with thin bones.
Should I do sit-ups for my posture?
Not with a rounded upper back or thin bones. In a 1984 Mayo Clinic study, women with thin spine bones given forward-rounding exercises had 89% new spine fractures, against 16% with back-arching exercises.
Is it too late to fix a hunched back at 70?
No. The UCLA trial was in people aged 60 and over. Vivian Vieritz still teaches yoga at 95 and sits tall despite osteoporosis. The shape changes slowly, but the back muscles answer at any age.
Does a dowager’s hump cause neck pain?
It often adds to it. When the upper back rounds and the head moves forward, the neck carries far more load and takes over some of the upper back’s work. Lifting the upper back takes that load off.
Where can I get help with a dowager’s hump in Darwin?
Flametree Yoga Studio teaches Iyengar yoga at Woolner and Coolalinga in Darwin and live online. Beginner classes work the arms, shoulders and upper back, and teachers adapt forward bends for anyone with thin bones.
Where to next
- New to yoga, or coming back? Start with our half price 10 class pass with 2 classes free, in Darwin or live online.
- For a workplace, team or group: book private yoga classes for groups, online, at a Flametree studio or at your venue.
- Want to see class times first? Look at the beginner timetable.
Flametree Yoga Studio, Darwin and live online. This article is general information, not medical advice. Feel free to check with your professional advisers if you wish, but also give yoga a try.
Sources: Greendale GA and colleagues, Yoga decreases kyphosis in senior women and men with adult-onset hyperkyphosis (118 people), Journal of the American Geriatrics Society, 2009; Greendale GA and colleagues, yoga for women with hyperkyphosis, pilot of 21 women, 2002; Sinaki M and Mikkelsen BA, Postmenopausal spinal osteoporosis: flexion versus extension exercises, Archives of Physical Medicine and Rehabilitation, 1984; Sfeir JG and colleagues, vertebral compression fractures associated with yoga, European Journal of Physical and Rehabilitation Medicine, 2018; Kathy Arthurson, Yoga Years, 2021; Maxine Tobias’s account of Mr Iyengar’s practice, 1992; Alison West, Guys Talking Yoga, 2023. Further reading: Greendale and colleagues, 2009, on PubMed. Full references are in the Strong Bones, Steady Feet ebook.
