The 3-step Dowager’s Hump Fix

I received an email from a reader earlier this year asking me a question about her dowagers hump.

Her doctor told her that she’ll have this hump forever. She was only in her 20s so of course this concerned her, and she reached out to me to get my thoughts.

I’ve been in the fitness/movement industry for nearly 7 years now and I never heard of this condition before this email.

So, I did what any modern-day-human would do and plugged dowagers hump into Google. I quickly realized that I knew exactly what this was but just knew the condition by its other labels.

Labels such as kyphosis and hunchback posture. Different terminologies but all referring to the same thing – a rounded upper back.

The good news is that this reader’s doctor was wrong.

Most people can absolutely reverse this type of posture, and in this article, I’ll explain exactly how you can do it.

What is a Dowagers Hump? 

Merriam Webster defines “dowager” as (1) a widow holding property from her deceased husband or (2) a dignified elderly woman. This use of the word is from the 16th century.

The term “dowager's hump” as a way to refer to a rounded spine posture comes from the 1920s.

This is likely why kyphosis and other terms are used more often to describe this type of posture. Saying someone has a dowager’s hump is arguably offensive and definitely outdated. Leave the dignified elderly women alone, why don’t you!

Regardless of what you want to call it, this posture is characterized by a curvature of the upper back and a forward head position.

This is what most people think of when they imagine bad posture - slouched shoulders and an image of someone moping around.

Most of the time, these types of postures can be changed by building better body awareness and strength. Posture is also a reflection of what’s going on in your mind and your emotional health.

When you think of someone that is sad and depressed, what kind of posture comes to mind?

Another important disclaimer is that there are certain genetic conditions that cause abnormalities in the spine. This seems to be the exception rather than the rule but nevertheless, it’s a critical distinction to mention.

If you have some type of disease or disorder that causes your spine to curve abnormally then the advice in this article is not for you.

The information in this article is meant for people who have a rounded spine and forward head posture because of muscular weakness and lifestyle habits.

How to Fix a Dowager Hump 

The 3 steps for reversing a dowager hump include: 

1. Developing awareness;  
2. Integrating corrective exercise; and 
3. Building strength. 

Step 1 - Developing awareness 

Becoming more aware of what is going on in your body is critical for building better posture. This doesn’t mean you have to watch your posture like a hawk and then immediately stand up straight when you notice that you are slouching. This method won’t work. 

You will eventually forget to adjust your posture, and your body will take the path of least resistance. It’s exhausting to constantly monitor your posture, and you’ll inevitably become frustrated when you forget to “stand tall.”

What I mean by developing awareness is building more open awareness where you pay attention to your experience. If you’ve been slouching in a chair for hours, are you even aware of it? What do you do when you do become aware of it? 

When you exercise, go for a run or move around, what position is your body in? What sensations are you experiencing?

Once again, this process is not purely physical either. What are your everyday thoughts about? What strong emotional energy is living in your body and not getting acknowledged? 

Awareness is not the action step, it’s the discovery phase. You are simply paying attention to what’s going on in your day-to-day experience, without judgment. 

Step 2 - Integrating Corrective Exercise 

Once you better understand the types of postures your body tends to rest in throughout the day, you can use corrective exercise to help you adopt healthier positions. 

This has a two-fold benefit. The first is that you give your body some much needed exercises that will bring you into more balance immediately. 

The second and probably more important benefit is that you start understanding what a better posture feels like. You become more acquainted with the sensations, contractions and other feelings that accompany a more balanced and healthier posture. 

In time, you will become much better at finding this healthy and balanced position throughout the day and especially during exercise. 

Step 3 - Building Strength 

Corrective exercises, which are usually low intensity, will teach you what a healthier posture feels like. But your body won’t rest in this position throughout the day until you build enough strength in the appropriate muscle groups. 

Sure, you can do your corrective exercises at the end of the day to “rebalance” but that’s a lot of maintenance. Why not just get strong?

A strong posterior chain (back, glutes, shoulders, etc.) will fight gravity more efficiently than a weak posterior chain. When these muscles have the adequate strength to “stand tall” without your conscious effort, they will. 

I don’t recommend you jump straight into strength training without some exposure to correctives first, however. 

This is because correctives serve an important foundational purpose. They teach you how to maintain a healthy posture during strength training – with a neutral pelvis and spine. 

If you don’t spend any time on correctives, you will likely strength train with the same type of dowager type posture you’re trying to correct. Not only will you fail to make improvements but you also risk injury and pain.  

In the next two sections, I’ll give you examples of both corrective exercises and strength exercises that will reverse and prevent a dowager’s hump. 

Corrective exercises to prevent dowager's hump 

If you’re going to learn any corrective exercise for your Dowager’s hump, let it be the Wall Stand. Done right, this exercise is a powerful way to get your body in a better position immediately.

You might feel interesting sensations come up but as long as it’s not painful, I recommend you explore them. Maybe this is it what feels like when your body is finally standing with a healthier posture.

The All 4s exercise is a bit more challenging since you need to put a lot of weight on your wrists. You don’t have to do this one for the full 2 minutes. I recommend holding it for only 30 seconds to a minute at first.

The beauty of the Cat/Cow exercise is that in addition to mobilizing your pelvis and spine, it helps you identify what your neutral spine position feels like.

By going through the two extremes of flexion and extension, you can eventually identify the healthy middle area that you’ll want to use in more loaded movements.

Strength exercises for dowager's hump 

The exercises in this section represent the core 4 movements in strength training – push, pull, hinge and squat. 

As long as you’re hitting these 4 movements in your strength training and consistently increasing the volume, you’re doing it right. 

Let’s start with a simple push-up. Although pushing exercises primarily challenge the front of the body (which won’t strengthen the posterior chain), a push-up will teach your body how to push from a proper position. 

The push-up is also one of the best bodyweight exercises because you can do it just about anywhere and it challenges your whole body. Your core, back and many other muscles are getting more resilient even though they’re not getting as much of a pump as the chest. 

The next exercise is a bodyweight row. I’m using rings to perform the exercise in the video above but you can also use a strong bar, TRX cables or whatever you have access to.  Getting good at rowing and pulling will make a HUGE difference in your posture. 

In my opinion, this is the lowest hanging fruit for most people. Getting stronger in pulling movements will get all those muscles that bring the shoulders back and down stronger, which will in effect, pull the spine back and down along with it. 

The RDL targets the entire posterior chain, and it doesn’t require a ton of flexibility to perform, like some other hinging exercises. What I love most about the RDL is that it allows you to practice extending your spine and keeping it in a better position. 

The posture you practice during an RDL is the exact opposite of the dowager’s hump posture. Your back is straight and your head is back.

Out of all the 4 main movements, I’ve personally struggled with the squat the most. This is likely because I’m 6’4 and have incredibly long femurs.  This might not be the case for you but because of my weakness in this movement, it has taught me a lot. 

One of the most obvious things it taught me is how much I want to round my back when performing the movement. Instead of using my hips to rotate and flex, my back wants to round as much as humanely possible in order to get lower. 

Because of how rounded the back is in the Dowager’s hump, this might be your experience too. If it is, I recommend you only go down as far as you can while maintaining a neutral spine. Try to get a little lower each week with a healthy spine angle. 

Programming and Closing Thoughts

For the corrective exercises, you can do them as much as you’d like. You’ll eventually find that you’re not getting as much from them as you used to, and this is an excellent time to shift more time and energy to the strength exercises.

The strength exercises I shared above are the easiest core four movements for most people to start with. They are not the only ones that exist however and they are not necessarily the best ones either.

If one of the exercises does not feel right for you, experiment with other exercises that fit that core four category (push, pull, squat, hinge). The key is to integrate what you learn in the corrective exercises to your strength workouts.

As long as you do this, all strength exercises in the world will have value for you.

Unlike the correctives, I don’t recommend you overdo it with the strength work. I don’t suggest exceeding 1-2x a week. If you’re eager to do something, you can practice your form on off-days with bodyweight or very low weights.

A final helpful tip is to record yourself during your strength workouts. This will help you confirm that your spine is in a good position and that you are doing what you think you are doing.