This blog post covers the best exercises and strategies to help fix a Dowager’s Hump.

A Dowager’s Hump is an enlarged prominence that is formed at the base of the neck.

(… it looks like a protruding bone at the base of the neck!)

(Note: The term “Dowager’s Hump” is sometimes referred to as Thoracic Hyperkyphosis (Hunchback Posture). In this blog post, it is specifically referred to as Hyperkyphosis of the Cervicothoracic junction.)

It is also nicknamed as having a “Buffalo Hump” or “Neck Hump”.

In This Blog Post

• Characteristics
• Causes
• Implications
• Can It Be Corrected?
• Test For Dowager’s Hump
• Exercises To Fix A Dowager’s Hump
• Common Questions

Characteristics

The main feature of the Dowager’s Hump is the excessive flexion (Hyper Kyphosis) at the Cervicothoracic junction (Base of the neck).

Other Characteristics:

causes

In my opinion – The main cause of developing a Dowager’s Hump is “bad posture”.

… Or more specifically, a Forward Head Posture.

This is where the head sits in a poked forward position. (See below)

Generally speaking – The more forward your head sits, the more stress is placed on the base of your neck.

To cater for this extra stress, the body will tend to respond by:

(… This is the body’s attempt to support your heavy head!)

After a prolonged period of time in this poor posture, this can lead to the deformation at the base of the neck – the Dowager’s Hump.

Note: There are certain conditions (such as Osteoporosis/Compression fractures and Cushing’s Syndrome) that can lead to a bump at the base of the neck. 

Implications

Although having a Dowager’s Hump does not inherently mean that there will be definite issues associated with it, there are still potential implications.

Neck Pain

As the head and neck are in a sub-optimal position, there is potentially more stress placed on the muscles and joints of the neck.

This may predispose one to developing pain and/or tightness in the neck.

Aesthetics

Some people do not like the appearance of having a Dowager’s Hump.

It can give the appearance of having a squashed neck.

(… It might even make you slightly shorter!)

Potential Risk To

Can it be corrected?

Yes.

… As long as the joints in the neck have not fused together.

Note: If the joints have already fused together, it is unlikely that you will be able to significantly change the appearance of the hump.

How to test if you have a Dowager’s hump

Note: It is completely normal to have slightly enlarged bones at the base of your neck area. Do not mistake this for having a Dowager’s Hump.

Observation Of Side Profile

If you can see a pronounced bump around the base of your neck, then you most likely have it!

Feel It

Place your hand at the base of your neck.

… Can you feel a significant bump?

X-Ray

If you really wanted to know the structural alignment of your neck, you can go to your general practitioner and request for an X-ray.

(Check to see if the C7 vertebrae sticks out too much!)

How to fix a Dowager’s hump

Note: If you have any doubts that these exercises will be suitable for you, make sure to consult a healthcare professional prior to attempting any exercise.

STEP 1: Releases
STEP 2: Stretches
STEP 3: Traction
STEP 4: Mobilization
STEP 5: Gain Control
STEP 6: Strengthening Exercises
STEP 7: Forward Head Posture
STEP 8: Ideal Head Position
STEP 9: Address Posture
STEP 10: Tips

1. Releases

It is important to release the tight muscles which may be associated with the formation of the neck hump.

Upper Trapezius

Instructions:

• Locate the Upper Trapezius.
  • Use Google if you are not sure where this muscle is.
• Place a massage ball between this muscle and a wall. (See above)
• Lean an appropriate amount of your body weight into the massage ball.
• Move your body over the massage ball to cover the entire muscle.
• Continue for 1 minute.
• Repeat on the other side.

Posterior Neck Muscles

Instructions:

• Lie down on the floor.
• Position the muscles at the back of your neck onto a massage ball. (See above)
• Make sure to cover the entire length of the muscle on either side of your spine (Base of the skull to the base of the neck).
• Gently rotate your head from side to side to emphasize certain areas.
• Do not apply any pressure to any bony areas in the back of the neck.
• Continue for 2 minutes on each side.

Sternocleidomastoid

Instructions:

• Locate the Sternocleidomastoid muscle.
  • Feel for a prominent band of muscle on each side of the neck. (See above)
• Gently massage these muscles using a pinch grip.
• Do not press too deep!
• Duration: 1 minute each side.

Scalene Muscles

Instructions:

• Make a fist with the hand.
• Place the back portion of the fingers against the side of the neck.
• Apply a gentle force into the neck.
• Starting at the collar bone, perform slow upward strokes towards the head.
• Continue for 10 upward strokes.

Note: It is important that you do not apply too much pressure as there are sensitive structures (such as nerves and blood vessels) in this region.

(If you are not comfortable with performing the Scalene release on yourself, please see a trained healthcare professional.)

2. Stretches

With the Dowager’s Hump, the muscles and joints at the base of the neck will likely be very stiff. Let’s loosen them up!

Decompression (Sides of Neck)

Instructions:

• Look downwards.
• Tilt your head towards the side.
• Gently pull your head down towards that same side.
• Completely relaxed your neck.
• Aim to feel a stretch on the side of the lower part of your neck.
• Make sure to avoid any pinching sensation on the side you are pulling your head towards.
• Hold for 30 seconds.
• Repeat on other side.

Decompression (Back of Neck)

Instructions:

• Tuck your chin in.
• Place your hands behind the back of your head.
• Whilst keeping your chin tucked in, gently pull your head downwards.
• Aim to feel a stretch at the back of your neck.
• Hold for 30 seconds.

Neck Stretch (Back/Side of Neck)

Instructions:

• Hold onto the under side of a chair with your hand.
• Lean your body weight towards the opposite side.
• Gently tuck in your chin.
• Look towards the arm pit on the opposite side of the hand holding onto the chair.
• Place your hand on the top of your head and pull your head towards the arm pit.
• Aim to feel a stretch on the back/side of the neck.
• Hold for 30 seconds.
• Repeat on the other side.

Sternocleidomastoid Stretch

Instructions:

• Sit in front of a table.
• Keep your chin tucked in and down throughout this stretch.
• Place your left fist on the left side of your chin.
• Place your left elbow onto the table in front of you.
• Rest the weight of your head onto your fist.
• Tilt your head to the left.
• Apply further pressure to the chin to increase the stretch.
• Aim to feel a firm stretch in the right side of the neck.
• Hold for 30 seconds.
• Perform on the other side.

See Post: Sternocleidomastoid Stretches

Front Of Neck Stretch

Instructions:

• Look upwards.
• Keep your mouth closed.
• Aim to feel a stretch at the front of your neck.
• Hold for 30 seconds.
• Note: Make sure that you do not experience any sharp pinching sensations at the back of your neck.

3. Traction

The following exercises will help decompress the tight joints in the neck.

This can reclaim more movement in the joints which will be required when correcting the bump at the base of the neck.

Traction (With Hands)

Instructions:

• Kneel in front of a chair.
• Place both elbows onto the seat in front of you.
• Place your palms under the sides of your jaw.
• Keep your chin in a slightly nodded position.
• Sink the weight of the head into your hands as you move your hips away from the table.
• Do not allow your neck to extend backwards.
• Keep your neck relaxed.
• Aim to feel a pulling sensation in your neck.
• Hold for 30 seconds.

Traction (With Resistance Band)

Instructions:

• Tie a resistance band to a stationary object. (Height: ~3-4 feet)
• Lie on the floor with your knees bent.
• Wrap the band under the base of the skull.
• Whilst still holding the band with your hands, slowly shuffle your body away from the anchor point.
• Let go and let the band pull your head.
• Move as far away until you can feel a stretch at the back of your neck.
• Completely relax.
• Hold for 1 minute.
• Note: Place a small towel between your head and the band if you feel more comfortable.

Traction (With A Device)

Alternatively – you can invest in a mechanical traction machine which will help decompress the the joints.

If you would like see 13 different exercises that will help decompress your neck:

See Post: Neck Decompression Exercises

4. Joint mobilization

The following exercises will help encourage more movement in the joints of the neck.

Joint Mobilization (With Ball Sock)

Instructions:

• Place 2 massage balls into a sock and tie a knot at the end. (see image)
• Lie on your back with your knees bent.
• Position the Dowager’s Hump between the 2 balls.
• Using your hands at the back of the head, support the weight of your head.
• Pull your head forwards so that your chin in closer to your upper chest.
• Lean an appropriate amount of body weight onto the ball sock by gradually taking some pressure off your hips.
• Aim to arch the base of the neck over the ball sock.
  • Small movements is the key here!
• Repeat 30 times.

Side Pressures

Instructions:

• Reach behind your neck with both hands.
• Feel for the Dowager’s Hump.
• Locate the spinous process of C7 and T1.
  • These are the bones the poke out in the middle.
• Place your fingers tips of either side of the spinous process.
• Apply an alternating pressure from the sides.
  • “Wiggle the bone from side-to-side”
• Continue for 1 minute.

5. Gain control of the joints

Now that there has been more movement unlocked in the neck, it is vital to reclaim the full control of the joints.

(Note: If the neck joints are still stiff, you will need to focus on the previous steps before proceeding to this one.)

Lower Neck Extension

Instructions:

• Look slightly downwards.
• Perform a chin tuck.
  • “Make a double chin”
  • (think about the movement as a book sliding back into the shelf)
• Whilst maintaining this chin-tucked position, proceed to subtly look upwards.
• Aim to feel a tight sensation at the base of your neck.
  • This movement should NOT hurt or cause a sharp pinch sensation!
• Do not let your chin poke forwards during this movement.
• Repeat 30 times.
• Do NOT force this movement into pain!
  • If you feel any pain, only move your neck in the range of motion the is comfortably available.
  • Over time – aim to increase the amount of movement.

For more exercises: Chin Tuck Exercises

6. Strengthening Exercises

Now that you have improved movement and control of the joints in the lower part of the neck, the next step in addressing the Dowager’s Hump is to perform the following strengthening exercises.

REMEMBER: Focus on extending from the base of the neck.

45 Degrees Torso Lean

Instruction:

• Lie down on the stomach.
• Rest your torso onto your forearms.
• Lean your torso backwards to approximately 45 degrees.
• Keep your chin slightly tucked in.
• Look slightly upwards.
• Aim to extend the lower part of the neck backwards.
• Hold for 30 seconds.

Against Gravity

Instructions:

• Lie down on your stomach.
• Tuck your chin in.
• Lift your head slightly off the ground.
• Aim to extend the lower part of the neck backwards.
• Hold for 10-30 seconds.

Resistance Band

Instructions:

• Loop a resistance band around the back of the head.
• Hold onto the end of the bands with your hands.
• Pull the resistance band forwards.
• Keep your chin in a slightly tucked position.
• Tilt your head slightly backwards.
• Aim to extend the lower part of the neck backwards.
• Hold for 10-30 seconds.

For more exercises: Neck Extensor Strengthening

7. Address Forward Head posture

A Forward Head Posture is where the position of the head is in front of the mid line of the torso.

Since the head is relatively heavy, the further forward it is positioned, the more pressure it places on the base of the neck.

To completely fix the Dowager’s Hump, it is very likely that you will need to address the Forward Head Posture.

It is strongly recommended that you check out the blog post as linked below for a comprehensive guide on how to address a Forward Head Posture:

See Post: Fix Forward Head Posture

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Here are some exercises to get you started:

Sub-Occipital Stretch

Tightness at the base of the skull tends to be associated with a Forward Head Posture.

Instructions:

• Place one hand at the front of your chin and the other at the back of your head.
• Apply a force to the front of your chin as to gently glide the chin backwards.
• Whilst maintaining this pressure, proceed to pull your head forward/down.
• Aim to feel a stretch at the back of your neck.
• Hold for 30 seconds.
• Repeat 3 times.

Sternocleidomastoid Stretch

A tight sternocleidomastoid muscle tends to pull the head forwards.

Instructions:

• Gently tuck your chin in.
  • (Keep this position throughout the movement.)
• Rotate your head towards the side you want to stretch.
• Tilt your head to the side away from the side you want to stretch.
• Use your hand to pull your head further into the tilt.
• Aim to feel a stretch on the side of your neck.
• Hold for 30 seconds.
• Repeat 3 times.

For more stretches: Sternocleidomastoid stretches

Deep Neck Flexor Activation

The Deep Neck Flexors are a group of muscles which are located at the front of the Cervical Spine.

These muscles are responsible for achieving and maintaining the ideal position of the head and neck.

Instructions:

• Lie down on your back.
• Place a pillow underneath your head if it is more comfortable.
• Flatten your tongue to the roof of your mouth.
• Gently breathe through your nose.
• Keep your neck muscles completely relaxed throughout this exercise.
• Nod your chin towards your chest.
• Aim to feel a gentle muscular contraction in the back of your throat and a lengthening sensation at the back of your neck.
• Hold for 5 seconds.

For more exercises: Deep Neck Flexor Exercises

Chin Tuck

This exercise helps bring the head into a more neutral position.

Instructions:

• Whilst sitting upright, gently tuck your chin in.
  • “Make a double chin.”
• Aim to feel a gentle lengthening sensation at the back of your neck.
• Make sure your eyes and jaw stay level, and move the head horizontally backwards.
  • Think of the movement like a book sliding back into the shelf.
• Hold for 5 seconds and repeat 30 times.

8. Maintaining the Correct head position

Here are some simple cues to help remind you to hold your head in the correct position.

Keep Your Neck TALL And ELONGATED

Here are some cues to help position your head in a more optimal position.

• “Keep your neck long and relaxed.”
• “Imagine your head is a balloon. Float your head away from your shoulders.”
• “Imagine someone pulling your head directly upwards.”

Maintain A Gentle Chin Nod

• “Bring your chin ever so slightly closer to the front of your throat.”
• “Do not poke your chin forwards.”

9. Address your posture

Although the exercises mentioned above will help address your Dowager’s Hump, there are other factors that we must consider.

The 2 other postural issues that predispose you to developing the Dowager’s Hump:

Collectively – they place an increased amount of stress to the base of your neck.

Address Hunchback Posture

If the Thoracic Spine (upper back) is hunched forwards, this can force the head to poke forwards.

The weight of the head in this forward position will place extra stress at the base of the neck.

For more information: Hunchback Posture

Address Rounded Shoulders

Having Rounded Shoulders is when the resting shoulder position is in front of the mid line of the torso.

Together with the weight of the arms, this forward resting position of the shoulders can cause the upper trapezius to pull on base of the neck.

For more information: Rounded Shoulders

10. Extra Tips

Try to implement the following tips.

Sitting Posture

Avoid slouching!

Being in a hunched position for a prolonged amount of time will naturally place more stress at the base of your neck.

Sit tall. Elongate your spine. And avoid poking the chin forwards.

For exact steps on how to sit with the ideal posture:

See Post: How To Sit With Proper Posture

Driving Posture

Generally speaking – car seats do not encourage a good driving posture. (See above)

If you need to drive on a consistent basis, it is important to set up the car seat appropriately to encourage the most optimal posture.

If you would like some posture tips for driving:

See Post: Proper Driving Posture

Sleeping Position

How do I fix a Dowager’s Hump while sleeping?

In regards to sleeping posture, the main issue is when you sleep on your back. (See below)

If you sleep on your back, avoid using an excessively thick pillow as this will push your head forwards and encourage the bump!

The aim is to use the thinnest pillow as comfortably possible without letting your chin jut forwards.

11. Common questions

If you have any other questions, feel free to ask it in the comment section down below and I will get back to you.

How long will it take to fix?

It really depends… Everybody is different!

However – if you have had your Dowager’s Hump for a long time, it is likely to be more difficult to influence any change in the appearance.

There are no quick fixes!

Do the exercises. Be Consistent.

Can surgery fix Dowager’s Hump?

The Dowager’s Hump removal involves surgically removing the fatty tissue deposits that sits around the hump.

Although this may reduce the overall appearance of the bump, the hunched position of the joints will remain unchanged.

Can wearing a heavy bag contribute?

Yes!

… Especially if you already have rounded shoulders!

The weight of the bag can place extra stress at the base of the neck.

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Conclusion

• The Dowager’s Hump is the bump at the base of your neck.
• The main cause is a Forward Head Posture.
• It is able to be improved… unless the neck joints are already fused.
• Initially – it is important to do all of the exercises mentioned in this blog post. From here – focus on the exercises that give you the best results.
• For best results: It is recommended to address your whole posture.

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Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. Seek guidance from a healthcare professional before starting any exercise and/or implementing any recommendation. For more information: Medical Disclaimer.