The Dowager's Hump

April 5, 2010

Just the name sends people into a frenzy as the image of it is something similar to the Hunchback of Notre Dame. A client with a very bad neck issue asked me today about a Dowager's Hump (DH) wondering what it is. So, here's the thing about this "syndrome" of sorts. First, if you google it, you are going to find some information on it but the info isn't actually 100% correct.

You see, this hump is the culmination of a tremendous amount of stress to the lower cervical vertebrae as the thoracic (middle back bones) spine perpetually flexes forward. The most common cause of a true DH is a subtle fracture of the spine. I've seen this type of fracture called a "wedge fracture" and happens in older adults. 

However...if you sit at a desk all day long and slouch as many of us do, or you lean your head forward to read your screen (by the way, you could just change your settings so the fonts are a little bigger... or maybe it's time for glasses...) you compress the front portion of the spinal bones that ultimately alters your posture regardless of actually causing a fracture of any bones. Even when you go to straighten up, if this posture is constant, at some point you can't get straight as the facet won't close. But this is only half the story of what I would define as a dowager's hump.

When your head carriage is forward, for every inch off the plumb line you go, it's an additional 10lbs of perceived weight that your brain and body have to deal with. So if you have a 3 inch forward head carriage, your head now weighs about 40 or so pounds depending upon the actual weight of your noggin. If the body and brain keep relaying this signal, the body does an amazing thing... it protects itself. It does this by laying down more and more fibrous material in the many layers of connective tissue. It's like a traffic jam of mechanoreceptors in one local area. Once they get in, they can't get out so no proprioceptive feedback is relayed in one local area. The body doesn't give up hope with its signals... to the contrary, it actually lays down more fibers and sends more material around the bones that are slowly deforming at an even faster rate. Because as much as the body is doing a good thing protecting itself from your bad postural habits, as it lays down this extra fiber, your spine actually become more stiff and adhered. The body is actually satisfied with this because it senses the head is more protected and won't fall off. You however, will start to notice not only an ache in your lower neck, if you feel the tissue back there it will feel thicker and more stiff than the tissue in other areas.

I've done enough dissections to tell you that this extra "fluff" is actually useless. As the tissue and fibers begin to create an interweaving of fat cells in the extra cellular matrix, the superficial layers become excessively thick, almost rubbery in texture. And although it seems to your body it's extra fluff is helping, over time, it's only making matters worse.

So can you stop or prevent a Dowager's hump from forming? The answer is YES! And yes, MELTing will help for sure! However, there are three things that make working on a hump like this difficult:

1. You have to be able to navigate your body on the roller well enough to directly treat it.

2. You have to work on it everyday.

3. You must be willing to change your behavior and your posture when you sit at your desk and make some consideration of the fact that YOU are causing your Dowager's hump.

Don't get me wrong, a Dowager's hump can be caused by osteoporosis and changes in the thoracic spine but more frequently, a fatty pad at the bottom of your neck space has been brewing for years and years... you are just noticing it when it's causing people to tell you to stand up straight and God forbid someone gives it a squeeze! OUCH! That 'fatty pad" can be painful. What you are grabbing is not muscle... it's grizzly connective tissue filled with a gaggle of mechanoreceptors that will give feedback if you touch it. But even if it hurts to the touch, you must MELT it! It won't get any better if you do nothing and it will certainly not stop growing if you ignore it.

So MELTing is a great place to start. Midback strength is very needed if you seem to be hunching or have neck issues to say the least but start with trying to move some of those staggnant receptors and get some much needed hydration back to the cells in your neck!

Good luck and happy MELTing!