The Dowager’s Hump

April 25, 2017

It’s no wonder this condition freaks people out – the name sounds like a mashup of Downton Abbey meets the Hunchback of Notre Dame. A client with a very bad neck issue asked me about a dowager’s hump (DH) and whether you can do anything about it. So, here’s the thing about this “syndrome,” of sorts. First, if you Google it, you are going to find some information, but it’s not necessarily 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) 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 it 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, which ultimately alters your posture, whether or not it leads to 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.

For every inch that your head is in front of your body, it’s an additional 10 pounds of perceived weight that your brain and body have to deal with. So if you have a 3-inch forward head carriage, that’s 30 extra pounds in addition to 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. Unfortunately this is 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 by protecting itself from your bad postural habits, your spine actually become more stiff and adhered with all this extra fiber. The body is actually satisfied with this because it senses that the head is more protected and won’t fall off. However, you’ll start to notice an ache in your lower neck, and 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 pretty useless. As the tissue and fibers begin to create an interweaving of fat cells in the extracellular matrix, the superficial layers become excessively thick, almost rubbery in texture. And although it seems to your body that this 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, MELT will help for sure! However, there are two things that make this difficult:

1. You have to work on it every day.

2. You must be willing to change your behavior and your posture when you sit at your desk and accept the fact that you may be 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 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 gristly connective tissue filled with a gaggle of mechanoreceptors that will give feedback if you touch it. But even if it hurts to the touch, it won’t get any better if you do nothing and it will certainly not stop growing if you ignore it.

So MELT is a great place to start. My favorite moves for people with a dowager’s hump are the Soft Ball Hand Treatment, Upper Body Compression, Rebalance with Upper Body Length, and the Neck Release Sequence. Shoot for one to two of these every day for the first two weeks. You definitely don’t have to do all of them at once: Mix and match to see what works for you.

Midback strength is very helpful if you find yourself hunching or have neck issues, but start by trying to get some much needed hydration back to the cells in your neck and shoulders!

Good luck and happy MELTing!

MELT Class

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