Poor posture is becoming increasingly common in modern society. Many people spend long hours using smartphones, working at a computer, driving, or sitting at a desk. Over time, these daily habits can contribute to a hunched back, rounded shoulders, forward head posture, and upper back stiffness.
In Japan, a hunched posture is often called “nekoze,” which literally means a posture similar to a cat’s curved back. In English, it may be described as rounded shoulders, poor posture, a hunched back, or excessive thoracic kyphosis.
Although poor posture may initially seem like a cosmetic issue, it can also affect the muscles, joints, breathing mechanics, balance, and movement of the entire body.
This article explains common causes of a hunched back and introduces practical rounded shoulder and poor posture treatment methods, including physiotherapy, stretching, strengthening exercises, manual therapy, and posture correction.
A healthy spine has several natural curves that help distribute pressure and allow the body to move efficiently. The thoracic spine, located in the upper and middle back, naturally has a gentle backward curve called kyphosis.
However, when this curve becomes excessive or when the shoulders and head move significantly forward, the posture may appear rounded or hunched.
Common signs include:
Poor posture does not always mean that there is a structural spinal problem. In many people, posture is influenced by muscle strength, flexibility, movement habits, and the way the body is used every day.
There are several factors that can contribute to rounded shoulders and a hunched back.
When working at a computer, people often move their head toward the screen and allow their shoulders to roll forward. Maintaining this position for several hours can increase tension in the neck and chest while reducing activity in the upper back muscles.
Looking down at a smartphone for long periods can place the head in a forward position. Repeatedly using this posture may contribute to neck stiffness and reduced movement of the upper back.
The pectoralis major and pectoralis minor muscles are located around the chest and shoulder. If these muscles become tight, they can contribute to the shoulders moving forward.
The muscles between the shoulder blades, including the rhomboids and middle and lower trapezius, help control the position of the shoulder blades. Weakness or poor coordination in these muscles can make it difficult to maintain an upright posture.
The thoracic spine needs to extend and rotate during normal movement. If the upper back becomes stiff, the neck and lower back may compensate for the lack of movement.
The most effective approach depends on the individual’s posture, mobility, muscle strength, lifestyle, and symptoms.
At a physiotherapy clinic, treatment may include several methods rather than relying on one technique.
Physiotherapy can help identify the physical factors contributing to poor posture.
A physiotherapist may evaluate:
The goal is not simply to force the body into a “perfect” posture. Instead, treatment aims to improve the body’s ability to move comfortably and maintain different positions efficiently.
Improving thoracic spine mobility is an important part of treating a rounded upper back.
One simple exercise is the thoracic extension exercise.
Sit on a chair with your feet firmly on the floor. Place your hands behind your head and gently extend your upper back over the back of the chair. Avoid forcing the movement or excessively arching the lower back.
Perform the movement slowly for approximately 8–10 repetitions.
Other useful exercises may include thoracic rotation and controlled spinal mobility exercises.
A tight chest can contribute to rounded shoulders.
A simple doorway chest stretch can be performed by placing your forearms against a doorway and gently moving your body forward.
Hold the stretch for approximately 20–30 seconds and repeat 2–3 times.
The stretch should feel comfortable. Sharp pain or numbness is not normal and should not be ignored.
Posture correction also requires strengthening.
Exercises such as:
can help improve the strength and control of the muscles around the shoulder blades.
One important point is that simply “pulling the shoulders back” all day is not necessarily the solution. The shoulder blades need to move naturally during breathing and arm movement.
The shoulder blade, or scapula, plays an important role in posture.
Healthy shoulder movement requires coordination between the scapula, thoracic spine, shoulder joint, and surrounding muscles.
Physiotherapy can therefore include scapular movement training to improve:
Improving scapular control can make everyday movements such as reaching, lifting, and working at a desk more comfortable.
Manual therapy and massage may be used as part of a posture treatment program.
Treatment may focus on areas that have become tense, including:
Massage may help temporarily reduce muscle tension and improve comfort. However, massage alone usually does not correct the underlying movement habits that contribute to poor posture.
For longer-term improvement, manual therapy is often combined with exercise and posture education.
Exercise is important, but what you do throughout the day is equally important.
If you spend eight hours sitting at a desk, performing exercises for ten minutes cannot completely compensate for poor movement habits during the remaining hours.
Try to:
The goal is not to maintain one rigid posture all day. Movement is an important part of healthy posture.
In many cases, exercise can significantly improve posture, especially when poor posture is related to muscle weakness, stiffness, or movement habits.
However, results depend on the underlying cause.
A flexible postural problem may respond well to strengthening and mobility exercises. On the other hand, structural spinal changes may require a different approach.
For this reason, a professional assessment can be helpful when posture problems are severe, persistent, or associated with pain.
There is no single treatment period for everyone.
Some people may notice improvements in movement and comfort within several weeks of consistent exercise. More significant posture changes may require several months of regular training.
The most important factor is consistency.
Doing posture exercises once a month is unlikely to produce significant results. A simple exercise program performed regularly can be much more effective.
You should consider professional assessment if your rounded back is accompanied by:
A physiotherapist can determine whether your symptoms are primarily related to posture, muscle imbalance, joint mobility, or another condition.
For people with mild posture problems, the following routine can be a useful starting point:
1. Thoracic extension
8–10 repetitions
2. Chest stretch
20–30 seconds × 2–3 repetitions
3. Resistance band row
10–15 repetitions × 2–3 sets
4. Wall angels
8–12 repetitions
5. Thoracic rotation
8–10 repetitions per side
Perform the exercises slowly and comfortably. If an exercise causes sharp pain, stop and seek professional advice.
A hunched back and rounded shoulders are common problems in modern life, but they do not necessarily have to become permanent.
Effective poor posture treatment usually involves a combination of thoracic mobility exercises, chest stretching, upper back strengthening, scapular movement training, manual therapy, and changes to daily habits.
Rather than trying to force yourself into a perfectly straight position, focus on improving your body’s ability to move, strengthen, and maintain comfortable positions.
If you have persistent pain or significant changes in posture, professional assessment by a physiotherapist can help identify the underlying factors and create an individualized treatment program.
At PAPC (Phnom Penh Acupuncture Physiotherapy Center), posture and movement can be assessed from a whole-body perspective. Treatment may be tailored according to your symptoms, physical condition, muscle balance, joint mobility, and daily activities.
Improving posture is not simply about standing straight. It is about helping your body move better and function more comfortably in everyday life.
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