The effect of physiotherapy exercises for the treatment of humpback has been proven. Neck hump is a common neck problem that is caused by lifestyle and incorrect sitting habits. Take a moment to examine how you sit – are you sitting straight or is your neck hunched forward? In the latter case, you may, like many people, be suffering from a hump, which is a visible bump at the bottom of the neck. The cause of humpback neck is often the improper position of the body and the forward curvature of the spine, which gives the body a constantly bent appearance. Although this situation seems scary, it is preventable and even reversible. What is humpback? Although people are mostly concerned about the beauty of the neck, neck hump can cause physical problems such as pain, extreme fatigue and shortness of breath. Aggravation of neck hump causes a condition called hyperkyphosis. Excessive curvature of the spine reduces lung function and capacity and in rare cases even increases the risk of death. The hump may take months to years to form. However, the body's natural aging process (especially the loss of muscle mass around the vertebrae of the spine) and conditions such as arthritis can accelerate this process or make the hump more prominent. Older women are more prone to hunchback and are at risk of bone loss due to the decrease in estrogen production after menopause. What is the cause of humpback neck? Apart from diseases or the aging process, there are four main causes for humpback neck: ### 1. Improper posture If you sit or stand for a long time and bend your shoulders forward, you may have a humpback neck due to poor posture because in these situations the neck and upper back are under pressure. Unfortunately, many of us routinely put our bodies in these positions, whether it's while working on the computer or relaxing on the sofa. Hand-held electronic devices also play an important role in putting the body in an inappropriate position. ### 2. Excessive use of technology Long-term use of electronic devices can cause poor posture and pressure on the neck and upper back, leading to a complication called "technology neck". Technology neck is caused by repeatedly bending the head forward and down to look at a smartphone, tablet or computer screen for long periods of time. Imbalance and muscle weakness, and as a result, pressure and tension in the upper back and neck, as well as the stabilization of abnormal spine curves over time, are some of the effects of this condition. ### 3. Overweight Excess weight is also effective in creating or aggravating humpback neck. Excess weight by putting more pressure on the spine and creating an abnormal curve in the spine, leads to the formation of hunchback. In addition, overweight people usually have more fat reserves, and the accumulation of fat in the neck and upper back area aggravates the neck problem. ### 4. Vitamin deficiency Lack of vitamins, especially calcium and vitamin D, can contribute to humpback. Patients who are deficient in vitamin D are at risk of bone mineral loss, also known as osteoporosis. In some patients, osteoporosis can lead to fractures in the thoracic spine and rounding of the upper back. Talk to your doctor about the need to include vitamins in your diet. Can physiotherapy help to treat humpback? Depending on the age, severity, and cause of the kyphosis, humpback can often be significantly improved with physical therapy. Some causes of kyphosis can be more difficult to treat, such as: - Vertebral fractures (for example, wedge fractures due to osteoporosis) - Degenerative disc disease - Scheuermann's disease These complications cause structural changes in the spine, meaning that sometimes the actual shape of the vertebrae or disc changes. Although physical therapy cannot correct the shape of these altered structures, the stiffness, weakness, and pain associated with them can be improved. Talk to your physical therapist if you develop any of these conditions, as a thorough evaluation is usually recommended before any treatment begins. Physical therapists can use manual techniques to move stiff joints in the spine and relieve muscle spasms around the area. Exercise helps improve this condition by strengthening weak muscles, improving flexibility in stiff muscles, and reducing spine stiffness. Physiotherapy exercises suitable for the treatment of humpback neck There are three different ways to fix a posture problem like a hunchback: strengthening, mobility, and stretching. Therefore, the focus in the first part of the treatment program is on relaxing the stiff areas at the back of the neck. Then the stiff muscles in the center of the hump of the neck are stretched, and finally some physical therapy exercises are performed to improve the position of the neck and strengthen the body muscles. ### First part: Mobility There are several techniques to increase the mobility of the chest area. Try to do at least one of the exercises every day. ### Exercise to move the chest You need a chair with a firm back to perform the chest movement exercise. Sit on it and place the towel on the back of the chair behind you. Then, with your hands together, pull your spine against the chair or towel for 1-2 seconds and repeat this 15-20 times. For a deep stretch in the chest area, you can open your hands completely and place them behind your head. But if you're just starting to practice, it's better to just stick to hand to chest position. Read more: Symptoms of neck arthritis and its treatment ### Chest extension with a foam roller If you want to add some variation to this exercise, you can use a foam roller or a rolled towel. Lie flat on the floor or a flat surface and place the towel or roller horizontally under your shoulder blades. Repeat the same steps; Roll your spine on the foam roller 10-15 times. Be sure to keep working on your movements as the upper back is likely to get tight. Eventually you will notice less discomfort as you stretch your spine more and more. ### Second part: Stretching Do you know the aggravating factors of poor posture? stiff muscles If the chest muscles are tight, the shoulders are drawn inward and the bad posture remains. With just a few stretches, you can target these tight chest muscles and reverse droopy shoulders. ### Stretching the chest muscles with the help of a door frame (Pec Doorway Stretch) One way to reverse a shoulder sag is to stretch your chest muscles with the help of a door frame. This stretching exercise is done by standing in the frame of a door or the corner of the wall. In a lunge position, stand facing the door and place one foot in front of the other. Place your hands on either side of the door frame, elbows shoulder-width apart. While keeping your head in a neutral position, lean forward slightly so that your body weight is transferred to the front leg. You should feel a slight stretch in your chest area. ### Supine Pec Stretch To do this stretch, you need a foam roller. For this stretch, lie upright on the foam roller so that the roller is directly in line with the spine. Keep your arms up and in line with your shoulders, palms up and bend your elbows. Hold this position for 20 to 30 seconds to allow gravity to pull tight muscles down. ### The third part: Strengthening After working on stretching the chest muscles and mobility of the spine, the next step is naturally to strengthen the muscles that keep the body upright. ### Diagonal movements from 3 sides (**3-Way Diagonals**) The diagonal band helps strengthen the pectoral muscles, straighten the humpback, and strengthen the rotator cuff. This exercise puts pressure on the back to provide adequate support in the areas needed. Hold each end of the band in one hand and pull it diagonally so that both hands are in opposite directions. Change the direction. Finally, pull the band horizontally and perpendicularly to the chest. Pull the strap, relax the neck, push the shoulder blades together and keep the thumbs up. Read more: Cervical spine surgery ### Supine Chin Tuck By strengthening the small muscles in the neck, the chin-up movement can reverse the forward head posture. To perform chin-ups, lie on your back and bend your knees so that your feet are flat on the floor. While keeping your back straight, drop your chin toward your chest to form a crunch. If you feel a slight stretch in the back of your neck, you're doing it right. Just remember to keep all your muscles flat on the floor. Otherwise, the effect of this exercise will be neutralized. #### At the end Note that reducing the hump of the neck takes time. Although there are physical therapy exercises to treat humpback neck, the most effective way to treat humpback neck is to see a chiropractor, as chiropractic treatments improve results. With regular check-ups by a chiropractor and making necessary adjustments, more effective exercises for humpback neck can be found that correct the posture and keep it in the right position.