Dowager’s hump. The hump on our back that typically increases with old age. Is it inevitable? Can it be avoided or reduced?
What is a Dowager’s hump?
A normal back has a curve outwards between the shoulder and lower ribs, called a kyphosis. After around 40 years of age this begins to increase in angle so that the curve gets more ‘humped’ also known as age-related hyperkyphosis. It occurs in 20 – 40% of those over 60.
What causes a Dowager’s hump?
A dowager’s hump increases more in women than men particularly after menopause.
One-third of those with severe hyperkyphosis have underlying osteoporosis with vertebral fractures.
That means in 2/3 of people there are other causes. These include:
- Back extensor muscle weakness
- Decreased spinal mobility and consequent stiffening of ligaments
- Degenerative disk disease
- Decreased bone mineral density (osteopenia and osteoporosis)
- Hereditary factors
Can we prevent dowager’s hump?
If you look at the list of causes, you’ll notice that they are typically a result of the way we live today. In fact scientists have even coined a term for this; slumped sitting and lack of use of extensor muscles in the spine is called “flexion relaxation phenomenon” (FRP), and is typical of our times as we engage in slumped sitting pretty much all the time.
In this study, the best way to sit to activate the muscles to keep our upper back from excessive humping is shown here in figure A: (A) Thoracic upright sitting. (B) Slump sitting. (C) Lumbo-pelvic upright sitting.
Are supportive chairs contributing to dowager’s hump?
We have been obsessed with designing furniture to take the work out of our muscles, and in doing so we have done our spinal muscles a disfavour and increased the likelihood of a humped back and lazy spinal muscles.
The ultimate in support in our office chairs has evolved as shown – note that fully supported we no longer need to use our postural muscles. (Picture source)
What would happen if someone suddenly removed the back of your seat?
This is the question that biomechanist Katy Bowman asked followers of her Nutritious Movement Facebook page. The most common answer: I’d fall backwards.
In this excellent article (What if we got exercise all wrong) Katy goes on to explain:
“Exactly. The outsourcing of postural muscles, designed to hold our bodies upright in a variety of positions, would for many be so weak and untrained that the entire structure would collapse. Sitting tall takes work, the type of work too many humans are unequipped to handle.”
(Katy Bowman has many excellent posts here and is coming to New Zealand in October for the Ancestral Health Symposium, talk outline here)
Once you have a dowager’s hump – can it be reversed?
The only proven way apart to reverse a dowager’s hump is by doing weight resistant exercise specifically to strengthen the bones and muscles; deadlifts are a great example.
The Bone Clinic in Sydney started working with women who had severe osteoporosis – training them to lift heavy weights, in order to see the effect this had on their osteoporosis. Was it unsafe? (NO) Did it make their bones stronger and reverse osteoporosis? (YES)
Even more intriguing is the effect it had on women’s bent spines, from the Bone Clinic’s results
“We have found that a Dowager’s hump can be treated. In fact The Bone Clinic’s exercise program has been shown to reduce the curvature of the spine, increase height and enhance function, appearance and confidence.
The significant improvement in posture also reduces the risk of further injury to the spine during lifting and decreases the risk of falling by enhancing your balance – incredibly important outcomes as your body continues to age.”
This is Denise H. Her before (our exercise program) and after photographs illustrate a remarkable decrease in her Dowager’s hump.
This is Sue S. After 8m of training – a noticeable increase in her posture as well. 
This is Wendy H. Wendy was another lady on the Griffith University randomised control study and we saw a significant improvement in her posture as well. 
And to inspire you – here is a clip with women doing deadlifts and other weights in the Sydney Bone Clinic programme
References
https://www.ncbi.nlm.nih.gov/pubmed/27538834
Inspiring indeed. Flicking the link to this to others who would greatly benefit by reading this. Thank you.
Great – thanks, I’m really into weights myself at the moment, What a difference! It is great to feel so strong and energetic