A guide to the causes of kyphosis, and the exercises you can use to fix it

Over the course of my career, I’ve often been asked about exercises to fix kyphosis. If this is a topic which interests you, then you should find this article both useful and interesting.

Additionally, I have written an article about exercises to fix lordosis, but the content is fairly similar. If you have both lordosis AND kyphosis, then I would recommend that you only read one of these articles.

Image showing different forms of kyphosis and a normal posture

What causes kyphosis?

Kyphosis, sometimes referred to as ‘hunch-back’ or ‘dowager’s hump’, is a spinal deformity where the thoracic part of the spine curves excessively. The upper part of the spine is supposed to curve outwards but when the curvature goes beyond a certain degree it is referred to as kyphotic.

There are four main causes of kyphosis:

• The first is congenital - in other words the spine develops incorrectly prior to birth.
• The second is adolescent - sometimes known as Scheuermann's Kyphosis and is usually associated with bad posture.
• The third is adult onset - triggered by trauma, such as an accident, an operation or a paralytic disorder.
• The fourth is degenerative - occurring because of osteoporosis or various other diseases and infections.

Using exercises to fix kyphosis

You will find all sorts of physical exercises for fixing kyphosis - they may well be advised by a physiotherapist. Massage and stretching are also recommended and, depending on the individual situation, these solutions may be very effective.

Exercise, massage and stretching are all good for you, providing they are not violent or counter-intuitive. The problem is, I often meet people who have done something apparently
recommended by a professional and have ended up injuring themselves.


A combination of these approaches may well result in you looking straight, or straighter, which may solve part of the problem. However, they will do nothing to correct the underlying, resilient muscular tensions that have caused, or contributed towards, your back to be hunched. You may look straight but still feel uncomfortable.

It is very easy for people, including professional care givers and medically trained experts, to overlook the fact that most people have very strong, resilient muscular habits. It is the BRAIN that controls these muscular habits; for muscles to contract, messages need to originate in the brain, travel along the nerve fibres and activate the muscle spindles. When we have habits of
tension and misuse it is our brain that needs to be retrained.

The messages from the brain to the muscles travel along well-worn routes which we feel familiar with. Unless the messages are re-routed, they will always follow the habitual path. It is perfectly possible to learn new routes, which begin as little footpaths, then become lanes and end up as super-fast highways.

The Alexander Technique focuses on this form of ‘neuro-muscular reeducation’. Lessons in the Alexander Technique are a gentle but thorough way of getting the muscles to function in their optimum state and can be used instead of, or in conjunction with, other approaches.

Using the Alexander Technique to fix the different causes of kyphosis

Congenital kyphosis

Congenital kyphosis is a fairly rare condition and it is not always clear why it occurs. Usually people have a range of often essential treatment, including massage, surgery, braces etc. some of which works for them, some which doesn’t.

For this condition, lessons in the Alexander Technique are always worth trying, in conjunction with the medical treatment. They won’t cure the kyphosis but they will help to address the underlying, habitual patterns of muscular tension, and markedly improve a person's comfort level and wellbeing.

Adolescent kyphosis

If you know a child who appears to be developing a hunched back it may be worth looking out for the following symptoms, which usually develop between the ages of 10 and 15, a time of considerable growth in the spine. 

These symptoms are typical:

• Tiredness and muscle stiffness, especially after a day of sitting in class
• Redness on the skin where the curvature is most pronounced and rubs against the back of a chair
• Pain made worse by activities involving twisting, bending, or arching backward, such as when participating in gymnastics, figure skating, dancing, or other sports requiring these types of movements
• Muscle spasms or muscle cramps
• Difficulty exercising
• Back pain or backache, which may come and go
• Limited flexibility
• Tight hamstrings
• Feeling off-balance

Serious damage is rare, but it is possible for Scheuermann’s disease to develop in such a way that the spinal cord or internal organs are harmed. For example, if the lungs become compressed by severe forward posture it can lead to breathing problems.

Having taught children affected in this way, I can say that they generally respond very well to lessons in the Alexander Technique, supplemented with regular back massages. They are young, so their postural habits are less entrenched. Also, they are quite motivated because of the discomfort, the physical restrictions or the embarrassment of looking different to their peers.

I would strongly recommend Alexander Technique lessons for teenagers with postural kyphosis.

Often, when the whole problem is postural, the child can easily be trained to just stop. When the kyphosis is more serious, or is progressing, I think it’s vital to try some lessons before considering a spinal brace or surgery. If these solutions can be avoided, all the better.

If these interventions are already in place it’s still worth having some lessons as the child can learn to make the best of the situation as opposed to developing additional problems such as extra tension in some muscle groups; weakening in others and altered proprioceptive feedback.

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Adult onset kyphosis

When accident, illness or trauma are the cause of kyphosis, lessons in the Alexander Technique will probably not be the first port of call. In these scenarios a person will require medical intervention and possibly physiotherapy or osteopathy. Lessons in the Alexander Technique often come later to help a person regain their balance and poise.

When medical or physical intervention is optional, it’s well worth consulting an Alexander Technique teacher before going ahead, as these interventions should be seen as a last resort.

Degenerative kyphosis

Some of the symptoms of kyphosis caused by ageing diseases such as arthritis, osteoporosis, disc degeneration etc. can be alleviated with lessons in the Alexander Technique. This is a practical approach based on common sense which many sufferers will endorse.

One or two lessons should give someone a sense of whether the technique will help them.

Kyphosis or just habitual slouching?

The vast number of kyphotic postures I encounter in my work as an Alexander Technique Teacher are not serious, in other words they are caused by postural habits as opposed to congenital defects, accident or disease. 

When people perform repetitive actions and hold postures over long periods of time, poor habits of muscular use are inevitable. I have met many a classroom teacher with a dowager’s hump from endlessly stooping over their pupils; dentists who hunch and fix while working on their patients’ teeth; anyone who spends a lot of time writing on a horizontal surface, as opposed to the old fashioned slopes etc.

Modern media, in particular computers and hand-held devices, appear to be
having a significant impact:

In this image, a little child who, under normal circumstances, would still be able to sit with
a perfectly straight back, is well on the way to becoming permanently hunched because
of his attention being fully absorbed on his gaming device.

In this image, the man is sitting on an exercise ball, presumably to help with his posture, and yet hunching towards his computer

I often come across ergonomic office solutions that are supposed to enable correct posture. The reality is that humans still find a way of letting their bad habits get the better of them.

Habitual slouching and hunching the upper back causes repercussions throughout the entire musculoskeletal system.

• the weight of the head has to be supported at an exhausting angle
• the internal organs are squashed under the weight of the upper body
• movement, circulation, digestion and breathing are put under strain
• any existing discomfort, ailment or injury will be aggravated


Lessons in the Alexander Technique can permanently and thoroughly correct
this type of kyphosis.

A case study - kyphosis caused partly by slouching

I once taught a girl with a slight adolescent kyphosis but also a pronounced and progressive scoliosis. I met her when she was about 14 and she clearly had a vertical twist in her spine, with one of her shoulders a lot further forward than the other. 

Lessons in the Alexander Technique meant that I was able to train her to be much straighter and eventually avoid surgery. At the end of each lesson she would be standing completely differently to normal; I would encourage her to observe her reflection in a full length mirror while mentally registering the unfamiliar feeling. It felt very weird for her, but in a good way.


With practice she was able to avoid allowing her own postural use to exacerbate the
original problem. Her kyphosis disappeared as her muscular use improved.


The risks of treating kyphosis through medical intervention

Sometimes doctors will prescribe a spinal brace for fixing kyphosis. This forces the spine into a better position and gives support to the back.

Hopefully the doctors will advise their patients of the risks. These include muscle weakness; proprioceptive distortion and a false sense of strength which can encourage people to lift more than is safe, or to exercise more than is appropriate.

Additionally, when kyphosis reaches a certain degree, surgery sometimes becomes essential. If the angle of the spine is severe, the increase in pressure on the heart and lungs can become dangerous.

Unfortunately, my colleagues and I, including osteopaths as well as other Alexander Technique teachers, regularly come across people who could have avoided surgery and have ended up in a regrettable state.

Sometimes a person may be so desperate for a solution, or their consultants may be so confident, that surgery goes ahead.

There are 3 problems with this:

1. Surgery might have been avoided with neuromuscular training
2. There may be side-effects that are worse than the kyphosis
3. There’s no going back


Not all doctors and surgeons know about the Alexander Technique, but this hasn’t always been the case:

‘We are convinced that Alexander is justified in contending that "an unsatisfactory manner of use, by interfering with general functioning, constitutes a predisposing cause of disorder and disease," and that diagnosis of a patient's troubles must remain incomplete unless the medical man when making the diagnosis takes into consideration the influence of use
upon functioning.’


-Extract from a letter signed by nineteen medical men and published in the British Medical
 Journal on May 29, 1937

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How to fix kyphosis using the Alexander Technique

1. Identify your muscular habits

Muscular habits will either be causing (mild) kyphosis or contributing to (severe) kyphosis.

I’m trained to feel the human muscular system with my hands much in the same way as a skilled rider is trained to manage a horse via contact through the seat and the reins. Good training and a lot of practice means that when I place my hand on a person’s shoulder, or the back of the neck, I am able to detect how they are using their postural muscles throughout their entire system, let alone in the area I'm touching. I’m able to determine which muscles are over-contracting and which ones are slack – a bit like an osteopath or a physiotherapist. The difference is that I’m able to gauge how the brain is involved – what sort of messages are being communicated to the muscles via the nerves.

2. Learn how to prevent or alter them

The involvement of the conscious brain is crucial to changing muscular habits. The activity that takes place in the skeletal, or postural, muscles is actually under conscious control. It may seem unconscious – we move all the time without thinking about it – but it’s really just pushed to the back of the mind to make space for concentrating on thousands of other everyday

With guidance it’s possible to be made aware of how much contraction is taking place in these muscles. Re-engaging the brain like this is a simple process of re-training. With practice the brain forms new pathways and new habits are created.


3. Learn to ‘project’ length and width in your back

'Muscle memory' is the term sometimes used to describe acquiring a physical skill. When a rugby player spends a few moments mentally projecting before kicking a goal it involves remembering exactly how it felt when he did it last time.

With kyphosis, the thoracic curve of the spine is exaggerated, creating compression in the spine that needs to be replaced with ‘freeing up’. When you picture this in conjunction with being physically shown it and being told when you get it right, the brain registers the positive feeling and remembers it for next time. With practice the desired result can be achieved in a matter of seconds and without assistance.

Freeing up

With the human musculoskeletal system, the backbone is designed to almost effortlessly lengthen upwards in upright balance, through a series of gentle curves. The effect of gravity pulling on the weight of the head activates the erector spinae muscles and the spine extends, leaving room for the ribs to move so that breathing can be expansive and easy. Habits of muscular tension can work against this process.


When I teach ‘freeing up’ I sometimes use the image of a fountain. A healthy spine, naturally freeing up, might feel something like the water at the centre of the fountain. A kyphotic spine might feel more like one of the curving lines of water at the edge.

A case study - kyphosis caused by osteoporosis

I gave a course of lessons to a deaf lady in her late eighties. Her kyphosis was very pronounced due to advanced osteoporosis. She was stooped forwards at a severe angle and experiencing a lot of discomfort.

I adapted the lesson to suit her needs. She would lie on the couch supported by at least half a dozen pillows and I would work on her neck and back. She stopped wearing her hearing aid after the second lesson in order to just focus on the physical process of releasing tension.

The kyphosis was not fixable, but the the relief and comfort she gained from the sessions was significant enough for her to continue for many months.

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The technique is primarily educational in nature, but learning and applying it has therapeutic benefits and preventative consequences for the health of the individual in the following cases:


  • Backache, neck ache, where posture is a factor

  • Pregnancy

  • Vocal disorders and vocal cord nodules

  • Stress

  • High blood pressure

  • Asthma

  • Hyperventilation

  • Anxiety states, including performance anxiety

  • Functional disorders

  • Osteoarthritis

  • Temporo-mandibular joint syndrome

  • Scoliosis

  • Kyphosis

  • Lordosis

  • Spondylosis

  • Migraine

  • Tension headaches

  • Cerebral palsy

  • Multiple sclerosis

  • Parkinson’s disease

  • Rehabilitation after stroke, injury, operation or other treatment

  • Prevention of backache in pregnancy

  • Dystonias

  • Non-specific regional pain syndrome

Alexander Technique lessons are relaxing, fun, enlightening and very non-intrusive. The teacher will use verbal and manual guidance, while you remain fully dressed, to show you where you’re holding tension.


It will always be a revelation. The whole problem is that your muscular habits have evolved over a lifetime and you’re simply used to them being there. You feel normal. So when the tension stops it is a great relief and seems so obvious you wonder how you didn’t realize what you were doing to yourself before.


A lot of what I teach is practical common sense: mechanical - simple ergonomics.


My job is to show you how to feel better and function more efficiently.

‘The Alexander technique is a well established method of teaching people to (among other things) return to their general level of muscle tone (invariably selectively increased in [certain] disorders) towards a more normal level. It is not an alternative technique (based on a non-conventional view of human physiology such as those of acupuncture or homeopathy) but is entirely consistent with orthodox medical and physiological theory and practice. It has been taught in this country for over 100 years and claims for Alexander lessons have been paid by major medical insurance companies, such as B.U.P.A. for over 50 years.’

-Dr Miriam Wohl, medical practitioner specialising in making functional assessments of
 people who have applied for DLA.


The National Back Pain Association
The British Association for Performing Arts Medicine

Medical applications of the Alexander Technique

In this image the teacher is gently using his hands to encourage the pupil to free her neck. 


Have a taster lesson with Jenny Skinner

I’ve been doing the Alexander Technique for over 30 years so I know a great deal about correcting kyphosis.

I am an expert in everything to do with body ergonomics.


I have had extensive, first class teacher training.


I have taught thousands of people over the last 20 years.


I love my work!

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Many famous people have had lessons

Jack Stern, spinal neurosurgeon:

'97% of people with back pain could benefit by learning the Alexander Technique - it is only a very small minority of back pain sufferers that require medical intervention such as surgery.'

Professor Nicholas Tinbergen, Nobel Prize winner for medicine and physiology :

'We already notice, with growing amazement, very striking improvements in such diverse things as high blood pressure, breathing, depth of sleep, overall cheerfulness and mental alertness, resilience against outside pressures, and in such a refined skill as playing a musical instrument.'

Sir Charles Sherrington, neurophysiologist:

'Mr Alexander has done a service to the subject [of the study of reflex and voluntary movement] by insistently treating each act as involving the whole integrated individual, the whole psychophysical man. To take a step is an affair, not of this or that limb solely, but of the total neuromuscular activity of the moment, not least of the head and neck.'

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