Causes of uneven shoulders
Exercises may help alleviate any pain resulting from bad posture.
How To Fix Uneven Shoulders From Scoliosis
Although scoliosis is a spinal condition, its effects can vary from patient to patient and aren’t just isolated to the back. As an unnatural spinal curve develops, it disrupts the body’s overall symmetry, and when it comes to addressing postural deviation such as uneven shoulders, the key is proactive treatment that addresses the condition’s underlying structural nature.
Scoliosis, as an unnatural sideways spinal curve, introduces a lot of uneven forces to the body. In children and adolescents, the main scoliosis symptom is postural deviation, and often, the condition’s earliest indicators are uneven shoulders and hips.
Scoliosis can affect the body in a multitude of ways, including postural changes, but let’s start with what it means to be diagnosed with scoliosis.
Being Diagnosed with Scoliosis
Being diagnosed with scoliosis means a progressive structural spinal condition has developed.
Scoliosis involves the development of an unnatural sideways spinal curve that also rotates, and has a minimum Cobb angle of 10 degrees.
Cobb angle is a measurement taken during X-ray that tells me how far out of alignment a scoliotic spine is.
When the spine’s natural and healthy curves are in place, the vertebrae (bones of the spine) are in a straight and neutral alignment, and they make the spine stronger, more flexible, and better able to facilitate the even distribution of mechanical stress.
When an unnatural spinal curve develops, certain vertebrae become tilted, shifting out of alignment with the rest of the spine, and a misaligned spine is one that’s not going to function optimally.
A patient’s Cobb angle measurement also shapes the design of effective treatment plans because it classifies conditions based on severity:
- Mild scoliosis: Cobb angle measurement of between 10 and 25 degrees
- Moderate scoliosis: Cobb angle measurement of between 25 and 40 degrees
- Severe scoliosis: Cobb angle measurement of 40+ degrees
- Very-severe scoliosis: Cobb angle measurement of 80+ degrees
In general, the higher the Cobb angle, the more severe the condition, and the more likely it is to cause noticeable postural changes.
Another key condition feature is its progressive nature, meaning that it will get worse over time, particularly if left untreated, or not treated proactively.
Where a scoliosis is at the time of diagnosis, and where a person’s posture is, is not indicative of where it will stay; only proactive treatment can work towards counteracting the condition’s progressive nature.
In addition to the wide-ranging severity levels of scoliosis, there are also different condition types, the most common being adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18, which is the form we’re currently focusing on.
So let’s start talking about scoliosis symptoms, one of which is postural deviation, such as uneven shoulders.
Adolescent Conservative Scoliosis Treatment Without Surgery, Susie’s Story
Common Scoliosis Symptoms in Adolescents
The idiopathic designation in adolescent idiopathic scoliosis means we don’t fully understand why it initially develops, but that doesn’t mean we don’t know how to treat it, and that also doesn’t mean we don’t understand what triggers its progression: growth and development.
Considering the stage that adolescents are in (puberty), or are entering into, at the time of diagnosis, this age group is at risk for rapid-phase progression.
When it comes to AIS, the condition’s early telltale signs are often uneven shoulders and hips, and this is due to the condition’s uneven forces.
In addition, scoliosis is known to cause the following symptoms in adolescents:
- Uneven shoulder blades
- The development of a rib arch
- An uneven waistline
- Uneven hips
- Arms and legs that appear to hang at different lengths
In addition to the aforementioned postural changes, changes to gait, balance, coordination, and clothing suddenly seeming ill-fitting can be additional condition indicators that warrant the need for further testing.
While there are no treatment guarantees, with early detection and a proactive conservative treatment approach, there are few limits to what we can achieve, and the reality is that most cases of scoliosis can be treated nonsurgically.
So why does scoliosis cause uneven shoulders, and how are they fixed?
Scoliosis Uneven Shoulders
There are three main spinal sections, and scoliosis can develop in any one section, or more than one as a combined scoliosis: cervical spine (neck), thoracic spine (middle/upper back), and the lumbar spine (lower back).
While each case is unique, generally, the section of the body most closely located to the spinal section affected is going to experience the most direct effects.
For example, when it comes to shoulder pain and uneven shoulders, this is most closely tied to thoracic and cervical scoliosis because it involves the upper sections of the spine, and the shoulders are located nearby as part of the upper body.
When the spine is aligned, the shoulders will be level on each side and front-facing.
When a structural issue like scoliosis comes into play, one shoulder can end up sitting higher than the other, with one shoulder blade protruding more on one side than the other.
If the shoulders are uneven, neck, shoulder, shoulder blade, and lower back pain can develop, and these symptoms increase if other bodily asymmetries are present, as is common with scoliosis.
Shoulder pain can feel like excessive tightness, soreness, and a pulling sensation is often felt in the shoulder sitting higher.
The shoulders can also take on a more rounded-forward appearance and feel like a knot is always present.
Shoulder pain is most closely associated with scoliotic curves in the upper back as this means the muscles of the upper back are working harder to support the unnaturally-curved section of the spine.
When it comes to fixing uneven shoulders from scoliosis, the answer is proactive treatment that addresses the underlying structural nature of the condition.
Scoliosis is a structural condition, meaning it involves a structural abnormality within the spine itself (the tilted vertebrae), so in order to treat it effectively, it has to be, primarily, impacted on a structural level.
Here at the Scoliosis Reduction Center®, I apply a conservative chiropractic-centered treatment approach started as close to the time of diagnosis as possible; this is valuable because scoliosis is simpler to treat early in its progressive line, when it’s going to be the most responsive to treatment.
As scoliosis progresses, the spine gets more rigid, making it less responsive to chiropractic care and making certain physical therapy techniques and exercises more difficult to perform.
First, I start with a series of chiropractic adjustments and techniques to work towards repositioning the position of the curve’s most-tilted vertebrae at its apex.
By addressing areas of vertebral subluxation, the spine is realigned, and this means the spine’s natural curves are restored as the condition’s uneven forces that cause postural deviation are also reduced, improving postural changes.
Once I see structural results, I shift the treatment focus to increasing core strength through physical therapy and scoliosis-specific exercises; a spine that’s surrounded by strong muscles is one that’s receiving optimal support and stabilization.
Corrective bracing is particularly effective on growing spines, and the ScoliBrace is my corrective brace of choice for adolescents; bracing can help augment corrective results by pushing the spine into a corrective position.
The final phase of treatment is rehabilitation, and this involves a series of custom-prescribed home exercises so patients can establish a rehabilitation program from home to further stabilize the spine for long-term sustainable treatment results.
By combining multiple condition-specific treatment disciplines and customizing treatment plans to address key patient/condition variables, scoliosis can be impacted on every level, which is precisely what its complex nature needs.
When it comes to condition-related postural deviation, the key is to address its underlying cause: the structural spinal condition.
By proactively treating scoliosis through reducing the curve and increasing core strength, as the condition’s uneven forces are improved, so too are its symptoms, such as uneven shoulders.
Causes of uneven shoulders
We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.
How we vet brands and products
Medical News Today only shows you brands and products that we stand behind.
- Evaluate ingredients and composition: Do they have the potential to cause harm?
- Fact-check all health claims: Do they align with the current body of scientific evidence?
- Assess the brand: Does it operate with integrity and adhere to industry best practices?
Was this helpful?
An injury can cause someone to develop uneven shoulders. People can also develop uneven shoulders due to posture, lifestyle factors, scoliosis, neurological conditions, and more.
Uneven shoulders refers to when one shoulder is higher than the other. For example, a person may notice that their left shoulder is higher than their right. They may occur due to certain habits or conditions. Typically, stretches and exercises are effective remedies. In other, more severe cases, people may require medical attention.
In this article, we discuss the causes of uneven shoulders, exercises to stretch and strengthen the shoulder muscles, and when to see a doctor.
Share on Pinterest Poor posture is a possible cause of uneven shoulders.
Causes of uneven shoulders can include:
Posture
An article in the Journal of Physical Therapy Science suggests that muscular and skeletal structures can develop into incorrect shapes due to certain postural habits.
If a person maintains poor posture, their shoulders can become uneven, as some sets of muscles become tight, and others become weak. One example is rounded shoulder posture (RSP).
RSP can cause the chest muscles to become tight and the shoulder muscles to become longer.
Exercises may help alleviate any pain resulting from bad posture.
Favoring the dominant side
The authors of an older study in the Journal of Athletic Training state that postural asymmetry is common among athletes.
Among males who played sports involving overhead motions, such as tennis, baseball, and volleyball, the study showed that the scapula (shoulder blade) on the dominant side was more inwardly rotated than the scapula on the nondominant side.
Certain sports, habits, and activities — typically those that involve the heavy use of one arm — can cause imbalances that lead to uneven shoulders.
Depending on the cause and severity of the imbalance, treatment may involve physical therapy and avoiding habits or activities associated with muscular, bone, and joint imbalances.
Scoliosis
People with scoliosis have an abnormal lateral curvature of their spine that can cause the shoulders to become uneven.
According to the American Association of Neurological Surgeons, scoliosis affects an estimated 2–3% of people in the United States, and it usually develops between the ages of 10 and 15 years.
People with scoliosis can wear a spinal brace that slowly corrects the curvature or undergo spinal fusion surgery.
In mild cases, a doctor may choose to monitor the curvature over time to see whether it will correct itself.
Nerve damage or conditions
According to a 2020 article , damage or conditions that affect the nerves responsible for sensations in the shoulder muscles, especially cranial nerve XI, can cause one shoulder to sit higher or lower than the other.
Nerve damage can occur due to injury or neurological conditions, especially those known to cause neuromuscular scoliosis, such as:
- cerebral palsy
- muscular dystrophy
- spinal muscular atrophy
- spina bifida
- spinal cord trauma
- a pinched nerve
Depending on the cause, treatment options can include:
- physical therapy
- surgery
- medication
Some exercises to help stretch and strengthen the shoulder muscles include:
The pendulum
- Lean forward with a flat back and slightly bent knees and put one hand to the side on a table or counter, letting the other arm hang freely.
- Gently swing the arm back and forward, then side to side, and then in a circular motion.
- Repeat steps 1 and 2 with the other arm.
Perform 2 sets of 10 repetitions, five or six times per week.
The crossover arm stretch
- Relax the shoulders and gently pull one arm across the chest as far as possible without causing discomfort, holding the upper arm in place with the other hand.
- Hold the stretch for 30 seconds, then relax for 30 seconds before repeating with the other arm.
- Repeat the two steps above 4 times on each side.
A person should do this exercise five or six times per week. It is important to avoid pulling or putting pressure on the elbow.
Standing row
A person will need an elastic stretch band.
- Make a loop of about 3 feet in length with the elastic band and attach the loop to a doorknob.
- Stand facing the doorknob, holding the band with the elbow bent to about 90 degrees.
- Keeping the arm close to the body, slowly pull the elbow back. The band should become more taut.
- Slowly return to the start position and then repeat the movement.
Perform this exercise three times a week, completing 3 sets of 8 repetitions each time.
External rotation with arm abducted 90º
- Make a loop measuring 3 feet with the elastic stretch band. Attach the look to a doorknob.
- Holding the band in one hand, raise this arm out to the side to shoulder height and then bend the elbow to 90 degrees, keeping the forearm in line with the upper arm.
- Slowly raise the hand until it is in line with the head. The band should become more taut.
- Return slowly and repeat.
Perform this exercise three times a week, completing 3 sets of 8 repetitions each time.
Internal rotation
- Making a 3-foot long loop with the band, tie the ends together and attach it to a doorknob. Keep hold of the other end.
- Stand with the elbow bent as though shaking someone’s hand.
- Keeping the elbow close to the side, bring the lower arm across the body.
- Slowly return and repeat.
Perform this exercise three times a week, and do 3 sets of 8 repetitions each time.
External rotation
- Follow steps 1 and 2 for the internal rotation exercise above.
- Keeping the elbow close to the side, rotate the arm outward slowly.
- Slowly return and repeat.
Perform this exercise three times a week, and do 3 sets of 8 repetitions each time.
If a person notices that their shoulders are uneven, they should talk with a doctor.
Anyone with severely uneven shoulders, additional concerning symptoms, or uneven shoulders with no apparent cause should also talk with a doctor or physical therapist.
Uneven shoulders can occur due to several habits and conditions — typically those that affect the shoulders, upper back and chest, or neck.
People with mildly uneven shoulders may respond well to at-home stretches and exercises.
More severe cases require medical attention from a doctor, physical therapist, massage therapist, or other licensed healthcare professional.
- Back Pain
- Body Aches
- Bones / Orthopedics
- Neurology / Neuroscience
- Rehabilitation / Physical Therapy
How we reviewed this article:
Medical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- Lee, D. Y., et al. (2017). Changes in rounded shoulder posture and forward head posture according to exercise methods.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684019/ - Ourieff, J., et al. (2020). Anatomy, back, trapezius.
https://www.ncbi.nlm.nih.gov/books/NBK518994/ - Oyama, S., et al. (2008). Asymmetric resting scapular posture in healthy overhead athletes.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582547/ - Rotator cuff and shoulder conditioning program. (2017).
https://orthoinfo.aaos.org/globalassets/pdfs/2017-rehab_shoulder.pdf - Scapula (shoulder blade) disorders. (2017).
https://orthoinfo.aaos.org/en/diseases–conditions/scapular-shoulder-blade-disorders - Schory, A., et al. (2016). A systematic review of the exercises that produce optimal muscle ratios of the scapular stabilizers in normal shoulders.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4886800/ - Scoliosis. (n.d.).
https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Scoliosis - Singla, D., and Vegar, Z. (2017). Association between forward heard, rounded shoulders, and increased thoracic kyphosis: A review of the literature.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659804/
Share this article
Medically reviewed by Angela M. Bell, MD, FACP — Written by Jennifer Huizen on July 15, 2020
Latest news
Related Coverage
Medically reviewed by Deborah Weatherspoon, Ph.D., MSN
Medically reviewed by Cynthia Taylor Chavoustie, MPAS, PA-C
Medically reviewed by William Morrison, M.D.
- About Us
- Contact Us
- Terms of Use
- Privacy Policy
- Privacy Settings
- Advertising Policy
© 2024 Healthline Media UK Ltd, Brighton, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Healthline Media is an RVO Health Company. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.
© 2024 Healthline Media UK Ltd, Brighton, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Healthline Media is an RVO Health Company. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.
