How To Fix Uneven Shoulders - Posture Direct

Uneven Shoulders is the asymmetrical posture where one shoulder is higher (or lower) as compared to the other side.

The shoulder blade can be elevated or depressed on the rib cage.

This blog post offers effective exercises to help level out uneven shoulders.

Table Of Contents

• Causes
• Is It Problematic?
• Tests for Uneven Shoulders
• Muscles Involved
• Exercises To Fix Uneven Shoulders

Causes

The postures and activities you subject your body to throughout the day has a strong influence on the overall position of your shoulders.

Think about it:

• Do you lift/carry things on one side?
• Do you lean towards one side whilst on the computer?
• Are you involved with a sport/occupation/play an instrument that requires predominantly using one hand only?
• Do you wear your bag over one shoulder?
• Do you always side sleep on the same side?

Over time – if you habitually adopt the asymmetrical position of your shoulders, having uneven shoulders will become apart of your default posture.

Note: There are also neurological causes that may also lead to this issue. (Not covered in this blog post)

Does it really matter that you have a shoulder imbalance?

Having shoulders that are not level does not necessarily mean that you will have symptoms.

However, in my opinion, there will always be one side that is loaded more than the other when you have uneven shoulders.

This may lead to imbalances in:

• Muscle size
• Strength
• Muscular tension
• Movement

Did you know… it is common to have a lower shoulder on your side of dominance?

How To tell if you have Uneven shoulders

Here are some simple ways to help you determine if you have uneven shoulders.

1. Uneven Collarbones

Instructions:

• Stand relaxed in front of a mirror.
• Locate the line of your collar bones.
• Compare the height.

Results: If one collar bone is higher/lower, then you have uneven shoulders.

2. Uneven Upper Trapezius

Instructions:

• Stand relaxed in front of a mirror.
• Locate the border of the Upper Trapezius muscle on either side.
• Compare the height.

Results: If one upper trapezius is higher/lower, then you have uneven shoulders.

(Note: Increased muscle bulk on one side may give a false illusion of a higher shoulder.)

3. Uneven shoulder blades

Instructions:

• Take a photo of your back.
• Locate the outline of the scapula.
• Compare the overall height of the scapula.

Results: If one shoulder blade is higher/lower, then you have uneven shoulders.

4. How do your clothes fit?

Does your shirt or bra strap tend to always fall down towards one side?

The shirt/strap will tend to drop towards the side of the lower shoulder.

muscles involved

(It is important to know the location of the following muscles when performing exercises for your uneven shoulders. Use Google if you are not sure.)

Elevated Shoulder

a) Tight and/or Overactive Muscles

(The following muscles pull the shoulder girdle UPWARDS.)

• Upper Trapezius
• Levator Scapulae

b) Weak and/or Inhibited Muscles

(The following muscles are not pulling the shoulder girdle DOWNWARDS.)

• Lower Trapezius
• Latissimus Dorsi
• Lower Serratus Anterior
• Pec Minor/Major
• Subclavius

Depressed Shoulder

(Note: A depressed shoulder can lead to conditions such as Snapping Scapula Syndrome and Thoracic Outlet Syndrome.)

a) Tight and/or Overactive Muscles

(The following muscles pull the shoulder girdle DOWNWARDS.)

• Lower Trapezius
• Latissimus Dorsi
• Lower Serratus Anterior
• Pec Minor/Major
• Subclavius

b) Weak and/or Inhibited Muscles

(The following muscles are not pulling the shoulder girdle UPWARDS.)

• Upper Trapezius
• Levator Scapulae

Exercises to fix Uneven shoulders

STEP 1: Address Spinal AlignmentSTEP 2: Determine Your Shoulder Blade PositionSTEP 3: Scapula ControlSTEP 4: Exercises For A HIGH ShoulderSTEP 5: Exercises For A LOW ShoulderSTEP 6: Neutral ShoulderSTEP 7: Postural HabitsSTEP 8: Other Causes Of Uneven ShoulderSTEP 9: One Shoulder More Forwards

1. Address Spinal Alignment

Before addressing the shoulders, you may need to address the spine first!

The position of the shoulders is strongly influenced by the position of the spine.

a) Scoliosis

If the spine is bent towards one side, this can automatically lead to one shoulder being positioned higher relative to the other side.

By addressing the misalignment of the spine, you may find that this naturally levels out the height of both shoulders.

For a full guide on how to address the alignment of your spine:

See Post: Scoliosis Exercises

b) Lateral Pelvic Tilt

If you have one hip that is higher than the other, this can influence the position of the spine (and thus the position of the shoulders).

This imbalance in the pelvis can be reflected in the uneven positioning of the shoulders.

For a full guide on how to address the alignment of your pelvis:

See Post: How To Fix Lateral Pelvic Tilt

2. Determine your shoulder blade position

a) High/Low Shoulder

By now – you should have a good idea of which is the higher/lower shoulder.

(If not, please feel to go back to the Tests For Uneven Shoulders section.)

This usually improves by addressing the asymmetric position of the spine. (see above)

b) Elevated/Depressed Shoulder

The next thing you need to determine is whether your shoulders are in an ELEVATED or DEPRESSED position relative to the rib cage.

This will dictate WHICH exercises you should be performing to bring the shoulders back to a more neutral position.

It is important to understand how your shoulder has deviated from the neutral position.

Ideal shoulder Blade position

In order to determine the position of the shoulder blade relative to the rib cage, we first need to understand what the ideal shoulder blade position is.

(Note: There is a degree of variability of this “ideal” position and will certainly differ in different people. Use the following as a rough guide line!)

a) Back View

Rough guideline

• Top of Scapula:
  • T2
• Spine of the Scapula:
  • T4
• Bottom of Scapula (Inferior angle):
  • T7-9
• Ideal resting position of the scapula:
  • Sits flat on the rib cage
  • Slightly angled outwards
• The position of the scapula on the left and right side should generally be even.

Interpretation:

• If your scapula sits higher than this position, then you have an ELEVATED shoulder.
• If your scapula sits lower than this position, you have a DEPRESSED shoulder.

b) Front View

The angle of the collar bone (clavicle) should have a slight upward angle. (see above)

Interpretation:

• If the clavicle is significantly upward slanted, then you have an ELEVATED shoulder.
• If the clavicle angle is flat or sloping downwards, then you have a DEPRESSED shoulder.

Note: Having Thoracic Kyphosis (Hunched Upper Back) may affect these results!

READ THIS

(Please make sure that you understand the following point before proceeding to the exercises to address your uneven shoulders.)

Your higher shoulder does NOT necessarily mean that you have an ELEVATED shoulder.

For example – It is possible to have both shoulders that are DEPRESSED, but one side may be relatively higher.

In this case – you would do the same exercises (for a depressed shoulder) for both sides, but may need to focus more attention on the side that is lower.

3. Control your scapula

The position of your shoulder blade will determine the position of your shoulder as a whole.

This is the reason why it is so important to have full control of the movement of your scapula.

(The following warm up exercise will help you with the rest of the exercises mentioned in the blog post.)

a) Scapula Rotations

Instructions:

• Shrug your shoulders up towards your ears.
• Squeeze the shoulders blades up and back.
• Retract the shoulders back.
• Squeeze the shoulder blade back and down.
• Relax.
• Perform 20 repetitions.
• Repeat the exercise going the opposite direction.

The goal with this exercise is to produce and control as much movement in your shoulder blade as possible.

4. Exercises for Elevated Shoulder

Note: You may or may not need to do exercises for both of your shoulders.

Address the side(s) where the shoulder has moved away from the neutral position.

1. Releases

a) Upper Trapezius/Levator Scapulae

Releases will help reduce the over-activity of the main muscles that elevate the shoulder.

Instructions:

• Locate the target muscles:
  • Upper Trapezius
  • Levator Scapulae
• Stand in front of the corner of a wall.
• Lean forwards.
• Place a massage ball between the region between the top of your shoulders and the wall. (see above)
• Apply an appropriate amount of pressure into the massage ball.
• Make sure to cover the entire muscle.
• Continue for 1 minute.

2. Stretches

Stretches will reduce the over-activity and tightness of the muscles that pull the shoulder upwards.

a) Upper Trapezius

Instructions:

• Pull your elevated shoulder downwards.
  • You can hold onto something to help anchor your shoulder down.
• Tilt your head away from the side that has the elevated shoulder.
• Using your hand, pull your head further into the tilt.
• Aim to feel a stretch in the region between the head and shoulder.
• Hold for 30 seconds.

b) Levator Scapulae

Instructions:

• Pull your elevated shoulder downwards.
• Look towards the armpit that is on the opposite side.
• Place your hand on the back of your head and apply a downward pressure towards the armpit direction.
• Aim to feel a stretch between the top of the scapula and your head.
• Hold for 30 seconds.
• For more stretches: Levator Scapulae Stretches.

4. Strengthening exercises

With an elevated shoulder, it is important to strengthen the muscles that pull the shoulder downwards (Scapular Depression) into a more neutral position.

How To Perform Scapular Depression

• Pull the shoulder blade DOWNWARDS.
  • “Pull your shoulder blade into your back pocket”
• Aim to FEEL the muscles contract at the base of the scapula.
• This motion will be used in all of the following exercises.

a) End Range Flexion

Instructions:

• Place the hand on the side of the elevated shoulder high up on a wall in front of you.
• Lean firmly into this hand.
• Perform Scapular Depression:
  • “Pull your shoulder downwards.”
• Hold for 30 seconds.
• Aim to feel the muscular contraction around the lower region of your shoulder blade.
• Perform 5 repetitions.

b) Scapula Push Ups

Instructions:

• Sit on the floor with your legs out stretched.
• Place the hand that is on the side of the elevated shoulder onto a yoga block.
• Lock your arms straight.
• Lean your body weight into your hands.
  • Your shoulder should naturally hitch upwards as you do this.
• Perform Scapular Depression:
  • Pull your shoulders down as you lean more weight onto the hand.
  • “Create distance between your ear and shoulder.”
• Aim to feel the muscular contraction around the lower region of your shoulder blade.
• Hold for 30 seconds.
• Perform 5 repetitions.
• Note: If you find this difficult, you can perform the same exercise whilst sitting on a chair with your feet on the ground. (= less weight on your hands)

c) Prone Arm Lift

Instructions

• Lie down on your stomach.
• Reach your hands out in front of you.
• Lift the arm on side of the elevated shoulder.
• Perform Scapular Depression as you lift your arm:
  • “Pull your shoulder blade down”
• Hold for 10-20 seconds.
• Perform 5 repetitions.

4. Taping

Taping your elevated shoulder in a downwards direction will help keep the shoulder in a better position.

Instructions:

• Gently pull your elevated shoulder down into a neutral position.
  • (Scapular Depression)
• Place the tape starting from above collar bone and pull back and down to the middle of your thoracic spine. (as above)
• Make sure you place firm downward pressure when applying the tape.
• Depending on your skin irritability, you can leave the tape on for up to ~2 days.

5. Exercises for A Depressed shoulder

Note: You may or may not need to do exercises for both of your shoulders.

Address the side(s) where the shoulder has moved away from the neutral position.

a) Releases

Releases will reduce the over-activity of the muscles that pull the shoulder downwards.

a) Side Of Rib Cage

(Target Muscles: Latissimus Dorsi/Serratus Anterior)

Instructions

• Lie down on the side with the depressed shoulder.
• Place a foam roller underneath the side of the rib cage.
• Apply an appropriate amount of body weight on top of the foam roller.
• Roll your body up/down over the foam roller.
• Make sure you cover length of the muscle.
• Duration: 1-2 minutes.

b) Chest

(Target muscles: Subclavius, Pectoralis Major/Minor, Anterior Deltoid)

Instructions:

• Lie facing downwards on the floor.
• Place a massage ball underneath the chest region.
• Apply an appropriate amount of your body weight on top of the massage ball.
• Perform a circular motion over the massage ball.
• Make sure to cover the entire chest region.
• Continue for 2 minutes.

c) Inter-Scapular

Instructions:

• Locate the region between your shoulder blade and spine.
• Whilst lying down on the floor, place this area on top of a massage ball.
• Apply an appropriate amount of your body weight on top of the ball.
• Cover the entire region.
• Continue for 1-2 minutes.

2. Stretches

Stretches will reduce the tightness of the muscles that pull the shoulder downwards.

a) Latissimus Dorsi

Instructions:

• Assume the position above.
• Hold onto a door frame with your hand.
• Whilst anchoring your legs as shown, aim to bend your mid section as much as possible.
  • Use your body weight to sink into the stretch
• Twist your pelvis away.
• Aim to feel a stretch on the side of your torso.
• Hold for 30 seconds.

b) Chest

Instructions:

• Place the hand on the side of your depressed shoulder onto a door frame. (see above)
  • Keep your hand up high.
• Lunge forward.
• Shrug your shoulder upwards.
• Do not arch your lower back.
  • Keep the lower rib cage down.
• Aim to feel a stretch in the chest region.
• Hold for 30 seconds.

c) Lower Trapezius

Instructions:

• Sit down on a chair.
• Slouch your upper back as much as you can.
  • Focus at bending your spine at the level of the lower shoulder blade.
• Shrug the shoulder upwards on the side of the depressed shoulder.
• Try to take a deep breath into the middle of your back.
• Aim to feel a stretch in the region around the lower shoulder blade.
• Hold for 30 seconds.

d) Serratus Anterior

Instructions:

• Assume the position as above with the depressed shoulder towards the floor.
• Lean your upper body weight onto your forearm.
  • Your shoulder should naturally hitch upwards.
• Whilst keeping your waist pinned down to the ground, push your torso up right.
• Aim to feel a stretch on the side of your rib cage.
• Take a deep breath into the area where you feel the stretch.
• Hold for 30 seconds.
• For more stretches: Serratus Anterior Stretches

3. Strengthening Exercises

Strengthen the muscles that elevate the shoulder towards a more neutral position.

a) How To Perform Scapular ELEVATION

Instructions:

• Hold onto a weight onto the side of your depressed shoulder.
• You can have your arms:
  • By your side or
  • Above your head
• Keep your elbows straight.
• Perform Shoulder Elevation.
• Feel the contraction of the region between the head and shoulder.
• Hold for 30 seconds.
• Perform 3 repetitions.
• Progression: Hold onto a heavier weight.

b) Shoulder Elevation (4 point kneel)

Instructions:

• Assume the 4 point kneel position.
• Lift and reach out a straightened arm in front of you so that your hand is pushing and holding a ball against the wall. (see above)
  • Try to be as far away from the wall as possible.
• Perform Scapula Elevation as you press the ball into the wall.
• Aim to feel the muscles on the top of the shoulder blade activate.
• Roll the ball in a circular motion.
• Keep your neck relaxed.
• Repeat 30 times.

6. Maintaining neutral shoulder

Now that you have:

• Released and Stretched out the tight muscles holding you in the uneven shoulder position and,
• Strengthened the muscles that bring the shoulder into a more neutral position

… the next step (and probably the most important!) is to activate the appropriate muscles (… the ones you targeted with the strengthening exercises) to maintain the correct shoulder position throughout the day.

Quick Tip: In the early stages of correcting your uneven shoulders, aim to correct your shoulder position to an amount that you are comfortable with.

(You do NOT need to correct it 100% straight away.)

As your body becomes accustomed to this new position, slowly increase the % of correction.

7. Address activities causing Uneven shoulders

If you do all of the mentioned exercises in this blog post, but then spend most of your time in the position/activity that has lead to your uneven shoulders in the first place… it is likely that your progress will be significantly hindered!

You will need to either:

• Improve your posture in this position/activity
• Reduce exposure to this position
• Eliminate doing it completely

8. Other Factor leading to Uneven shoulders

There are many different positions that the shoulder complex can adopt which could give the appearance of uneven shoulders.

a) Winged scapula

A Winged Scapula is when the inner border of the shoulder blade protrudes off the rib cage.

This can lead to the appearance of having Uneven shoulders.

For a full guide on how to address a Winged Scapula:

See Post: Winged Scapula Exercises

9. One Shoulder More Forwards

The other presentation that relates to having uneven shoulders is having one shoulder that is more forwards as compared to the other side.

How To Test For A Forward Shoulder

Instructions:

• Get someone to take a photo from an angle that is looking down onto your shoulders. (see above)

Results: Observe if you have one shoulder that is more forward as compared to the other side.

Muscles Involved

a) Tight and/or Overactive Muscles

• Pec Major/Minor
• Subclavius
• Latissimus Dorsi
• Anterior Deltoid
• Subscapularis
• Serratus Anterior

b) Weak and/or Inhibited Muscles

• Rhomboids
• Lower/Middle Trapezius

Exercises For A Forward Shoulder

I have created a comprehensive blog post covering this issue.

See Post: Exercises For Rounded Shoulders

Perform the suggested exercises on the above blog post on the side that is rounded forwards.

Rotated torso

If your torso is rotated, it can give the appearance of having one shoulder more forward than the other.

Here is a quick test:

Instructions:

• Take a photo from the above head position.
• Find the line of your pelvis.
• Fine the line of your torso.

Results: If these 2 lines are not parallel, then you have a rotated torso relative to your pelvis.

If your upper torso is rotated to the right, your left shoulder will be orientated in a more forward position.)

For exercises to fix a Rotated Torso:

See Post: Rotated Torso

Conclusion

• Uneven shoulders is the asymmetrical position of the shoulders.
• It can result in imbalanced loads on the shoulders which may eventually lead to all kinds of issues.
• Before correcting your uneven shoulders, any tilting of the torso must be addressed.
• If the shoulders remain uneven after the torso is aligned, then focus on the exercises that are appropriate to your specific presentation.
• Make sure that you address any activities/positions that are encouraging your uneven shoulders.

What to do next…

1. Any questions?… (Leave me a comment down below.)

2. Come join me on the Facebook page. Let’s keep in touch!

3. Start doing the exercises!

Disclaimer: The content presented on this blog post is not intended to be used as a substitute for professional advice, diagnosis or treatment. It exists for informational purpose only. Use of the content is at your sole risk. Seek guidance from a health care professional before starting any exercise and/or implementing any recommendation. For more information: Medical Disclaimer.