Understanding and Fixing Rounded Shoulders and Shoulder Pain: A deep Dive
Rounded shoulders and the associated anterior shoulder pain are common issues affecting posture, comfort, and performance. If you’ve ever experienced that weird shoulder pain right behind your shoulder blade or tightness around your upper torso, this guide is for you.
Understanding why your shoulders feel off and how to fix them starts with knowing the mechanics of your shoulder — specifically the two key joints involved.
Shoulder Mechanics: The Two Critical Joints
1. Glenohumeral Joint — The Main Shoulder Ball-and-Socket
This is where your upper arm bone (the humerus) fits into the shoulder blade (scapula) socket (glenoid fossa).
When dealing with rounded shoulders, the main problem is excessive internal rotation at this joint:
Shoulders appear pushed forward.
Elbows rotate inward, making it feel “natural” to have your arms in front, not down by your sides.
This forward rotation pushes the ball of the humerus forward inside the socket, stressing the joint.
Key Muscles at Glenohumeral Joint Rotation:
Internal Rotators (often tight/dominant):
Pectoralis Major (chest muscle)
Latissimus Dorsi (large back muscle, the “V” shape)
Teres Major
Subscapularis (a rotator cuff muscle beneath the scapula)
External Rotators (often weak):
Infraspinatus
Teres Minor
Posterior Deltoid (has a longer lever but can worsen joint stress if overused)
Important: Many people compensate for weak infraspinatus and teres minor by overusing the posterior deltoid during external rotation exercises, which ironically pushes the ball of the humerus forward and worsens anterior shoulder pain (like biceps tendonitis). Effective rehab focuses on activating the smaller rotator cuff muscles.
2. Scapulothoracic Joint — The Shoulder Blade on the Rib Cage
Your scapula glides over your rib cage and its position greatly influences shoulder health.
Scapular Movements to Know:
Tipping (anterior tip or posterior tip)
Rotation (upward and downward)
Protraction and Retraction (forward and backward movement)
In rounded shoulders, you often see:
Anterior tipping: The bottom corner of the scapula pokes out, mainly due to tightness in:
Pectoralis Minor
Upper Trapezius
Levator Scapulae (muscle connecting neck to scapula; often feels like neck tightness)
Downward rotation dominance: The scapula does not rotate upwards properly when you raise your arm. Instead, you elevate the shoulder blade without adequate rotation, causing pinching in the shoulder space.
Muscles Affecting Scapula Rotation:
Upward Rotators (weak in rounded shoulders):
Serratus Anterior (appears like serrated knife blades along the ribs)
Lower Trapezius
Downward Rotators (tight and dominant):
Levator Scapulae
Rhomboids
Pectoralis Minor
How to Fix It: Release the Tight, Activate the Weak
Step 1: Release Tight Muscles
Use foam rollers, lacrosse balls, or professional manual therapy to release:
Pectoralis Major & Minor
Upper Trapezius
Levator Scapulae
Posterior Deltoid
Latissimus Dorsi
Subscapularis (Note: subscapularis is tricky to self-release due to its location under the scapula; guidance is recommended here)
Step 2: Activate Weak Muscles
Focus on strengthening and properly recruiting:
Serratus Anterior
Lower Trapezius
Infraspinatus
Teres Minor
Tip: When training external rotation, ensure you’re activating the infraspinatus and teres minor, not just the posterior deltoid to avoid aggravating the joint.
Final Thoughts and Advice
Just telling someone to “pull your shoulders back” isn’t enough.
Correcting rounded shoulders requires understanding which muscles are overactive and which are underactive.
A balanced approach releasing tight muscles and strengthening weak ones will restore shoulder mechanics, reduce pain, and improve posture.
For persistent issues, consider personalized professional assessment and therapy.
