Working with A Dowager's Hump

Fig. A

This (fig. A) would be the Dowager's Hump in its purest form which is a collapsing of the first and second rib down and also a shrinking of the space front to back of the sternum and vertebra. The mid thoracic vertebra gets pulled towards the sternum and vice versa. With the 7th vertebra depicted in red starting to topple off. There are several forms of the pattern, as the body can deal with the aberration in many different ways depending on its strengths and limitations.

It is important to note that it is not the fault of the 7th vertebra that it is displaced so much. Quite the opposite in fact. At an earlier stage when this pattern was starting to develop in the body, that area was probably one of the more adaptable places. That being so,it had to shift because other parts of the body could not adjust to changes that were required. It will have continued its journey migrating forward and downward until it reached a point that it could no longer change. The vertebra has then to be braced to stop further change. This bracing, created by a wad of tissue which you can see and feel on top of the 7th vertebra, also surrounds the whole vertebra. The area will be very dense and locked down with little to no movement.

At the same time as the vertebral shift, shrinking occurs front to back around the heart. Once again, the thoracic vertebra through the design and shape of the bone will bow inward to the point in which it cannot bend or shift anymore. It will have hit the limit of adaptation causing it to stop and solidify, resulting in a further loss of movement and adaptability in the body.


Necks are very adaptable to change and have a lot of movement, below c7 will require the most work. Just working the area of 7th vertebra alone is not enough and will have limited results. You first must create support from below to lift the ribs and viscera. Along with creating space for the diaphragm, lungs and heart. Extensive work is required throughout the whole spine to allow the body to spread the pattern through the whole system. Extensive work is also required to allow the mid-thoracic vertebra to open and flex again. The opposite will be true in the neck which will need work to allow it to come into extension. Once you have completed this foundation work, you can start the migration of C7 back aloft its mantlepiece. It is important to note that a lot can be achieved in 10 hours of work but changing this pattern can take years, and there will probably still be small residual signs of the pattern having once been there. A lot of adaptability work and orientation work of the head in relation to the spine is also needed so as once you have released the areas that need it the client has to be shown the new options available to them via orientation work.

Fig. B

The body can spread the aberration in different ways throughout the body. This version (Fig. B) will present with greater bend through the mid-thoracic below the 7th vertebra in red. It often presents with greater collapsing downward of the 1st and 2nd ribs which will pull the head even further forward as it loses support from below.


The work is similar as with the first version with the main difference being the mid-thoracic vertebra are subject to inflexion and have to be worked with the intention of opening them the opposite way allowing them to extend more. The curve in the neck is likely to be stronger.

Finally, there is a version of this pattern (Fig. C) that forms through degeneration of vertebral space and wedging of the vertebra. Often Osteoarthritis, osteoporosis and Rheumatoid arthritis are involved or present with this formation. It is important to note dealing with some of these ailments requires a high knowledge and skillset and should be approached with caution. Although it can be possible to stop the structural pattern progressing it is unlikely that you will get a meaningful structural change to the wedging and shape of the vertebra. It is, however, possible to get very meaningful changes with osteoarthritis concerning the pain levels associated with it. I have never seen any evidence that it removes or reduces arthritis, only that you can greatly reduce the pain and dysfunction associated with it. Rheumatoid arthritis is harder to work with, and you will get less of an improvement with the clients subjectively noticing less of a change. It requires extensive work from the practitioner and the client. I often wonder if addressed in its very early stages could the pattern's progress be halted or slowed?

All tissues flourish when high levels of movement pass through them. Once you are past the blood supply, the tissue relies on transporting its nutrients and building blocks by forms of osmosis which are greatly assisted by movement such as compression and stretching of the tissue. It is my firm belief that part of the cause of this type of degeneration is a reciprocating event. The more the body shifts, the more it locks down stopping this vital movement; the more restricted the vital blood supply, nutrients and building blocks are to that area. This lack of flow to the most needed areas creates a change to the metabolic action which leads to a change in the homeostasis leading to further degenerative actions starting within the body.


The population with degenerative processes happening in their body are likely to be older, and on top of the issues they have, their body will be slower to adapt and change. Especially if they have lived a sedentary life. With osteoporosis, it might not even be possible to work with them if it is severe. Be careful around small delicate bones like the 12th rib this is advanced work and requires a high level of skill and concentration. Work with a movement practitioner or a physiotherapist who specialises in this type of rehabilitation to start reactivating the area. All of the degenerative processes mentioned above require respect, caution and a realisation there is a limit to the work and the results achieved.

In conclusion, all though it may not be possible to achieve structural change, there will be many people who achieve great results in reduced pain and improved function of their bodies leading to a vastly improved way of life.

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