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The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers.

Since an early age, most people have had the experience of being told to stand up straight and stop slouching, whether it comes from a physiotherapist, a teacher, or even your own mother. Poor posture is widely theorised to increase the risk and be a direct cause of a number of injuries and conditions.Image

Addressing poor posture and mechanics is common place for physiotherapists, and is often a key part of rehabilitation in shoulder injuries, due to the role poor posture is thought to have on the movement of the scapula (shoulder blade). Today’s blog is looking at a research article by Stephanie Lynch and her colleagues at the University of North Carolina, that examined firstly whether an exercise programme designed to improve forward head and rounded shoulder made measurable improvements, and secondly whether improving these postures helped reduce pain in elite swimmers suffering with “swimmers shoulder”.

The authors recruited 28 elite level collegiate swimmers who presented with a forward head round shoulder posture and shoulder pain to take part in a non-laboratory based experimental study. The Swimmers were split up into two groups, experimental and control. The experimental group was given postural exercises designed to correct the posture for an 8 week period, these involved strengthening of the lower and middle fibers of trapezius and serratus anterior and stretching of pectoralis minor and cervical extensors. The control group was to carry on as normal. Prior to starting the exercises, both groups were assessed for the postural position, shoulder pain and function, and maximal strength of muscles around the shoulder blade.The results revealed that the experimental group had decreased forward head and shoulder position, suggesting that posture did improve after the exercise programme. The authors also reported that pain did improve in the experimental group. Interestingly, there was no difference in strength between the two groups after the exercise program.

Perhaps the most important finding from this study was the improvement in posture following the exercise programme. For physiotherapists, who regularly provide exercises to improve posture as part of rehabilitation programmes for a number of conditions, the finding provides evidence that these exercises can help make postural improvements. The authors also concluded that addressing posture can help improve shoulder related pain and prevent it from re-occurring. Despite these findings, all research has strengths and limitations which must be considered.Strengths:

  • The authors described very detailed but clear instructions about how they carried out their study, which allows the reader to understand the process of the study.
  • The authors conducted a smaller experiment, known as a pilot study before they carried out the main study. This helped them iron out any flaws in their procedure and ensure the measures were accurately tested.


  • Although the study provided information on the age, BMI, and distance the participants swam, it gave no indication as to whether they were male or female, which makes it difficult to generalise the results of the study to the wider population.
  • The pectoral stretch was only maintained for 5 seconds in each repetition, current guidelines suggest that at least a 30-second stretch is required to gain length in muscle tissues. Suggesting, postural improvements may have been greater if the stretch was held for longer.

Although no study is perfect and often requires further research to develop a more conclusive argument. This research does indicate that posture can be improved, and although it may not come from just trying to sit up straight, incorporating these exercises may improve your posture and even reduce your likelihood of developing shoulder injuries.