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Several types of injury can cause someone to develop uneven shoulders. People can also develop uneven shoulders due to particular habits, lifestyle factors, or muscular, bone, or neurological conditions.

In this article, we discuss the causes of uneven shoulders, exercises to stretch and strengthen the shoulder muscles, and when to see a doctor.

a doctor examining a mans shoulder to find out why it is unevenShare 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.

Find tips on how to improve posture here.

Exercises may help alleviate any pain resulting from bad posture.

Learn about exercises to help improve posture here.

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.

Learn more about scoliosis here.

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:

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

  1. 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.
  2. Gently swing the arm back and forward, then side to side, and then in a circular motion.
  3. 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

  1. 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.
  2. Hold the stretch for 30 seconds, then relax for 30 seconds before repeating with the other arm.
  3. 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.

  1. Make a loop of about 3 feet in length with the elastic band and attach the loop to a doorknob.
  2. Stand facing the doorknob, holding the band with the elbow bent to about 90 degrees.
  3. Keeping the arm close to the body, slowly pull the elbow back. The band should become more taut.
  4. 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.

A person can purchase elastic stretch bands here.

External rotation with arm abducted 90º

  1. Make a loop measuring 3 feet with the elastic stretch band. Attach the look to a doorknob.
  2. 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.
  3. Slowly raise the hand until it is in line with the head. The band should become more taut.
  4. Return slowly and repeat.

Perform this exercise three times a week, completing 3 sets of 8 repetitions each time.

Internal rotation

  1. 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.
  2. Stand with the elbow bent as though shaking someone’s hand.
  3. Keeping the elbow close to the side, bring the lower arm across the body.
  4. Slowly return and repeat.

Perform this exercise three times a week, and do 3 sets of 8 repetitions each time.

External rotation

  1. Follow steps 1 and 2 for the internal rotation exercise above.
  2. Keeping the elbow close to the side, rotate the arm outward slowly.
  3. 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.