Specialista in Ortopedia Pediatrica
Postural kyphosis / rounded back
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
1.Doorway chest stretch
Stretches anterior muscles that pull the shoulders forward
Standing in a doorway, forearms on both sides with elbows at shoulder height. Step forward bringing the chest through until a stretch is felt at the front of the shoulders. Hold while breathing deeply, without arching the lower back.
3 × 30 seconds, twice daily
2.Wall angels
Shoulder mobility and scapular stabiliser activation
Back against the wall, feet slightly forward, lower back in contact. Arms at 90° with elbows and backs of the hands touching the wall. Slide the arms upward keeping contact, then return. If the hands lift off, stop earlier: that is the current limit.
3 × 10 slow reps
3.Prone Y-T-W
Strengthens the back, lower trapezius and rhomboids
Prone on the floor, forehead resting down. Lift the arms forming first a Y (arms up and open), then a T (arms out to the side), then a W (elbows bent close to the body). Squeeze the shoulder blades in each position, holding 3 seconds. Keep the neck long, do not lift the head.
3 sets of 8-10 reps per position
4.Resistance band row
Pulling strength for the back muscles
Band anchored at chest height (door handle). Standing, arms extended forward, pull the handles toward the body bringing the elbows back and close to the sides, squeezing the shoulder blades. Return slowly under control (2-3 seconds). Keep the trunk still: do not compensate with the back.
3 × 12-15 reps, 3 times per week
5.Thoracic extension over a foam roller
Restores extension of the thoracic spine
Lie with the foam roller placed across the upper back, knees bent and hands behind the head supporting it. Gently extend backward over the roller, then come up. Move the roller a few centimetres and repeat over 3-4 levels. Never force the lower back.
2 × 8 extensions per level
6.Prone extensor endurance hold (Sorensen)
Trains thoracolumbar extensor endurance, the typical deficit in rounded back
Prone on a table with the trunk free beyond the edge from the pelvis up, arms crossed on the chest and ankles held by an adult. Lift the trunk until aligned with the legs (no further) and hold while breathing normally. Stop if lower back pain appears.
3-5 holds of 10-20 seconds, progressing toward 60 seconds, 3 times per week
7.Cat-cow with extension focus
Gentle mobility and thoracic spine awareness
On all fours, hands under shoulders and knees under hips. Alternate arching up (cat) and extending (cow), focusing on the thoracic region during the extension phase: open the chest forward rather than only dropping the lower back.
2 × 10 slow reps
8.Chin tuck
Counteracts forward head posture (text neck)
Seated or standing with a straight back. Draw the chin straight back, as if making a "double chin", lengthening the back of the neck upward. Do not bend the head down: the movement is a backward translation. Hold 5 seconds and release.
3 × 10 reps, several times daily
9.Front plank
Trunk stability supporting upright posture
Prone on forearms with elbows under the shoulders, body in line from head to heels. Start with knees on the floor and progress to the toes once the hold is stable. Engage the abdominals and glutes, avoiding the pelvis sagging.
3 × 20-40 seconds
10.Hip flexor (iliopsoas) stretch
Stiff hip flexors alter pelvic and spinal alignment
Lunge with the back knee on a cushion. First squeeze the glute of the back leg to tilt the pelvis posteriorly, then gently push the hips forward. Keep the back straight: if it arches, the stretch is lost.
3 × 30 seconds each side, daily
11.Hamstring stretching
Short hamstrings favour trunk collapse into flexion
Supine, one leg extended and the other lifted with a strap around the foot. Straighten the knee until tension is felt behind the thigh, keeping the lower back on the floor. Stop at the first tension, without pain.
3 × 30 seconds each side, daily
12.Posture at the desk and with screens
Postural education for daily activities
Set up the workstation: monitor at eye level, backrest supporting the back, feet flat on the floor, elbows and knees at 90°. Breaks every 20-30 minutes to stand and move. With a smartphone, bring it to eye level instead of bending the head down.
Every day, breaks every 20-30 minutes
13.Recommended sports
Sport supports the work on posture
Swimming (especially backstroke and breaststroke), climbing, gymnastics, dance, yoga and martial arts are excellent for postural kyphosis as they strengthen the extensors and improve body awareness. Any regular activity is preferable to being sedentary.
2-3 sessions per week
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- Fever, redness or warmth of the joint, or inability to bear weight
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Ortopedia Pediatrica - ASST Gaetano Pini-CTO
ortopediaevolutiva.com • 26/08/2026
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MioDottoreBefore You Start
Who is this guide for?
Adolescents with postural kyphosis (not structural). For Scheuermann's disease, consult specialist.
What you need
Clear floor space, mat or soft surface, comfortable clothing. Some exercises may require resistance bands or supports.
Suggested frequency
Usually 1-2 times daily, as directed during the visit. Consistency is more important than intensity.
Common mistakes to avoid
- •Focusing only on back while ignoring core and hips
- •Prolonged incorrect postures during study/gaming
- •Occasional exercises instead of daily
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
Detailed Exercises
- 1
Doorway chest stretch
Stretches anterior muscles that pull the shoulders forward
Standing in a doorway, forearms on both sides with elbows at shoulder height. Step forward bringing the chest through until a stretch is felt at the front of the shoulders. Hold while breathing deeply, without arching the lower back.
3 × 30 seconds, twice daily - 2
Wall angels
Shoulder mobility and scapular stabiliser activation
Back against the wall, feet slightly forward, lower back in contact. Arms at 90° with elbows and backs of the hands touching the wall. Slide the arms upward keeping contact, then return. If the hands lift off, stop earlier: that is the current limit.
3 × 10 slow reps - 3
Prone Y-T-W
Strengthens the back, lower trapezius and rhomboids
Prone on the floor, forehead resting down. Lift the arms forming first a Y (arms up and open), then a T (arms out to the side), then a W (elbows bent close to the body). Squeeze the shoulder blades in each position, holding 3 seconds. Keep the neck long, do not lift the head.
3 sets of 8-10 reps per position - 4
Resistance band row
Pulling strength for the back muscles
Band anchored at chest height (door handle). Standing, arms extended forward, pull the handles toward the body bringing the elbows back and close to the sides, squeezing the shoulder blades. Return slowly under control (2-3 seconds). Keep the trunk still: do not compensate with the back.
3 × 12-15 reps, 3 times per week - 5
Thoracic extension over a foam roller
Restores extension of the thoracic spine
Lie with the foam roller placed across the upper back, knees bent and hands behind the head supporting it. Gently extend backward over the roller, then come up. Move the roller a few centimetres and repeat over 3-4 levels. Never force the lower back.
2 × 8 extensions per level - 6
Prone extensor endurance hold (Sorensen)
Trains thoracolumbar extensor endurance, the typical deficit in rounded back
Prone on a table with the trunk free beyond the edge from the pelvis up, arms crossed on the chest and ankles held by an adult. Lift the trunk until aligned with the legs (no further) and hold while breathing normally. Stop if lower back pain appears.
3-5 holds of 10-20 seconds, progressing toward 60 seconds, 3 times per week - 7
Cat-cow with extension focus
Gentle mobility and thoracic spine awareness
On all fours, hands under shoulders and knees under hips. Alternate arching up (cat) and extending (cow), focusing on the thoracic region during the extension phase: open the chest forward rather than only dropping the lower back.
2 × 10 slow reps - 8
Chin tuck
Counteracts forward head posture (text neck)
Seated or standing with a straight back. Draw the chin straight back, as if making a "double chin", lengthening the back of the neck upward. Do not bend the head down: the movement is a backward translation. Hold 5 seconds and release.
3 × 10 reps, several times daily - 9
Front plank
Trunk stability supporting upright posture
Prone on forearms with elbows under the shoulders, body in line from head to heels. Start with knees on the floor and progress to the toes once the hold is stable. Engage the abdominals and glutes, avoiding the pelvis sagging.
3 × 20-40 seconds - 10
Hip flexor (iliopsoas) stretch
Stiff hip flexors alter pelvic and spinal alignment
Lunge with the back knee on a cushion. First squeeze the glute of the back leg to tilt the pelvis posteriorly, then gently push the hips forward. Keep the back straight: if it arches, the stretch is lost.
3 × 30 seconds each side, daily - 11
Hamstring stretching
Short hamstrings favour trunk collapse into flexion
Supine, one leg extended and the other lifted with a strap around the foot. Straighten the knee until tension is felt behind the thigh, keeping the lower back on the floor. Stop at the first tension, without pain.
3 × 30 seconds each side, daily - 12
Posture at the desk and with screens
Postural education for daily activities
Set up the workstation: monitor at eye level, backrest supporting the back, feet flat on the floor, elbows and knees at 90°. Breaks every 20-30 minutes to stand and move. With a smartphone, bring it to eye level instead of bending the head down.
Every day, breaks every 20-30 minutes - 13
Recommended sports
Sport supports the work on posture
Swimming (especially backstroke and breaststroke), climbing, gymnastics, dance, yoga and martial arts are excellent for postural kyphosis as they strengthen the extensors and improve body awareness. Any regular activity is preferable to being sedentary.
2-3 sessions per week
Frequently Asked Questions
Is rounded back permanent or can it be corrected?
Postural kyphosis (non-structural) is correctable with consistent exercises and postural awareness. If the child can "self-correct" by voluntarily straightening up, the kyphosis is postural. Scheuermann's disease (structural kyphosis) has a bony component and requires specific treatment.
Do smartphones and video games cause rounded back?
They don't cause structural kyphosis, but prolonged forward-bent postures (head forward, shoulders closed) reinforce incorrect postural patterns. "Text neck" is a real issue: bringing the phone to eye level and taking breaks every 20-30 minutes are simple but effective interventions.
Which sport is best for rounded back?
Swimming (especially backstroke and breaststroke), climbing, gymnastics and yoga are excellent for postural kyphosis as they strengthen extensor muscles and improve body awareness. Dance and martial arts are also great. Any sport is better than being sedentary.