I am 62 years old and have noticed in recent years that I am becom­ing very round-​shouldered. My back­bone sticks out and I am devel­op­ing what looks like a hump. Is this to do with hav­ing bad pos­ture? Is there any­thing I can do to improve it?

The clas­sic “dowager’s hump” con­jures up images of a little old lady with a walk­ing stick and a very bent-​over back that per­man­ently bows her head. Thankfully there are fewer cases these days of this very extreme spinal dis­tor­tion, which is gen­er­ally the res­ult of mul­tiple back frac­tures over time caused by osteo­porosis (brittle bones). Back frac­tures tend to be very pain­ful.

After men­o­pause all women are at greater risk of devel­op­ing osteo­porosis, because the hor­monal changes at mid­life cause rapid drop-​offs in bone dens­ity. Later in life men, too, are more sus­cept­ible to bone-​thinning.

The first thing, then, is to check out whether you have osteo­porosis, or any other dis­ease pro­cess that is affect­ing your mid-​spine. The GP can arrange the rel­ev­ant tests. The National Osteoporosis Society has excel­lent inform­a­tion and advice if you do have osteo­porosis; a com­bin­a­tion of exer­cise, good diet and med­ic­a­tions usu­ally effect­ively sta­bil­ises the con­di­tion.

Whether or not you have thin­ning bones, you should cer­tainly do some­thing about your pos­ture. Half a life­time of acci­dental bad habits – slouch­ing around, hunch­ing over the com­puter, peer­ing over the steer­ing wheel and so on — can all con­trib­ute to sig­ni­fic­ant pos­tural changes that might leave you more than a little round-​shouldered.

Do your own pos­ture check. Get a friend to take pho­tos or set up a couple of mir­rors so you can look at your side­ways pro­file while stand­ing nor­mally. Ideally the top of your hip, top of your arm, neck and ear lobe should all sit on the same ver­tical straight line, which also goes down to your ankle. If your shoulders, neck and head are for­wards of this line, your pos­ture could do with some improve­ment.

I really recom­mend seek­ing pro­fes­sional help at this point so you can learn exactly how to cor­rect your pos­ture. You may even bene­fit from an ini­tial visit to an osteo­path or physio­ther­ap­ist to do some work on any major imbal­ances around your shoulders and neck.

Alexander Technique, Pilates and Tai Chi can all help to re-​balance your muscles and cor­rect your pos­ture, whether sit­ting, stand­ing or mov­ing around. Gym or home exer­cises can help, too, but in all cases check that your instructor is fully qual­i­fied for your needs as an older adult. You can usu­ally expect to be given lots of back and abdom­inal muscle strength­en­ing exer­cises, plus stretch­ing for tight chest, shoulder and neck muscles. The pro­gramme should tackle your whole pos­ture, not just the bit around your slop­ing shoulders.

There is no quick fix for retrain­ing your pos­ture. But within a couple of months you should both feel and see the dif­fer­ence as you regain a more upright, taller and alto­gether more attract­ive way of car­ry­ing your­self.