The Spine 99
FIGURE 3.26 Improving kyphosis. (A) Strengthening upper back extensors; (B) stretching abdominal muscles and increasing upper
back range in extension; (C) technique: thoracic extension while maintaining neutral lumbopelvic alignment.
A1
BC1
A2
C2
of the shoulder termed “rolled shoulders,” this must
also be addressed (chapter 7).
However, if kyphosis is painful or pronounced,
it is important to seek a medical evaluation to rule
out Scheuermann’s disease or other medical condi-
tions. Scheuermann’s disease classically develops
around puberty and actually involves a wedging of
one or more thoracic vertebrae related to abnormal