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Uneven shoulders: why is one of my shoulders higher than the other?

Do you have uneven shoulders? You’re not alone! Many people have one shoulder that is higher than the other. This blog post will explore the causes of uneven shoulders and discuss some treatment options.

What is meant by uneven shoulders?

Uneven shoulders occur when the two shoulders are not level with each other. As a result, there can be a slight or significant difference in height. It can range from a few millimetres to a few centimetres.

What are the consequences of having uneven shoulders?

Uneven Shouldes can cause issues

Having uneven shoulders can cause several issues, both aesthetically and functionally. Aesthetically, they can make your upper body look disproportionate. Functionally, uneven shoulders can cause pain and dysfunction in the shoulder joint and the neck and back.

What muscles, bones, and joints make up the shoulders?

Shoulder muscles front view

The shoulders are made up of several muscles, bones, and joints.

The main muscles that make up the shoulders are the following:

Shoulder muscles back view
  • Deltoids: These are the large, triangular muscles that cover the shoulder joint.
  • Rotator cuff: This group of muscles and tendons attach the shoulder blade to the upper arm bone.
  • Trapezius: This is a large, flat muscle that runs from the base of the skull to the middle of the back. It comprises Upper Trapezius, Middle Trapezius, and Lower Trapezius sections.
  • Pectoralis major and minor: These are the large muscles in the chest that attach to the shoulder blades.
  • Latissimus dorsi: This is a large muscle in the back that attach to the shoulder blades.

The bones that make up the shoulders are:

Bones that make up the shoulder
  • The clavicle is the collarbone, which attaches the arm to the body.
  • The scapula is the shoulder blade, which articulates with the clavicle and humerus (upper arm bone) to form the shoulder joint.
  • The humerus is the upper arm bone, which articulates with the scapula and clavicle to form the shoulder joint.

The joints that make up the shoulders are:

  • The glenohumeral joint is the main shoulder joint, which is a ball-and-socket type of joint. It is formed by the articulation of the humerus and scapula.
  • The acromioclavicular joint is a small joint between the clavicle and the acromion (a bony projection off of the scapula).
  • The sternoclavicular joint is a small joint between the clavicle and sternum (breastbone).
  •  

Which muscles are the scapular stabilizers?

Several muscles stabilize the scapula. These muscles are important because they keep the shoulder blade in proper alignment and prevent it from moving too much. The primary scapular stabilizers are the following:

  • Serratus Anterior: This muscle attaches to the ribs and runs along the side of the chest to attach to the scapula.
  • Levator Scapulae: This muscle attaches to the neck and runs down to connect to the scapula.
  • Rhomboids (major and minor): These muscles attach to the spine and run diagonally to connect to the scapula.

Does Scoliosis cause uneven shoulders?

Scoliosis is a condition that causes the spine to curve sideways. It can cause uneven shoulders, as well as uneven hips and waist. People with Scoliosis often have one shoulder that is higher than the other.

The side bend that accompanies Scoliosis creates a situation in which the shoulders may appear uneven due to the changes that occur below within the spine.

How can leg length discrepancy lead to uneven shoulders?

Leg length discrepancy (LLD) is a condition in which the two legs are of different lengths. It can be caused by several factors, including muscle imbalance, bone growth abnormalities, trauma, or nerve damage. In addition, LLD can lead to uneven shoulders because it causes the pelvis to tilt to one side. This tilting creates an unstable foundation for the shoulders, leading to unevenness.

Can uneven shoulders make your shoulders rotate?

Yes, uneven shoulders can cause your shoulders to rotate. When one shoulder is higher than the other, it puts the shoulder joint in a position of imbalance. This can cause the muscles and ligaments around the joint to become tight, leading to rotation.

As the rib cage on one side sits lower and shorter, it can force the shoulder blade to move outward (protract). The change in the resting position can then cause internal rotation – a turning in of the arm.

Nevertheless, as the body tries to achieve equilibrium, the internally rotated shoulder may go into a counter rotating one. This would be to maintain stability across the shoulder girdle.

What are some other causes of uneven shoulders?

There are several possible causes of uneven shoulders, including muscle imbalances, injury, and poor posture

Carrying bag on one shoulder can lead to uneven shoulders

Muscle imbalances

Muscle imbalance can occur when the muscles around the shoulder joint are not in balance. This can happen due to the overuse of specific muscles or the underuse of others. When the muscles are not in harmony, it can cause unevenness at the joint, which can lead to one shoulder being higher than the other.

As an example

When you have one dominant side, this often happens with right-handed or left-handed people. The dominant side is usually more assertive, which can cause the muscles on that side to be tighter. This can pull the shoulder up (on the dominant side), making it appear higher than the other shoulder. For example, a right-handed person may have a higher right shoulder due to tightness in the Upper Trapezius muscle, Levator Scapula, and upper back muscles. As the left shoulder (the opposite shoulder) sits lower, it can give the appearance of uneven shoulders.

Injury

Injury to the bones or muscles around the shoulder joint can cause asymmetrical shoulders, or even shoulder instability. This is often seen in athletes who participate in overhead activities, such as baseball or tennis.

Poor posture

Poor shoulder posture can also lead to uneven shoulders. When the shoulders are not in alignment, it can cause one side of the body to bear more weight than the other. This can lead to muscle imbalances and unevenness at the shoulder joint. 

Also, suppose uneven shoulders are due to side bending of the spine. In that case, there is the possibility of rotation of the spine and rib cage. This paired movement can create bad posture patterning. In addition, the changes (due to a lack of support from the spine) have the potential to lead to forward head posture.

Fracture or break in your clavicle (collarbone)

This can cause the shoulder on the injured side to appear higher than the other.

Spinal disc degeneration

As changes occur in the spine, the lack of support can cause one shoulder to drop lower than the other.

Carrying bag on one shoulder

If you often carry a bag on one shoulder, it can cause that shoulder to appear higher than the other.

Desk position

If you sit at a desk all day, your posture can suffer. You may favour one side over the other as you sit ‘down’ into the chair. This can cause one shoulder to appear higher than the other.

What are some treatment options for uneven shoulders?

There are many allied health therapists that can assist with uneven shoulders

There are several ways to treat uneven shoulders. Treatment will depend on the underlying cause of the unevenness.

For example, this is due to the following:

  • Scoliosis treatment may involve wearing a back brace or undergoing surgery.
  • For leg length discrepancy, treatment may involve using a shoe lift, physical therapy, or in extreme cases undergoing surgery.
  • For muscle imbalances, treatment may involve physical therapy or exercises to correct the imbalance.
  • Injury treatment will depend on the type and severity of the injury. In some cases, surgery may be necessary to repair bones or muscles.
  • For poor posture, treatment may involve exercises and stretches to improve posture. Physical therapy or one of many accredited allied health practices may also be recommended.
  • Desk position treatment may involve using an ergonomic desk and chair or changing your workstation.
  • Bag carrying poorly, treatment may involve carrying the bag in both hands or using a backpack.

Uneven shoulders can also be treated with massage, chiropractic care, and other allied health modalities. These modalities can help to release tension in the muscles and improve alignment at the joint.

Who can help fix uneven shoulders?

Therapist assessing shoulder balance

The treatment for uneven shoulders will depend on the underlying cause. Some possible treatments include:

  • Physical therapy: A physical therapist can help to correct muscle imbalances and improve posture.
  • Exercises: Exercises can be used to correct muscle imbalances and improve posture.
  • Massage therapy: A massage therapist can help to release tension in the muscles and improve alignment at the joint.
  • Chiropractic care: Chiropractic care can help to improve alignment at the joint and release tension in the muscles.
  • Osteopathy: Osteopathy can help to improve alignment at the joint and release tension in the muscles.
  • Physiotherapy: Physiotherapy can help to correct muscle imbalances and improve posture.
  • Movement based therapy: Movement based therapy such as yoga and pilates can help to correct muscle imbalances and improve posture.

The bottom line

If you have uneven shoulders, there are several possible treatment options available. Treatment will depend on the underlying cause of the unevenness. Some possible treatments include physical therapy, exercises, massage therapy, chiropractic care, and osteopathy. If you are unsure of the cause of your uneven shoulders, it is best to consult a healthcare professional to determine the best course of treatment.

PLEASE NOTE

PostureGeek.com does not provide medical advice. This information is for educational purposes only and is not intended to be a substitute for professional medical attention. The information provided should not replace the advice and expertise of an accredited health care provider. Any inquiry into your care and any potential impact on your health and wellbeing should be directed to your health care provider. All information is for educational purposes only and is not intended to be a substitute for professional medical care or treatment.

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