Just like every other part of the body, variations in shoulder shape are normal. Shoulders come in all shapes and sizes — they can be broad, rounded, or sloped.

In some instances, a sloped shoulder may be the result of a genetic condition. Sloped shoulders may also be caused by lifestyle habits.

In this article we’ll discuss what causes sloped shoulders. We’ll also look at whether or not their shape can be altered.

Sloped shoulders differ from rounded or hunched shoulders, which may be caused by poor posture, excess weight, or conditions such as scoliosis.

  • Rounded shoulders appear rotated towards the front of the body.
  • Hunched shoulders appear lifted up towards the neck.
  • Sloped shoulders lack a horizontal plane and slope downwards.

If you have extremely sloped shoulders that completely lack a horizontal plane, you may have one of several genetic conditions — such as Williams or CHARGE syndrome, described below.

You may also be a bodybuilder who has overworked their trapezius muscles. This can happen in either men or women.

Sloped shoulders are associated with a number of genetic conditions. They may also be caused by lifestyle factors.

Causes of sloped shoulders include:

Weight lifting

Bodybuilders who overbuild their trapezius muscles while neglecting their deltoid muscles may acquire a sloped-shoulder look.

One exercise which might cause this to happen is the shoulder shrug. Ironically, this exercise is meant to eliminate sloping.

Shoulder shrugs build up the upper trapezius muscles. If done with too many reps or too much weight, an exaggerated, sloped shoulder may result.

Overdoing heavy deadlifts can also have this effect.

Prolonged shoulder pressure

If you spend lots of time hauling around an overly stuffed shoulder bag, you may wish to rethink that habit.

Weighing down the shoulders with heavy bags on straps may shorten the levator scapulae muscles in the neck. This can cause the shoulders to take on a sloped appearance.

One possible example of this can be seen in early 19th century portraiture. During this period, many women of the upper classes appear to have exaggerated, sloped shoulders.

When coupled with tiny waists, this look was highly prized.

It’s been hypothesized that the shoulder shape of women during this era was influenced by the heavy weight of their petticoats. These garments were worn day in and day out, starting in the teenage years.

Petticoats weighed approximately 10 pounds, and were attached to boned corsets by shoulder straps, which weighed down shoulders for hours at a time.

While not proven, this theory may show the effect of very prolonged shoulder pressure.

Williams syndrome

Williams syndrome is a rare, genetic condition caused by a chromosomal anomaly.

Children born with Williams syndrome may have heart problems due to a narrowing of the aorta. They may also have sloping shoulders, elfin-like facial features, and an elongated neck.

Williams syndrome affects all ethnicities and genders equally.

CHARGE syndrome

The word “CHARGE” is an easy way to remember how this syndrome presents:

People born with this genetic condition often, but not always, have sloped shoulders. Some children with CHARGE syndrome who have sloped shoulders have trouble lifting their arms above their heads.

The most common trait that individuals with CHARGE syndrome develop are colobomas, or holes in the eye, caused by missing tissue in the structure which forms the eye.

The low-set, steeply sloped shoulders associated with genetic conditions may sometimes cause pain or hardship.

If you or your child have sloped shoulders caused by a genetic condition, talk to a doctor about treatment options, such as physiotherapy. In some instances, a surgical solution may be recommended.

When sloped shoulders are caused by over-exercising the trapezius, you may be able to alter their shape over time by changing the way you work out.

One way to do this is by placing more emphasis on the deltoids, with exercises such as the anterior deltoid raise. Working with a coach who can instruct you on proper form and positioning may help.

If your shoulders are sloped, the levator scapulae muscles at the back and sides of your neck may be shortened. Physiotherapy can help elongate these muscles. This may help reduce sloping, plus alleviate tension and pain in the area.

Working with a trainer can help you identify and target specific muscle groups in your shoulders, arms, and back, creating a balanced lifting routine. This may help you avoid sloped shoulders.

Maintaining good posture can also help. Standing and sitting properly helps to align your spine, neck and head, giving your shoulders a broader shape.

Doing shoulder stretches may help elongate the levator scapulae muscles, keeping them long.

Having sloped shoulders can cause tension to develop in the back and sides of the neck. The resulting pain or discomfort may be more pronounced if you carry heavy packages while your arms are held straight down on each side.

Dropped shoulder syndrome isn’t the same as sloped shoulders. It’s earmarked by cervical radiculopathy, a condition caused by inflammation or damage to a nerve root in the cervical spine.

  • Causes. Cervical radiculopathy may be caused by muscle spasms, cervical disc hernias, or age-related wear-and-tear of the spinal discs located in the neck. Dropped shoulder syndrome may also be caused by weak or too-long neck muscles, which elevate the trapezius and other muscles in the shoulder, causing compression of the cervical nerve root.
  • Symptoms. Unlike sloped shoulders, people with dropped shoulder syndrome typically experience shooting pain, which can be significant. Chest pain, tingling, and numbness may also occur.
  • Diagnosis. Dropped shoulder syndrome may initially be diagnosed visually by a medical professional, but requires confirmation with tests such as an X-ray, and an electromyography (EMG). An MRI may also be done.
  • Treatment. This condition may be treated with exercises designed to strengthen the muscles that lift the shoulder up. One study showed significant improvement of this condition through exercise in 12 to 18 weeks.

Sloped shoulders differ from rounded or hunched shoulders, and are not the same thing as dropped shoulder syndrome.

Sloped shoulders may be associated with a genetic condition or caused by lifestyle factors.

Overworking specific muscle groups in the shoulders may cause sloping. It may also be caused by prolonged weight from items held on the shoulders, such as heavy shoulder bags.