You may have noticed, over years of practice, the appearance of a bulge at the junction between the neck and the upper back. This phenomenon, commonly known as a "buffalo hump," is more common than one might think among professionals working in a bent posture — and foot care is no exception.
Two very distinct causes
Buffalo hump refers to a visible accumulation of tissue in the cervicothoracic region. It can be pathological — associated with Cushing's syndrome, prolonged corticosteroid therapy, or certain metabolic diseases — or, far more frequently encountered by clinicians, postural. In the latter case, it is not a fatty deposit but a progressive structural adaptation: increased thoracic kyphosis, chronic forward head posture, soft tissue thickening, and persistent muscle tension.
Why are foot care professionals at risk?
Podiatry work involves, for several hours a day, a demanding posture: head bent forward, protracted shoulders, rounded upper back, and visual attention concentrated on a small area. In the long term, this leads to a shortening of the pectoral muscles, a weakening of the scapular stabilizers, and an accentuation of thoracic kyphosis — precisely the conditions that give rise to this characteristic cervicothoracic protrusion. The accompanying signs are often well-known: neck pain, cervicogenic headaches, tension in the trapezius muscles, and shoulder fatigue at the end of the day.
Prevent and correct
This deformity is largely preventable and often reversible with early intervention. From an ergonomic perspective, the key is to bring the foot towards you rather than the other way around, adjust the patient's chair height, and use magnifying loupes to limit neck flexion. In parallel, a targeted strengthening program for the rhomboids, middle and lower trapezius, and thoracic extensors — supplemented by stretches for the pectorals and anterior neck muscles — forms the basis of effective postural rehabilitation. Pulling exercises (rowing, resistance bands) are particularly recommended to counteract the effects of hours spent in flexion.
When to consult?
If the hump appears quickly, increases in size, or is accompanied by unexplained weight gain, high blood pressure, muscle weakness, or purplish stretch marks, a medical cause — especially excess cortisol — must be ruled out without delay.
For foot care professionals, a buffalo hump is primarily a sign of chronic postural adaptation. It is not an inevitability: taking care of one's own body mechanics is, in itself, a clinical act.
This article is provided for informational and educational purposes only. It does not constitute medical advice and is not a substitute for a consultation with a qualified healthcare professional. If you experience symptoms or have concerns about your health, consult a doctor or specialist.