We live in a tech-dependent world where interactions are dependent on swiping, scrolling, flipping and tapping. While dependence on our smartphones isn’t new news, the health implications are making big headlines. We can’t deny that our cell phone usage is an unhealthy distraction. Research has determined that texting, and to a lesser extent reading on a device, modify gait performance. If the body is not functioning at optimal performance, we predispose ourselves to musculoskeletal injuries such as, but not limited to: neck pain, tension, trigger points, mid-back strain, low back pain, and shoulder pain. We must learn to avoid prolonged postures, and if inevitable have a plan to protect the body.
What are Musculoskeletal Disorders?
The term musculoskeletal disorders (MSDs) are used to describe conditions that affect the muscles, bones, and joints. Common MSDs linked to cell phone use include hand, wrist, forearm, arm and neck pain. MSD’s that are linked to high cell phone use are more often grouped into minor physical disabilities. If left untreated, these disorders can progress to chronic conditions. Chronic conditions are those which last 3 months or more. MSDs are extremely common, and your risk increases* with age. Early diagnosis is the key to easing pain syndromes in order to decrease* the likelihood of further body damage. Protecting posture is a vital component of reducing* technology-related MSDs.
Be aware of posture change
We tend to overlook the idea that our smartphones can be causing the body harm. We associate instead with the conveniences the device provides us. In one hand-held device we surf the net endlessly, play games, read the news, pay our bills, shop online, and can even monitor our children as they sleep in another room. However, when we talk, text or read we lack ergonomics and the phone dictates our biomechanics. It is these working positions that do not support a neutral spine and we adopt postures that increase* the risk of musculoskeletal disorders. How does this happen? First we must understand the neutral spine, and how it works.
What is a Neutral Spine?
The spine is our supportive structure; similar to the framework of a house. We have seven cervical (neck) bones (vertebrae), twelve thoracic (midback) vertebrae, five lumbar vertebrae (low back), a sacrum, and a tailbone (coccyx). Vertebral discs are located in between the bones and their primary function is to act as shock absorbers. There is a total of twenty-three vertebral discs in the spinal column.
Specific problems with any of these discs may prompt different symptoms, including back pain, neck pain, and sciatica.
These bones and discs work together to form the 4 spinal curves:
- Cervical Curvature
- Thoracic Curvature
- Lumbar Curvature
- Sacral Curvature
This alignment is designed to allow you to move throughout the day and complete various tasks. It is important to be aware of the plumb line, a real or imaginary line that is drawn from the center of the head downward, and expected to intersect with the human body at specific points. The plumb line is used to explain how forces interact with spinal curves. The first plumb line is straight on, which we call the anterior-posterior view. In this view, the plumb line should run vertically down the midline of the body dividing it symmetrically into right and left halves, indicating even weight distribution on both sides.
The second view is a side view and the plumb line should run vertically and bisect the ear, the cervical vertebral bodies, the center of the shoulder joint, the lumbar vertebral bodies, the center of the hip joint, just behind the knee cap, and through the ankle. This line is a great tool to determine whether there is an even distribution of weight between the front and the back of the body. Try taking a picture of yourself, or ask a friend to take some for you. Research indicates that frequent smartphone use can lead to the use of a non-neutral neck posture. This frequent deviation from the plumb line can lead to the development of musculoskeletal disorders.
Risk Posture Types to be Aware of:
Increased neck and thoracic flexion
Loss of the cervical curvature
Forward Head Posture and rounded shoulders
Anterior Pelvic Tilt
The Slumper and the Giraffe are the most common presentations to expect when examining the effects of high technology use. The key to good back posture is to keep the right amount of curve so that we place the least strain on supporting muscles, joints and ligaments.
By using the risky posture characters, it may make it easier to compare to the correct posture plumb line seen at the far left of this illustration. This exercise is done to visualize better the plumb line and make a correction as you go about your day completing different activities.
Summary of Postural Changes with Talking and Texting:
Repetitive or prolonged head flexion posture (The Slumper) while using a smartphone is known as one of the risk factors for pain symptoms in the neck. Study results suggest that text messaging, which is one of the most frequently used categories of smartphone, could be a main contributing factor to the occurrence of neck pain of heavy smartphone users. Head flexion, or bringing your chin to your chest is a deviation from the natural curve of the neck. Yes, the neck is made to move in 6 different planes of motion. However prolonged postures are detrimental. So exactly how much strain are we adding to the body when we work in risky postural zones? Research indicates that the compressive load on the cervical vertebrae (bones) and discs in the neck during forward flexed position was 10kg (22.04 lbs) greater than in the upright neck position!
Non-invasive Interventions for Prevention of MSD’s:
Avoid the development of chronic conditions by addressing the following lifestyle changes.
Avoid bending your neck forward and instead focus straight ahead, relax your shoulders, slightly squeeze your shoulder (scapulae) blades together and pull your head back. While many treatments have been advocated for postural correction, research supports that Practice of relocation of head on the trunk can yield effective results.
Stretching is a form of physical exercise in which a specific muscle or tendon (or muscle group) is deliberately elongated or stretched in order to improve* the muscle’s felt elasticity and achieve comfortable muscle tone. The result increased muscle control, flexibility, and range of motion. Elongated muscles are less susceptible to injury.
The centers for disease control recommend strength training on 2 or more days a week that work all major muscle groups (legs, hips, back, neck, abdomen, chest, shoulders, and arms). Choose varied workouts to focus on all 4 spinal curvatures. It is especially beneficial to focus on the deep neck muscles because studies have shown it can improve* the ability to maintain an upright posture of the cervical spine.
Ice applications are known for their analgesic effect. The most effective protocol is repeated application of 10 minutes duration. The target temperature is reduction* of 10-15 degrees C. Using repeated, rather than continuous, ice applications helps sustain reduced* muscle temperature without compromising the skin and allows the superficial skin temperature to return to normal while deeper muscle temperature remains low.
Prevention is the key to success, however seeking the guidance of a health care professional can assist your postural retraining. Remember, your spine goes everywhere with you, take care of it.
- PLoS One. 2014; 9(1): e84312.
- Ergonomics. 2015 Feb;58(2):220-6.
- J Phys Ther Sci. 2015 Jan; 27(1): 15–17
- J Manipulative Physiol Ther. 1999 Nov-Dec; 22(9):594-609.
- International Journal of Sports Medicine [2001, 22(5):379-384]