Heads Up: Are You Developing “Text Neck”?

Billions of people now walk around hunched over their smartphones. The hazards of texting include motor vehicle accidents, exposure to EMFs, and walking into fountains—but here's a new one to add to the list: "text neck."

New York spine surgeon Kenneth Hansraj performed a study to assess the incremental effects of a forward-tilted head posture on your cervical spine. His conclusions, published in Surgical Technology International in November 2014,¹ have attracted significant media attentinbson.

Dr. Hansraj summarized his findings as follows:²

"The weight seen by the spine dramatically increases when flexing the head forward at varying degrees. Loss of the natural curve of the cervical spine leads to incrementally increased stresses about the cervical spine. These stresses may lead to early wear, tear, degeneration, and possibly surgeries.

While it is nearly impossible to avoid the technologies that cause these issues, individuals should make an effort to look at their phones with a neutral spine and avoid spending hours each day hunched over."

Imagine Your Head Weighing as Much as Several Bowling Balls!

Your head weighs about 12 pounds, and if you spend a significant amount of time hunched over—meaning, your head bent forward and down as when texting, emailing, or gaming—the forces on your cervical spine are substantial.

The degree to which this position affects your spine depends on the angle of the bend and the amount of time you spend with your head in this position.

In his study, Dr. Hansraj determined that, when you bend your head forward at 15 degrees, its weight effectively increases from 12 pounds to 27 pounds. At 45 degrees, your head exerts 49 pounds of force, and at 60 degrees, 60 pounds—this is like carrying an eight year-old child around on your neck for several hours a day!

Others claim that the pressure on your spine doubles with every inch of head tilt.³ In 2013, some 1.91 trillion text messages were sent in the US, according to CTIA, The Wireless Association.⁴ Smartphone users spend an average of two to four hours per day hunched over their devices, which amounts to 700 to 1,400 hours per year that they are exerting this stress on their spines.  High schoolers may be even worse off, spending an additional 5,000 hours in this position, according to the study.

According to Hansraj,⁵ "text neck" may lead to early wear and tear on your spine and early spinal degeneration. As you repeatedly pull and stretch this area, it may become inflamed over time, which can result in muscle strain, pinched nerves, herniated discs, and abnormalities to your neck's natural curvature.

This forward neck posture has also been linked to headaches, neurological problems and heart disease. That is sad because it is relatively easy to assume a healthy natural posture with your neck. All you need to do is slide your chin up at 45 degrees, which puts your head over your shoulders and causes your chest to move forward.

Not Everyone Agrees with Dr. Hansraj

Although most agree that cell phones contribute to poor posture to some degree, a few experts don't accept the conclusion that cellphones are responsible for a spate of spinal wreckage.  

Washington University neurosurgeon Ian Dorward has criticized Hansraj's study for not specifying where the numbers came from. Dr. Dorward makes the point that people have evolved to have their heads flexed in a variety of different angles and postures without issue, such as when reading a book.⁶ 

He argues that the biomechanical forces on the spine and poor posture related to obesity and excessive sitting are a far more serious concern—which I believe is a legitimate argument.

Dorward does concur that the musculoskeletal problems associated with spending an inordinate amount of time with your head in a forward flexed position is a valid concern   However, Dr. Hansraj may be onto something when it comes to the effects on children:

"The problem is really profound in young people. With this excessive stress in the neck, we might start seeing young people needing spine care. I would really like to see parents showing more guidance."

In a recent UK study⁷ involving 10 year-olds, up to 10 percent may already have the precursors to bad backs, and nine percent of the kids already showed degenerative disc problems with at least one disc. The researcher attributed this to lugging heavy school books, watching TV, and playing video games, but texting may play a significant role.

Rates of back pain are on the rise for children⁸ as well as adults. This can partly be blamed on our modern technological habits, but greater factors may be poor diet, inactivity, excessive sitting, and obesity.

More Than Just a Hunch

Posture is more powerful than previously thought, influencing your thoughts, feelings, and actions. Not only can poor posture affect your physical body, but it's also been shown to affect your mood, self-concept, and how others perceive you.

For example, slouching compresses your internal organs, restricting their function and making you appear heavier. An open, expansive, upright posture is considered a "power posture" by humans, as well as by other primates.⁹ Posture can even affect your memory recall:¹⁰

"When sitting in a collapsed position and looking downward, participants in a study found it much easier to recall hopeless, helpless, powerless, and negative memories, than empowering, positive memories.

When sitting upright and looking upward, it was difficult and for many of the participants nearly impossible to recall hopeless, helpless, powerless, and negative memories and easier to recall empowering, positive memories...

Sitting up straight helps increase blood flow and oxygen to the brain, and according to some accounts, by up to 40 percent."

Poor posture can have wide-ranging detrimental effects on your body, several of which are listed below. Therefore, paying attention to your posture— which includes the position of your head, neck and shoulders—should be an important part of your overall health plan.

When It Comes to Serious Health Problems, 'Text Neck' Pales in Comparison to Prolonged Sitting

Prolonged sitting is not conducive to good posture, but recent studies indicate that postural problems are not the only worry if you are tied to your desk. Prolonged sitting actively promotes dozens of chronic diseases, including excess weight, type 2 diabetes, and premature death, as discussed by Dr. James Levine in the above interview. Dr. Levine is the author of Get Up!: Why Your Chair Is Killing You and What You Can Do About It. Studies looking at life in agriculture environments show that people in agrarian villages sit for about three hours a day. Compare that to average American office workers who may sit for 13 to 15 hours a day—and odds are their heads are hunched over for the majority of that time.

But what if you're going to the gym every night after work—does that protect you against the damaging effects of inactivity? Mounting research says NO, and the evidence is overwhelming. More than 10,000 studies now illuminate the many ways that sitting is devastating to health. According to Dr. Levine, there are at least 24 different chronic diseases and conditions associated with excess sitting. One analysis of 18 studies determined that those who sat for the longest periods were twice as likely to have diabetes or heart disease, compared to those who sat the least.¹⁷ According to lead researcher Thomas Yates, MD:¹⁸

"Even for people who are otherwise active, sitting for long stretches seems to be an independent risk factor for conditions like diabetes, cardiovascular disease, and kidney disease."

A 2009 study¹⁹ produced similar findings. Higher sitting times correlated with increased risk for type 2 diabetes, heart disease, and other prevalent chronic health problems—even for those who exercised regularly. Simply put, the more you sit, the higher your risk for chronic health problems. On the other hand, if you spend less time in a chair and more time doing low-intensity, everyday activities, your risk for chronic health problems falls significantly, regardless of whether or not you go to the gym.

Gravity Is Both Friend and Foe

Gravity keeps our tissues strong by exerting continuous forces on our bodies, but it can be damaging if your posture is poor. In an anti-gravity situation such as in outer space, your body deteriorates far more rapidly, which is why such time and energy is devoted to protecting astronauts from its effects. According to Dr. Joan Vernikos, former director of NASA's Life Sciences Division and author of the book Sitting Kills, Moving Heals, sitting for extended periods of time mimics a low-gravity environment.

According to Dr. Vernikos: "The key to lifelong health is more than just traditional gym exercise, three to five times a week. The answer is to rediscover a lifestyle of constant, natural low-intensity non-exercise movement that uses the gravity vector throughout the day."

By engaging in simple, ordinary activities—things like cooking, gardening or picking up a sock off the floor—you increase the force of gravity on your body. Studies tell us that in order to be effective, the activity needs to be spread out. According to Dr. Vernikos' research, the minimum number of times needed to interrupt sitting in order to counteract cardiovascular risks is in the neighborhood of 35 times per day. This helps explain why vigorously exercising a few times a week is inadequate. If you want to improve your posture and your overall health, it's imperative that you engage in intermittent movement throughout your day, and avoid sitting as much as possible.

The Best Cure for Your Posture: Intermittent Movement

Intermittent movement (also called non-exercise activity) is beneficial for your posture because you avoid sitting hunched over for extended periods of time. As I've become increasingly aware of the importance of intermittent movement, I've assembled a variety of strategies to help you counter the ill effects of sitting.

My approach incorporates posture correction and core strengthening exercises, Dr. Vernikos' recommendation to stand up frequently, and a variety of quick exercises you can do throughout the day. In terms of operating electronic devices with proper posture, practice looking down at your device with only your eyes, instead of bending your neck—and try holding your device up higher. If you wear glasses, make sure your prescription is current.

• Stand up as much as possible. You might want to experiment with a stand-up desk. You certainly don't need to stand all day long but you are likely far better off standing as your posture and your likelihood of movement tends to improve. If you cannot work standing up, make an effort to interrupt your sitting frequently throughout the day. Strive to get up around 35 times a day, evenly spaced throughout the day.  
• Walk more. Wear a fitness tracker, and set a goal of walking 7,000 to 10,000 steps each day, which is more than five miles. While you could probably walk this distance all at once, it's best to spread it out evenly throughout the day, as much as your schedule will allow. I tend to walk 12,000-16,000 steps a day and concentrate most of that during my solar noon walk on the beach. Get in the habit of using the stairs and parking farther away from entrances.
• Take 30- to 60-second exercise breaks. While Dr. Vernikos says that simply standing up and sitting back down may be enough to do the trick, you may want to do more. While you're up, try adding a variety of different body movements when you stand up throughout the day. I've compiled a list of 30 intermittent movement videos to give you some ideas.
• Foundation Training. I regularly do Foundation exercises developed by Dr. Eric Goodman, which address weakness and imbalance in your posterior chain of muscles. To learn more about this, I suggest listening to my interview with Dr. Goodman.
• Posture Training. Poor posture is more the norm than the exception in the US. An estimated 80 percent of the US population will experience back pain at some point in their lives, and poor posture is the leading cause. One approach is the Gokhale Method, which helps retrain your body back to its "primal posture" and correcting the habits that may be causing pain.