Txt neck – What’s really going on ;)

text neck

As a chiropractor I see people with all sorts of aches and pains but one trend I have noticed is neck pain and associated problems like headaches, migraines and jaw pain on the rise over the past few years.

Often ‘poor posture’ is the generalised cause but I feel a more specific cause is right under our noses, quite literally – smart phones.

So what’s really the problem with cell phones?

Firstly it’s important to understand how the neck and spine works to best appreciate how the use of phones is damaging our health.

The spine has a number of curves that act like a suspension system, evenly distributing weight and forces without overloading one area of the spine. The neck more specifically has a gentle ‘C’ shaped curve which keeps the head upright, eyes parallel and distributes the weight of the head through the spine.

The neck vertebra are unique in their structure. Their small thin structure allows for fast, intricate and accurate movements. The further down the spine the bones become wider and thicker, dealing with the increase load that is placed on them. Think of the neck as a formula 1 car, nimble, fast and delicate. The low back vertebra are more the off road 4×4 car, sturdy and hard wearing.

The problem comes with sitting and working with things in front of us. Over time we start to slouch with the head creeping forward, which undoes the natural curves of the spine. This places huge stress on the small neck joints, which in turn causes the surrounding muscles to get tight and stiff. With every inch the neck moves forward more weight and stress is being placed on the neck vertebra. Like holding a bowling ball close to the body and then further away, the work load increases even though the weight doesn’t. We are now effectively asking the formula 1 car to go off road, not a good idea.

Over the past few years a lot of money and research has gone into ergonomics, how we should be sitting, moving and lifting. No doubt driven by fear of future litigation when it becomes apartment that the deterioration of a generation’s health may be driven by the sedentary work postures we adopt. We now know how to set up our desk station and car seat to maintain good healthy posture. But is it possible to have good posture when looking at our phone?

There are two ways to tackle this problem. Firstly look at how we use our phones and secondly how much we use our phones.

Often we hold our phone below eye level causing the head to tilt forward, past the neutral position, the danger zone. Ideally we would keep the head in neutral whilst looking at our phone but this would result in people walking around with their phone out at eye level and I don’t see that catching on very soon. The potential for technology in eye wear is a real solution to this problem but until then we need to look at the amount of time we are on the phone. Looking down for short periods of time is very safe for the neck, in fact that’s what the neck is designed to do but prolonged (over 10 minutes) bending of the neck (looking down) is what causes the muscles and joints to over stretch. Limiting use to short bursts is ideal. If you love to catch up on social media at night then try lying on your back when looking at the phone. The solution however may be as simple of not using your phone as much as we are. Not a popular option but often the simplest solution is the best one.

In the meantime here are some great stretches to help alleviate the tightness that comes from txt neck.
Stretches to help with the problem:

Rolled up towel:

Lying on the floor and placing a tightly rolled up towel under the neck for 2 minutes can help undo much of the stress from a forward head position. Great to do before bed.

rolled towel under neck

 

Movement:

Introduce movement every 20 minutes. This can be as simple as rolling your shoulders, going for a 30 second walk, standing or stretching.

Rules:

Have rules about phone use. Commuting to work – then listen to a pod cast and put your phone away. Try and refrain from looking at your phone whilst walking along the street.

phone rules

And most importantly seek professional advice from a Chiropractor, Physiotherapist or Osteopath if you are experiencing neck pain and headaches. Don’t reach for the pain killer, you’ll only delaying the inevitable.

hp-chiropractic

 

If you enjoyed this article please check out our archive for more like it. If you’d like more info please contact us via email at chiroexercises@gmail.com.au

4 Exercises to Transform Your Posture

super posture

Correct upright posture is not only essential for a healthy spine and body but crucial when making a first impression. Someone with a slouched forward drawn posture will automatically make you think they lack confidence, are passive and timid. Compare that with someone who stands tall with shoulder back and chest out, this portrays a strong confident individual. If you were having to pick between two similarly qualified candidates for a role in your organisation you’d most likely pick the one who exudes confidence.

Using good posture as a tool to portray confidence has been used by political candidates, sports professionals, musicians and those in authority for hundreds of years.

beyonce good posture

Beyonce with strong confident posture

So how can we all improve our posture? The following four simple exercises will help combat the effects of prolonged sitting which is the main contributing factor of a slouched drawn forward posture.

  1. Stretch the tight chest muscles
Stretch through a doorway,

Stretch through a doorway,

Hold for 30 seconds and repeat 3 times throughout the day

2. Strength the weak mid back muscles

Step 1

Step 1: Tall with chest raised and shoulders back.

 

Step 2 -squeezing shoulder blades together

Step 2 -squeezing shoulder blades together

 

Using a theraband and standing with good upright posture open the arms out whilst squeezing the shoulder blades together. Aim for 3 sets of 12 repetitions. If you don’t have a theraband a light 1-2kg weight will suffice

 

3. Stretch the tight hip flexors

 

Hip Flexor stretch

Hip Flexor stretch

Hold for 30 seconds and do 3 times on each leg

4. Switch your Glutes back on.

Glute bridge

Glute bridge

Before raising your buttocks off the floor lightly engage (tense) your abdominal muscles then squeeze your buttocks together and lift. Aim for 3 sets of 12 reps

Making these part of your usual exercise routine and sticking to it is a great way to improve posture. Repetition and consistency, like most things with our health and fitness, will enable you to achieve great results, great posture and hopefully future success.

Would you like a complimentary postural assessment from a chiropractor near you? Enquire via email at chiroexercises@gmail.com

Thoracic Dysfunction – My clinical observations

evolution-man-computer

Whether the presenting complaint or a cog in the chain of dysfunction I have found a restricted hyperkyphotic thoracic spine a recurrent finding in patients of all ages. Seemingly caused by the repetitive demands of daily life i.e. sitting, driving, and poor posture, this is one of the most important areas to address with patients. This article will go into detail why I think this is the case and how I go about treating it.

The knock on effects of a restricted hyperkyphotic thoracic spine are numerous. Lets go through a few of them:

  • Increased degenerative changes to the thoracic, lumbar and cervical spine. The curves of the spine work as the body’s suspension system. Beautifully distributing load,weight and forces through the frame into the ground without over-loading one area. The thoracic spine is the middle link in this suspension chain. An increase kyphosis and reduced flexibility of the thoracic means that this load cannot be distributed evenly instead being focused on key linkages of the spine, namely: C/T junction, mid-lower thoracic spine and lower lumbar spine.

  • Altered respiratory function: Reduced thoracic mobility will in turn reduce rib motion and lung capacity. The accessory respiratory muscles become over activated (Sternocleidomastoid, Scalenes group and Pectoralis minor) and the primary respiratory muscle (diaphragm, intercostalis, upper abdominals) become tight. This is a hot topic for research with some links between chronic disease and increased kyphosis being found.

  • Reduced scapular and shoulder function. An increased kyphosis is often accompanied by tight anterior neck and chest muscles. The shoulders becomes drawn forward placing the scapulars in a chronically protracted position. The scapular stabilisers become weak and under-activated whilst the upper traps become over-activated. This position of the scapular shortens the rotator cuffs leading to trigger points, shoulder pain and possible knock on effects of sub acromial bursitis and rotator cuff tendinopathy.

  • Forward head position: The anterior position which the head tends to adopt with this presentation can often lead to headaches, reduced concentration, migraines and neck pain. This in itself can lead to reduced sleep quality and fatigue.

So the chronic effects of a forward drawn / slumped posture are much more than just low back or shoulder pain. Worryingly this is becoming more common in children who are picking up bad postural habits from sitting at school and having to carry a heavy backpack. Highlighting the importance of correct posture to kids and showing them how to effectively pack their back packs to reduce strain on the spine is tremendously important in the prevention of long term dysfunction.

468488_Thoracic_vertebrae

I like to use the following analogy to describe the issue with my patients.

The spine is influenced by muscles at the front and back to keep us upright. Like the guide wires of a tent these need to be pulling evenly for a balanced, stable platform. Prolonged sitting, slouching, working with laptops, carrying bags etc cause the front muscles to become tight, pulling the mid back and shoulders forward. This is the same as tightening the guide wires on one side of the tent only. As you can imagine this causes the spine to be unbalanced. The body tries its best to correct this by recruiting other muscles but adopting the troublesome postures everyday means it is in vein. Chiropractic can help re-establish the normal balance and movement to the spine and muscles. When you’re moving better and more balanced we will then look to strengthen the muscles which have become weak to get you more stable.

This can be elaborated or stripped back to suit the needs of your patient.

How do I tackle this postural epidemic.

Firstly its important to mention that this pattern of symptoms is not caused by the dysfunction of the thoracic spine alone. As I mentioned in my earlier article :Tight Hip Flexors: A Catalyst For Dysfunction, prolonged sitting causes shortening of the hip flexors which has numerous knock on effects. I have found that addressing this dysfunction in conjunction with the thoracic spine has great outcomes.

When treating patients with this presentation I focus on a few key areas.

  • Correct spinal restrictions / dysfunction with adjustments.

  • Release anterior tight muscles (Psoas, Pecs, abdominals, Scalenes, SCM) with soft tissue techniques (Active release, PIR, massage, Dry needling, Graston technique – all work well)

  • Home exercise prescription: Hip flexor stretching, pectoral stretching- 3 x 30 second holds twice every day. Foam roller thoracic extension stretches. Ergonomic advice

Once the patient is moving better I start to incorporate strength and stability work.

  • Dead bug exercises,

  • ‘Y’ exercises for scapular stability,

  • gluteal activation exercises (see What is Hamstring Dominance?)

  • Bruggers relief position whilst at work – every hour for the first week. Progression to Bruggers relief with theraband.

  • All the while continuing with the home stretching

Of course every patient is different with their presentation. The stresses and strains they put on their bodies will be unique to them and their bio-mechanics. The above treatment techniques are a rough guide to what I have found useful. However assessing the bio-mechanics of a patients feet, pelvis, looking at their pillow, exercise routine and stress levels are also useful to rule out other possible contributing factors.

Education is also a key step in the long term health of any patient. A real understanding of the importance of good posture, keeping mobile and functional is just as important as any home advice. Arming the patient with knowledge and tools so they can go onto educate their family, friends and colleagues is a duty of care we should all be implementing.

Encouraging Yoga, Pilates and exercises classes are a great way for patients to stay mobile in a fun structured way. Encouraging mobility exercises as part of their already existing exercise routine is a great way for patients to stay compliant. Patients who have to make changes in their routine to accommodate their exercises tend to give them up.

In summary the numerous knock on effects of a dysfunctional thoracic spine means that its correct identification, treatment and rehabilitation is crucial for the health of our patients. This includes looking beyond the thoracic spine as the sole area of dysfunction. Giving our patients the tools and education on how to prevent recurrences empowers them to take control of their own health and function.