Can texting kill me? A look at Forward Head Posture

   

Ask Peyton about a pain in the neck.

                               ““Posture follows movement like a shadow” Charles Scott Sherrington 

I find that the above quote has never been more applicable than it is today. We are looking at an issue directly related to the modern age and a sedentary lifestyle. While it may be tempting, I will try to avoid a Unabomber like manifesto against modern technology. My cause of disagreement is not with technology but it lies with a sedentary lifestyle, its contribution to a lack of drive, obesity, shorter life spans, and postural dysfunction. Recently I met some friends for dinner, since I was the first one at the restaurant. I decided to keep my phone in my pocket and do a little people watching. A couple of older gentlemen in the corner were arguing over spring training, but most people were on their phones only they were not talking. In today’s article we are looking some of the issues that are becoming all the more common as the result of the ever increasing use of technology. The use of cell phones for up to 6 hours a day texting, using Facebook, Twitter, Snapchat or Instagram. Also the use of a laptop, an I pad or a desk top computer for eight hours at work and who knows how long at night. In the United States two hundred trillion text messages are received every single day, which is more than an entire years worth or regular mail.  The average American teen sends an average of 3,339 texts per month this is 500% increase in the last two years. Texting is the number two use for cell phones after using the phone to check time. In 2010 Americans spent $42.8 million on mobile devices, it has been projected that this will reach $1.8 billion in 2015. Further evidence that this is on its way to becoming a global issue is that worldwide  sales of smartphones increased at a rate of 42.3 percent from 2012 to 2013, according to Gartner, Inc. Sales of smartphones accounted for 53.6 percent of overall mobile phone sales in 2013, and exceeded annual sales of feature phones for the first time. All statistics aside this is a global health issue with serious consequences that can be prevented. The aim of this article is just that to expose this issue, then to communicate a couple of solutions. So as to trigger thought into our posture and how we carry ourselves. 

Like my friend Tara said "Not a Good look ladies"

So what is Forward Head Posture or FHP you may be asking. FHP is a common postural misalignment, it is defined as existing when the head is positioned in front of the vertical postural line. The head is supposed to sit directly on the neck and shoulders like a golf ball on a tee. Long term forward neck posture leads to “long-term muscle strain, disc herniations and pinched nerves.”2  According to Kapandji for every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds.”3 Rene Cailliet M.D., a medical writer and former director of the department of physical medicine and rehabilitation at the University of Southern California states: “Forward head posture can add up to 30 pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. FHP results in loss of vital capacity of the lungs by as much as 30 percent. This shortness of breath can lead to heart and blood vascular disease. The entire gastrointestinal system is affected; particularly the large intestine. Loss of good bowel peristaltic function and evacuation is a common effect of FHP. It causes an increase in discomfort and pain because proprioceptive signals from the first four cervical vertebrae are a major source of the stimuli which create the body's pain controlling chemicals (endorphins). With inadequate endorphin production, many otherwise non-painful sensations are experienced as pain. FHP dramatically reduces endorphin production.” FHP has been shown to flatten the normal neck curve, resulting in disc compression, damage and early arthritis.4 FHP is a sign of upper crossed syndrome along with rounded shoulders and upper back, pain in the upper back and neck, and  tension headaches.  It is a very common postural issue and it’s estimated to occur between 66% and 90% of the population. Also of note is the association of decreased respiratory muscle strength in patients which can affect the ability to breath and reduce lunge capacity by as much as 30%. Upper Crossed Syndrome or UCS and Lower Crossed Syndrome LCS are syndromes are characterized by alternating sides of inhibition and facilitation in the upper quarter and lower quarter. Dr. Vladimir Janda came up with the crossing syndromes, physicians use the system to predict patterns of tightness and weakness in the sensorimotor system’s attempt to reach homeostasis.  The use of this system allows clinicians to stop chasing the pain and focus on the root cause of the pain rather than the source of the pain. 

The most recent study released published in November 25th, 2014 issue of Surgical Tech International by KK Hansraj. The reason for the study was to assess the forces incrementally seen by the cervical spine as the head tilted forward, into worsening posture. This was necessary for cervical spine surgeons to understand in the reconstruction of the neck. The result of the study demonstrated that  the weight seen by the spine dramatically increases when flexing the head forward at varying degrees. An adult head weighs 10 to 12 pounds in the neutral position. As the head tilts forward the forces seen by the neck surges to 27 pounds at 15 degrees, 40 pounds at 30 degrees, 49 pounds at 45 degrees and 60 pounds at 60 degrees. At 90 degrees the model prediction was not reliable. In researching this article the thing that was scary was the increase in the findings of forward head posture that goes hand in hand with the increase in cell phone usage.  This has become a global phenomenon, effecting the population of the United States, and South Korea as well.   It is an issue in South Korea as well the Teuntuen Hospital, a clinic that specializes in neck and spine treatments notes that the number of patients suffering from neck pains that visited the hospital in the last year was 811 in their 40’s , followed by 699 patients in their 20’s. A hospital official went on to state most of the visitors in their 40’s, neck pain is often related aging and degeneration. The number of young people in their 20’s and 30’s surged after the first iPhone was releases in Korea in 2010.  The number of patients with neck pain in their 30’s jumped 25.8 percent last year in comparison to the previous year. The number of patients with neck pain in their 20’s increased 16 percent and only a 9 percent jump for those in their 40’s.1    

Forward head posture can be identified by the positioning of the ear in front of the shoulder rather than sitting above it. While this may be easy to recognize, it should be diagnosed by a Physician, Chiropractor, Physical Therapist or a Health Care Professional. This leads us to the real question at hand.  What can you do to avoid FHP and what solutions are available to you? 

Solutions for FHP

1. Consult a medical professional Chiropractor or Physical Therapist get examined, have an x-ray and measure the extent of the FHP. This will allow you start a corrective program with adjustments, exercises as well as rule out poor ergonomics and every day situations that put you bad postural position 
2. Adjust the height of your computer of gaming monitor so that the top third of the monitor is even with your eyes and the screen is 18 to 24 inches away. Also support the lower back. 
3. When on a computer every 20-30 minutes sit up strait and pull the neck and head back over the shoulders. Hold for a count of 3 and do 15-20 reps. 
4. Backpacks should be at the maximum 15% of the child’s weight. They should not be worn over one shoulder. Always use a waist belt and if available, a chest belt to neutralize the load.
5. If you are at a job where you have to sit at a desk for a long time, it is recommended that you take a small break from the desk every hour, and rotate the neck and shoulders. Light stretching is always helpful.

This video from Kelly Starrett  maybe”The most important M-Wod Video”. 

This article was rewritten due to the release of the results from the study titled “Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head.” by KK Hansraj.  A study which was performed to help surgeons reconstruct the neck, but is also educational for the general public. I was part of a conversation yesterday that touched on the lack of ingenuity in popular culture and music specifically.  Unfortunately there is some truth to that line of thinking in certain areas of modern society. It has been said before, we are living in a renaissance in matters of the physical body, movement etc and a golden age of Coaches and trainers.  This is made possible by the dissemination of studies like this on a weekly basis. When you couple this with amount of high level health and fitness coaches and trainers, it sets the groundwork for giant strides in these areas. In the coming weeks and months I will be writing about herniated discs, glutes for performance, and a special office workers survival guide.  

1 Korea Joongang Daily “Smartphones becoming real pains in our necks” Park Tae-kyun

2 Mayo Clinic Health Letter, March 2000 

3 Kapandji, Physiology of the Joints Volume 3 

4  (Roentgenographic findings of the cervical spine in asymptomatic people. (Spine, 1986;6:591-694)

5 “Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head.” by KK Hansraj.