Text Neck!

Fix my Spine with Iona Collins MMBS, BMedSci(Hons), MRCS, FRC(Orth)

We ignore the influence that our 5Kg heads have on our unsupported necks as we constantly hold our heads in front of our body by bending our necks

Standing upright with good spinal posture, results in the weight of our body, from our head downward, being transmitted very close to the spinal column. The shock-absorbing discs are loaded symmetrically and are therefore less likely to wear out. The green arrow represents our ideal “centre of gravity”.

Looking down brings the head forward in relation to the body. This means that the 5Kg weight of our head is generating a centre of gravity which runs in front of the spine. The shock-absorbing discs are now eccentrically, or asymmetrically loaded. This means that there is more force going into the backs of the discs rather than the fronts of the discs and, over time, the discs fatigue, fail and bulge backwards. The red arrow represents the “centre of gravity”.

Our shock-absorbing discs have to put up with eccentric pressure placed upon them, which, like a repetitive strain injury, gradually wears the back of the discs and causes them to bulge. When we start experiencing neck pain or pins and needles in our hands, then this can be the first sign of a problem which we generated when we first started attending to our smart phones a few years ago.

Here’s some supporting evidence

A Japanese study in 2016 reported that people with weak muscles at the back of their neck also suffer with trapped nerves in the neck. This suggests that habitually bending the neck forward and neglecting neck extension results in the tendency for spinal nerves in the neck to become pinched, usually by disc bulges. While the MRI evidence appears very convincing to those who understand the biomechanics of how discs wear, it could be argued that the MRI is a snapshot in time, so it’s impossible to prove cause and effect from the same picture. True, but, a second publication from 2008 linked poor neck posture with more wear in discs in the neck. Another article in 2002 showed reversibility of disc bulges on MRI by placing people’s neck in traction and hey presto, the disc bulge went away while the traction was in place.

Here’s a simple test (look around and make sure that nobody’s watching you).

Step 1. Look up to the ceiling

Step 2. Look down to the ground

Step 3. Put this lovely magazine down, and put one hand on the back of your head and the other hand on your chin

Step 4. Now repeat step 1 and step 2

You will find that in order to look up and look down, you have nodded your head.

You have not, however, moved your neck.

Over time, our habitual neglect of neck movement in preference of head movement means that we allow our necks to stiffen up, as well as habitually overload our discs in our necks by holding our head too far forward in relation to the rest of our body.

See for yourself: Here are X Rays used to looking at neck mobility in somebody who was asked specifically to look up as far as possible and down as far as possible.

While the skull is moving well at the top of the neck, the neck itself hardly moves at all!

So, what can we do to prevent neck problems due to “wear and tear” or spondylosis?

Robin McKenzie, a physiotherapist from New Zealand, understood the importance of good posture and maintaining spinal flexibility. In his book “Treat Your Own Neck”, he demonstrated a series of neck extension exercises which he and many others have found beneficial in relieving neck pain. Although exercises are useful, ideally, we should be habitually and constantly checking ourselves to make sure that we are not drifting into slouched, spinally-challenging postures. We should give ourselves a spinal stretch now and again, by arching our necks and our backs backwards ie. the opposite of the slouched posture, in a bid to stop our spines from stiffening up.

Next year, make the most of gazing at the sky when the Air Show comes to town and, until then, raise your arms when texting to maintain a horizontal gaze. This way, you should avoid the growing trend of neck pain due to “Text Neck”.

For more information about general self-management of your spine, please visit www.fixmyspine.co.uk

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