Text Neck

A modern day problem

How much time a day do you spend looking down at a device? 30 mins? 1 hour? Maybe 2? Chances are you underestimate the total time that you spend on your mobile device, be it your phone, tablet or e-reader. Individuals in one Canadian university community spent more than 3.5 h PER DAY on average using mobile devices to text, email, or browse the Internet (Berolo, Wells, & Amick, 2011). THREE AND A HALF HOURS!! That’s equivalent to watching the Godfather Part II every single day. Bear in mind that this average time from this study did not even include time spent on a computer or laptop. But unlike with computer use, particularly within many workplaces, there is no established ergonomic guidelines for the use of mobile devices (Vasavada, Nevins, Monda, Hughes, & Lin, 2015). Is it any wonder then that so many people nowadays complain of headaches and severe spinal, neck and shoulder pain? This is an increasing problem in our modern societies with high associated health costs (Ning, Huang, Hu, & Nimbarte, 2015)and has been coined as text neck (Gearhart, 2018). Worryingly, children as young as eight years old are being effected by text neck issues (Gearhart, 2018), and owing to the high rate of smartphone ownership (<95% of 18-34 year old Americans and Australians (Poushter, 2016)), this problem is only going to get worse across all ages.


Now, there is a good chance that you are reading this on a device: what position is your neck in? Answer: your neck is in a flexed position, cervical flexion; there is now greater gravitational load on the muscles of your neck in this position, greater than that when using a desktop computer, and in fact, 3-5 times more than when in a neutral position (Vasavada et al., 2015). This constant increased load reduces the range of movement (ROM) of the neck muscles and alters muscle activation (Johnston, Jull, Souvlis, & Jimmieson, 2008). Nowadays, devices are only getting bigger, which in turn creates greater cervical flexion as these devices often can’t be held and have to be placed on one’s lap (Kietrys, Gerg, Dropkin, & Gold, 2015). Owing to the neck’s unique role in supporting and moving ours heavy heads, it is extremely vulnerable to strain and injury, and too many of us simply take it for granted. The muscles in our bodies are predominantly designed for movement. Even those small muscles in your back that help to stabilise and support your spine need movement and stretching. This is no different for the muscles in and around your neck. These poor guys have to support that heavy lump of a head that we all carry around all day, and when adequately strengthened and stretched, no pain would be experienced. But the majority of us spend a good part of our day in prolonged protracted positions and DO NOT stretch or move the neck and shoulder muscles as we should. Consequently, pain and headaches are a common and increasingly debilitating result. Almost 41% of Chinese adolescents complain of significant neck and shoulder pain as a result of device usage (Shan et al., 2013). In fact, there are so many studies being published on this that there is no way that we can ignore text neck any longer and we need to increase education regarding the proper treatment and preventative behaviours that we all need to adopt to avoid developing or exacerbating text neck (because chances are, you have it).


Preventative approaches:
Simple habits that we can all endeavour to adopt include simply holding your phone/device at eye level or remembering to lie on your stomach if you’re planning on spending a long time on the phone. Alternatively, use voice-to-text as often as possible and be mindful to vary your whole body posture periodically (Gearhart, 2018; Toh, Coenen, Howie, & Straker, 2017a). Other simple options include: setting a ten minute alert that reminds you to move or look up and around every ten or so posts when scanning Reddit or Instagram, etc. etc. There are so many little things that we can do but we have to make the conscious choice to incorporate these behaviours so that we can reduce the negative effects of what is fast becoming an all-consuming addiction in our society.


How massage can alleviate these issues:

And this brings us to massage, which is both a preventative approach and a pain relief treatment for text neck (Cheng & Huang, 2014). How do we at MOTR use massage to help you out? Well firstly, using our knowledge to educate you on the preventative methods mentioned above, as well as on techniques, such as Muscle Energy Technique (MET), which you can then incorporate into your day to help stretch and strengthen your neck muscles. And obviously we massage. Myofascial trigger point and pressure release, connective and deep tissue massage and passive stretching of your neck can help manipulate and release those tight knots that have built up over prolonged device use, reduce pain and even improve mental health! (Celenay, Kaya, & Akbayrak, 2016; Cheng & Huang, 2014). Depending on the muscles most effected, our therapists will position you in either a prone, supine, side-lying or seated position in order to access your neck muscles and fully assess their ROM.

Although much of the focus here has been on the neck in regards to negative musculoskeletal consequences of device usage, our forearms/wrist flexors and extensors, as well as our upper trapezius muscle can also be significantly effected as a result of the prolonged unnatural positions held when using our devices (Kietrys et al., 2015; Toh, Coenen, Howie, & Straker, 2017b). Again, a combination of preventative stretches, and massage will assist you in alleviating your pain, and it will be best to consult with your MOTR therapist.

Using our handheld devices has become the norm; as such, we have to be smarter and proactive in their use. Recognising the importance of preventative behaviours, such as stretching and consciously moving throughout the day, coupled with therapeutic and remedial massage approaches can significantly assist you in reducing your neck pain, improving your quality of life and ensuring that you can have a future filled with many more hours browsing Instagram.

Ready to find out more?

Massage On The Run

Celenay, S. T., Kaya, D. O., & Akbayrak, T. (2016). Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: A prospective, randomised controlled trial. Manual Therapy, 21, 144–150. https://doi.org/10.1016/j.math.2015.07.003

Berolo, S., Wells, R. P., & Amick, B. C. (2011). Musculoskeletal symptoms among mobile hand-held device users and their relationship to device use: A preliminary study in a Canadian university population. Applied Ergonomics, 42(2), 371–378. https://doi.org/10.1016/j.apergo.2010.08.010

Cheng, Y. H., & Huang, G. C. (2014). Efficacy of Massage Therapy on Pain and Dysfunction in Patients with Neck Pain: A Systematic Review and Meta-Analysis. Evidence – Based Complementary and Alternative Medicine; New York, 2014. http://dx.doi.org.dbgw.lis.curtin.edu.au/10.1155/2014/204360

Gearhart, R. (2018, July 4). “Text Neck” Means Trouble For Those Addicted to Mobile Devices. Chicago Defender; Chicago, Ill., p. 15.

Johnston, V., Jull, G., Souvlis, T., & Jimmieson, N. L. (2008). Neck Movement and Muscle Activity Characteristics in Female Office Workers With Neck Pain. Spine, 33(5), 555. https://doi.org/10.1097/BRS.0b013e3181657d0d

Kietrys, D. M., Gerg, M. J., Dropkin, J., & Gold, J. E. (2015). Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting. Applied Ergonomics, 50, 98–104. https://doi.org/10.1016/j.apergo.2015.03.003

Ning, X., Huang, Y., Hu, B., & Nimbarte, A. D. (2015). Neck kinematics and muscle activity during mobile device operations. International Journal of Industrial Ergonomics, 48, 10–15. https://doi.org/10.1016/j.ergon.2015.03.003

Poushter, J. (2016, February 22). Smartphone Ownership and Internet Usage Continues to Climb in Emerging Economies | Pew Research Center. Retrieved February 21, 2019, from http://www.pewglobal.org/2016/02/22/smartphone-ownership-and-internet-usage-continues-to-climb-in-emerging-economies/

Shan, Z., Deng, G., Li, J., Li, Y., Zhang, Y., & Zhao, Q. (2013). Correlational Analysis of neck/shoulder Pain and Low Back Pain with the Use of Digital Products, Physical Activity and Psychological Status among Adolescents in Shanghai. PLoS One; San Francisco, 8(10), e78109. http://dx.doi.org.dbgw.lis.curtin.edu.au/10.1371/journal.pone.0078109

Toh, S. H., Coenen, P., Howie, E. K., & Straker, L. M. (2017a). The associations of mobile touch screen device use with musculoskeletal symptoms and exposures: A systematic review. PLoS One; San Francisco, 12(8), e0181220. http://dx.doi.org.dbgw.lis.curtin.edu.au/10.1371/journal.pone.0181220

Toh, S. H., Coenen, P., Howie, E. K., & Straker, L. M. (2017b). The associations of mobile touch screen device use with musculoskeletal symptoms and exposures: A systematic review. PLoS One; San Francisco, 12(8), e0181220. http://dx.doi.org.dbgw.lis.curtin.edu.au/10.1371/journal.pone.0181220

Vasavada, A. N., Nevins, D. D., Monda, S. M., Hughes, E., & Lin, D. C. (2015). Gravitational demand on the neck musculature during tablet computer use. Ergonomics, 58(6), 990–1004. https://doi.org/10.1080/00140139.2015.1005166