Nek minnit it’s text neck

As we were driving through Kelburn to the Wellington CBD the other day I noticed several people walking to work with their heads down. One was holding an ipad in one hand and scrolling down with the other, another was keying into his smart phone, some had earphones on as they strolled along. Even those with no electronic gadgets tended to be gazing downwards. Only one – a young woman at the lights on the corner of Victoria St and Vivian St – stood upright, looking attentively about her. She checked her mobile briefly then put it back in her pocket.

This brought to mind an item that hit the news in 2014 – you may remember it – ‘text neck’. The US news media had picked up on the results of a study by New York spinal surgery specialist Kenneth Hansraj. The story went viral worldwide ending up in our NZ newspapers.

Hansraj and his team had constructed a model of the human spine and head and then subjected it to the ‘pressure’ of flexing the head forwards – mimicking what millions of us do everyday using our smart phones. The human head is surprisingly hefty weighing in at 5 kilos on average. They found that bringing the head downwards dramatically added to the pressure on the spine. Even a relatively small angle of 15° more than doubled the effective weight of the head on the cervical (neck) spine to 12.2 kilos. At a 30° angle this tripled it to 18 kilos and at a 60° angle to 27 kilos. They were not able to measure what happened at 90° – perhaps (and I’m guessing here) because by that stage the ‘head’ was too unstable and kept snapping off the ‘spine’. A 60° angle sounds a bit excessive. Who would bend that far? But looking at Hansraj’ diagram below I would say that it is within the range of what I have seen.

Kenneth Hansraj: Assessment of Stress in the Cervical Spine caused by Posture and Position of the Head, 2014

So what’s the problem? After all the human head and spine are designed to be flexible and bend. The problem lies in the amount of time spent in this stressful position.

Hansraj believes it has reached epidemic proportions: “Just look around you, everyone has their heads down.” Certainly my brief ride to town confirmed that!

“The problem is really profound in young people,” he said. “With this excessive stress in the neck, we might start seeing young people needing spine care.” (Wear-and-tear on the spine is normally only seen in people over 50.)

Hansraj advocates smart phone users make an effort to look at their phones with a neutral spine and avoid spending hours each day hunched over. He defines neutral spine or good posture “as ears aligned with the shoulders and the ‘angel wings’, or the shoulder blades, retracted. In proper alignment, spinal stress is diminished. It is the most efficient position for the spine.” And suggests users look down at their device with their eyes so there is no need to bend the neck.

On the face of it, this is good advice. Addressing the way we stand and move is the key. However in my experience as a Feldenkrais® practitioner it is almost impossible for most people to achieve the neutral, non-damaging position that Hansraj recommends and illustrates in his diagram – the 0° position above.

This is because after years of use of devices such as stationary and laptop computers, tablets, mobile phones and more recently smart phones, many people have habituated their bodies to poor postural positions whether sitting or standing. In particular their middle and upper spine has acquired a rigidity that reduces their flexibility. Thus pulling back the shoulder blades while they have a rigid, even a slightly kyphotic (i.e. bent over), middle and upper spine will prevent their head ever attaining its optimal position. Pulling back the shoulders blades may only accentuate the problem with the head position.

Nor will advising people to ‘look down at your device with your eyes’ achieve much. A more radical approach is needed. Check out my next post for more about this radical approach.

– Alan Cameron ©

How to get rid of text neck without getting rid of your iPhone

As I said in my last blog, just telling people how they should stand with a so-called ‘neutral spine’, does not mean they will be able to do it. This is because how we stand, sit, walk or run etc. is the result of a lifetime of learnt habits that engages our brain and whole nervous system in a certain way.

For example, when we first learn to ride a bicycle, we are all attention with our nervous system on high alert – keen, of course, not to fall off! But once we’ve learnt the skill, our brain takes over the unconscious control of this skill and we are then able to ride without thinking about it. This frees us up our conscious brain to be engaged in doing lots of other things. Imagine if we had to think precisely about every action before we did it – human civilisation would scarcely have got off the blocks!

The good news is that, irrespective of age, our brain is a work in progress. We can rewire our brain to rid ourselves of bad habits (like text neck) and acquire good ones instead.

We do this simply by activating the brain through learning. When we are learning something new, MRI imaging shows the whole brain alight with the effort of paying attention. Once we have mastered or memorised the new skill, the surge of electrical activity diminishes as the brain creates a pattern of synaptic connections. It is as if the brain has downloaded the new skill into a memory template that can be re-activated whenever we need it and without our consciously thinking about it.

This is the genius of the Feldenkrais Method®. Everything we do involves movement somewhere in the body – even the act of thinking. Using slow, small and gentle, movements allows us to bring our attention to how we are currently organising our body to sit, stand, read, listen, run, do computer work etc. Slow and small is how the brain is best able to learn. And gentle movements, because we cannot learn when using unnecessary effort or in discomfort and even less so when in pain.

Once our brain is on alert, we need to pay attention not only to what difficulties we are experiencing but also to what works easily without any pain or discomfort. We are then sensing our own bodies – not being told what to do or imitating someone else or doing repetitive exercise without awareness. We are aiming to find out our own individual good position or posture – and not somebody else’s!

In fact, Moshe Feldenkrais took the view that there was no such thing as ‘perfect posture’. What was important was neutral posture – that is, a posture that enables you to take any action you want to from that position. So if you are threatened, you can quickly flee. If you are sitting, you can easily stand or move position and perform some other task without having to re-arrange yourself first. It is about learning to function more efficiently and with less effort.

I am convinced that only a recovery of this brain-based somatic (body) awareness amongst the general population will do anything significant to address the public health concerns of Dr Kenneth Hansraj[1] and others. Text neck is just the tip of the iceberg.

– Alan Cameron ©

[1] Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head, Kenneth K Hansraj.