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The Mito Guide For Text Neck Syndrome
(Figure 1) Photo by photo by Nasik Labadan on Unsplash

Table of Contents

What Is Text Neck Syndrome

This strange name has been created to describe a new musculoskeletal problem developed in the past few years, especially during Covid 19 pandemic. This name refers to postural weaknesses caused by the constant leaning forward of our heads caused by the daily use of electronic devices such as smartphones, tablets, and computers (especially laptops).

The constant leaning forward bend of our head causes a strain on our neck or cervical spine muscles and put great pressure on our cervical spine joints (vertebrae).

This issue is becoming predominantly globally as worldwide smartphone users are increasing year by year; in 2020 in some European and non-European countries such as the UK, US, France, Germany, and Italy more than 75% have been reported to be smartphone users and the average time spent on a smartphone was 4 hours per day.

Looking at this statistic the increase in neck and headaches in the past few years and during the covid 19 pandemic makes perfect sense.

Let’s look first at the cervical spine biomechanics:

  • The cervical spine’s muscles, tendons, and ligaments are meant to support the head’s weight of 10 to 12 pounds in a neutral position balanced atop the cervical spine.

When texting on a phone, it is common to bend the head forward and look down at approximately a 45- 60 degree angle, which places about 50 to 60 pounds of force on the neck.

  • The neck is not able to withstand this amount of pressure over a prolonged period.
  • Forward head posture is characterized by flexion of the lower part of the cervical spine and an extension of the upper cervical spine. These changes occur to maintain the eyes horizontal which is a fundamental condition for our brain and eyes to process all the images from outside. The overextension of the upper cervical spine leads to a reduction of the space for the atlantoaxial and atlanto-occipital joints, a shortening of the suboccipital muscles, a compressing of the facet joints, and irritation of the small ligaments at the back of your head. This combination is one of the main causes of tension-type headaches.
(Figure 2) By Dr. Johannes Sobotta - Sobotta's Atlas and Text-book of Human Anatomy 1909, Public Domain, httpscommons.wikimedia.orgwindex.phpcurid=29817226

Consequently to the head position your body posture will change:

  • There will be an increase in the natural thoracic curve, the kyphosis. This change is called hyperkyphosis. 
  • This will cause tightness in your pectoralis muscles, weakness in your upper and lower trapezius, rhomboids, and levator scapulae muscles.
  • A protraction of your shoulder blade will occur as well. 
  • The above postural defects are part of a more complex body presentation which is known as the upper cross syndrome.

Looking at the screen of your smartphone all day won’t change just your posture but will cause several aches and issues, here a list of the most common symptoms of text neck syndrome are:

  • Muscle weakness: the forward bending position of the neck places your neck muscles in an overstretched position which blocks them to activate efficiently.
  • Neck pain: an anterior forward bend of the neck puts great pressure on your joints and especially on your neck discs causing articular pain.
  • Neck stiffness: your muscles are overstretched and due to the overstretched position, their flexibility is compromised leading to general stiffness and reduction of the natural range of motion.
  • Headaches: at the back of your skull there is a group of tiny muscles called suboccipital. These are responsible for postural control of the head, if they are overstretched or inflamed they may cause tension-type headaches. 

If an individual maintains this awkward and stressful posture for the neck, in the long run, is gonna suffer from:

  • Early spinal degeneration: vertebrae in your neck are squeezed during a forward bending of the head, keeping this position for a long time may lead to discs bulging damaging irreversibly your spine. Disc bulging can worsen into a disc prolapse causing nerve compression and impingement. 

The typical symptoms of spinal compression are numbness, pins and needles, and pain down one or both arms.

  • General joint stiffness and muscle ache: neck muscles become weak because of the overstretched position so shoulders and back muscles start to compensate and be overactive causing aches and joint stiffness.
(Figure 3) By Andwall2 - Own work, CC0, https://commons.wikimedia.org/w/index.php?curid=79267021

Management of Text Neck Syndrome

The best treatment for Text Neck syndrome is prevention. Since it is an “occupational” condition, it is strictly related to the amount of time that you spent on your devices (laptops, smartphones, and tablets) therefore one of the most effective treatments is to cut down the number of hours looking at the screen. 

Unfortunately, we do not work always in an ideal condition, and often is not possible to reduce the hour spent on the computer but do small adjustments to our daily habits can make a difference: 

  • Have small breaks often when you are looking at the screen, especially at work.
  • Adjust the device position, to discharge your neck from pressure your screen should be at eye level. If you’re using a smartphone avoid placing it at waist level.
  • Avoid static positions for a long time.
  • Maintain an appropriate distance between you and your device (too much distance will increase head forward bending).

If you’re already suffering from some of the listed symptoms you can try several options: 

  • Stretching exercises: stretching will allow you to lengthen the short muscles reducing muscle tension, improving flexibility, and restoring range of motion.
  • Strengthening exercises: if the pain and tension have been persistent for a few months probably you will need to rehabilitate and strengthen your muscles. As mentioned before, the head moving forward causes tension and muscle weakness due to poor posture, therefore you will need to rehabilitate your muscles to do their function again.
  • Contrast Therapy: ice and heat could be an option to manage inflammation and reduce pain. Low levels of pain will permit you to have more range of motion and consequently do more stretching and strengthening exercises. 
  • Painkillers: your GP or pharmacist may suggest you take painkillers such as ibuprofen, paracetamol, naproxen, etc. if you need to use any medications always seek medical advice. 
  • Medical Interventions: for chronic and recurrent pain your consultant may suggest you try cortisone injection, a strong anti-inflammatory medication injected directly into the affected joint)

How MiTo Clinic Can Help?

If the pain does not go away with exercises, painkillers, or Ice and heat the MiTo team will be glad to help and suggest you the best course of action!

Here is a list of possible exercises that you can do to stretch and strengthen your muscle:

 

Chin Tuck Exercise in a supine position 

1. Muscles involved: Cervical Erector Spinae, Deep neck flexors, Lower neck extensors.

2. Joints involved: Cervical Spine (neck)

3. Procedure: lay down flat on a carpet or a mat as shown in the video. Move your chin towards the back of your head as you exhale. Hold for a couple of seconds. Relax. Go back to the neutral position and repeat. 

4. Precautions: Pay attention to keeping your neck aligned and moving your chin backward and not downward. Do not force the movement beyond measure. If you feel pain stop doing the exercise. 

5. Effects: strengthens deep neck flexor muscles, and promotes good neck posture.

Levator Scapulae Exercise in a seated position 

1. Muscles involved: Levator scapulae, Upper Trapezius.

2. Joints involved: Cervical Spine (neck)

3. Procedure: Sit on a chair or sofa as shown in the video. Remember to maintain a good posture with your body. Move your chin towards your chest and turn your head towards your shoulder. Hold for a couple of seconds. Relax. Go back to the neutral position and repeat. You should feel a gentle stretch at the base of your neck. 

4. Precautions: Pay attention to not force the movement beyond measure. If you feel pain stop doing the exercise. 

5. Effects: Improves neck range of motion, improves levator scapulae flexibility. 

Scapular Retraction in a seated position

1. Muscles involved: Mid Back muscles (Trapezius and Rhomboids).

2. Joints involved: Mid Back and Scapulo-Thoracic (Shoulder Blades).

3. Procedure: Sit down facing the back of a chair and grip your hands on it. Squeeze your shoulder blades towards the midline.

4. Precautions: Pay attention to not arch the lower back or neck too much as you may injure your spine. Do not force the movement beyond measure and if you feel pain stop doing the exercise.

5. Effects: improve shoulder blade mobility and thoracic spine stability.

 

Upper Back Mobility: Figure 8

1. Muscles involved: Mid Back muscles (Upper and Mid Trapezius, Rhomboids, and Thoracic Erector Spinae).

2. Joints involved: Upper and Mid Back, Scapulo-Thoracic (Shoulder Blades).

3. Procedure: Sit down on a chair o sofa as shown in the video. Remember to maintain a good posture. Move your hands to the back of your head as shown in the video. Start designing an 8 figure in the air, imagine your elbows as the tip of a pencil. After you finished the figure. Go back to the neutral position and relax. Repeat.

4. Precautions: Pay attention to not apply too much pressure with your hands at the back of your head. Your elbows are bent but relaxed. Do not force the movement beyond measure and if you feel pain stop doing the exercise.

5. Effects: improves shoulder blade mobility, improves upper and mid-back mobility, promotes thoracic spine stability and strengthens back muscles.

 

Child’s pose

1. Muscles involved: Upper, Mid, and Lower Back Muscles (Thoracic Erector Spinae, Upper-Mid-Lower Trapezius, Latissimus Dorsi, Rhomboids, Levator Scapulae, and Lumbar Erector Spinae).

2. Joints involved: Neck, Entire Back, Shoulder Blades, Sacro Iliac Joints, Hips.

3. Procedure: sit down on the floor (use a mat or a carpet)  and rest on your knees. From this position lean forward and rest your forehead on the floor as shown in the video. Remember, as much as possible, to keep your buttocks close to your heels. Once you’re in position stretch your arm to reach something in front of you. You should feel a gentle stretch in all of your spine and around your hips. Go back to the neutral position and relax. Repeat.

4. Precautions: If you are suffering from disc problems be cautious at doing these exercises as the forward bent posture could cause you pain. Remember to use a carpet or a mat or to perform a child’s pose on soft surfaces. Do not force the movement beyond measure and if you feel pain stop doing the exercise.

5. Effects: improves spinal flexibility and mobility, improves flexibility of Back Muscles, promotes good posture.

 

Wrist Flexors and Extensors Muscles Stretching

1. Muscles involved: Wrist Extensors and Extensors.

2. Joints involved: Shoulder, Elbow, Wrist.

3. Procedure: Find a comfortable position you can do these exercises either in a standing or seated position. Remember to maintain a good posture. Move your arm straight in front of you as shown in the video. With the opposite hand start pulling gently your fingers towards your straight arm. You should feel a gentle stretch in the lower region of your forearm. Go back to the neutral position and relax. Repeat. This exercise will stretch your Wrist Flexors.

To stretch your Wrist Extensors move your arm straight in front of you as shown in the video. Gently push with your opposite hand your wrist downward. You should feel a gentle stretch of the upper part of your forearm. Go back to the neutral position and relax. Repeat.

4. Precautions: Pay attention to not apply too much pressure with your hand on your wrist. Do not force the movement (flexion or extension) beyond measure and if you feel pain stop doing the exercise.

5. Effects: Improves Wrist Flexors and Extensors flexibility, Improves Wrist and Elbow mobility.

 

Frequency

Stretching exercises: Hold the position for at least 5 seconds, and repeat 5 times on each side.

Strengthening exercises: repeat 10 times in total. 

If you don’t have a Swiss ball feel free to use a normal chair, you should perform this routine once a day for at least 3 times a week or as a daily break from your work. 

Golden rule: If an exercise is hurting you or triggering your symptoms don’t do it.

If you have any doubts, questions, or need any help to relieve any pain. Call or Book an appointment with us. 

This is the end of the blog, MiTo Team says thank you to have read it and hopes that you enjoyed it. 

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Bibliography

 

1. Fiebert, I. et al., 2021. Text neck: An adverse postural phenomenon. Work, 69(4), pp.1261–1270.

2. P, S. & Tamboli, S.A., 2020. Prevalence of text neck syndrome in young-adult population. International Journal Medical and Exercise Science, 06(02), pp.749–759. 

3. All the pictures from Unsplash and Wikimedia commons 

4. All the videos have been provided by MiTo Healthcare Clinic

All the information from this blog is made with passion, love, and expertise by the MiTo team, always relying on what science says.

 

Text Neck Syndrome: Medical Disclaimer

Although the MiTo team is composed of healthcare practitioners, we are not your healthcare practitioners (yet XD). All the content on this website is for informational and educational purposes only and does not constitute medical advice. We always strive to provide an accurate and reliable source of information, but the information on this website does not substitute any professional advice and you should not rely solely on this blog content. Always seek medical-professional advice in the area of your particular needs or circumstances before making any decision concerning your health.

 

 

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