By Dan Davidson, DC
Many of our patients walk around with their heads jutting forward like a tortoise peeking out of its shell. That’s not just a bad posture habit; it’s become a silent epidemic known as “tech neck” — a new and exciting twist on forward head posture. And it’s getting worse with every scroll, click, and swipe.
Poor posture has been around as long as gravity, but now it is affecting younger generations at an alarming rate. Increased screen time is accelerating this problem. Tweens, teens, and adults of all ages are hunched over phones and tablets, playing video games and endlessly texting. This constant downward gaze creates a perfect storm for tech neck.
The Digital Age: A Breeding Ground for Postural Dysfunction
The average American now spends over six hours per day using digital media. A recent Journal of Physical Therapy Science study1 reported that people spending more than five hours per day using a smartphone are more likely to develop tech neck. The rise of technology and increased remote work since the COVID-19 pandemic has further accelerated this problem with makeshift workstations for home computers and laptops.
But the rise of tech neck has not gone unnoticed, with numerous articles highlighting the perils of our digital lifestyle. The solutions presented usually fall short of addressing the root causes. Temporary fixes are often suggested, such as over-the-counter medications, prescription drugs for pain relief, and even invasive procedures such as nerve ablation therapy and surgery.
Our intimate knowledge of gravity’s long-term impact positions us to lead the charge against the rising tide of tech neck. It’s not merely about recommending that patients take breaks from their devices or reduce screen time. Our mission is more profound — to guide our patients in redefining their relationship with gravity from the ground up.
Unmasking Other Culprits
While tech gets a bad rap, it’s not the only posture villain. We slouch forward with reading, driving, working, hobbies, and activities of daily living. Compromised sleeping posture without proper support for the normal cervical curve is another huge contributor.
The journey to balance begins at the foundation — our feet. Fallen arches create a domino effect up the kinetic chain, resulting in leg-length inequality and alterations in the sagittal plane. This pattern of imbalance and compensation is not new, and our digital habits have intensified it.
Tech neck usually involves hyperkyphosis in the upper thoracic spine. Initially, patients also present with an early loss of normal cervical lordosis, which can progress to a reversed cervical kyphotic curve over time, also known as upper cross syndrome. This postural distortion is characterized by a cross pattern of weakness in the deep cervical flexors and rhomboid mid-thoracic muscles, combined with overactivation of the neck extensors and pectoralis chest muscles.
A sedentary lifestyle2 and poor nutrition can contribute to osteoporosis3 later in life, which can hasten anterior thoracic vertebral body wedging. This, in turn, can further accentuate tech neck as another common contributing factor for seniors.
Health Detriments of Forward Head Posture
Tech neck increases compressive loading on tissues in the cervical and thoracic spine, particularly the facet joints, discs, muscles, and ligaments. Common symptoms include neck pain, TMJ syndrome, tension and migraine headaches, and thoracic pain.4 Rounded shoulders can also result in shoulder pain and dysfunction relating to altered scapular muscle activity and balance.5
Chronic tech neck can lead to disc and facet joint degenerative changes because of increased gravity stress forces. For every inch that the head (8 to 10 lbs.) protrudes forward, the posterior region has a counterload of 12 lbs. When we look down at our phones at a 60-degree angle, it causes 60 lbs. of pressure.6 That is like adding six 10 lb. bowling balls on top of our head, neck, and shoulders when we check our text messages.
A recent study showed 83% of patients with neck pain (caused by faulty posture) experienced a changed breathing pattern. Weak respiratory muscle function and dysfunctional breathing were associated with musculoskeletal pain patterns.7
Imbalanced trunk posture has also been shown to increase chronic sympathetic activation of the autonomic nervous system, decrease heart rate variability (HRV), and dampen vagus nerve tone.8 Older patients with tech neck have been shown to have reduced standing static balance with measurable sway when eyes are closed.9 This is a common risk factor for falling injuries. Kids with tech neck have a lower center of gravity, so the static balance dysfunction is often not yet evident in younger ages.
When we see a 90-year-old senior with an exaggerated FHP, we realize the seeds for that dysfunction were planted years earlier. For younger patients today, what will be the “back of their future” in relation to the digital acceleration of tech neck? As chiropractors, we are basically “gravity counselors” and can offer prevention intervention now to change the trajectory of future postural dysfunction.
The foundation of clinical treatment is chiropractic adjustments that restore balanced, aligned motion and nervous system function. Improved flexibility allows the body to begin adapting to optimal postural positioning. Focusing on myofascial release coordinated with muscular strengthening and rebalancing helps the body functionally reset due to neuroplasticity.
Postural retraining can be enhanced with some devices patients wear for neuromuscular reeducation. However, most importantly, strengthening the region is critical to correcting posture by improving the muscular posture core. Adding posture-corrective devices, such as custom, flexible orthotics, and strengthening make great strides in moving the patient forward in care and overall improvement.
Postural Kinetic Chain from the Ground Up
Foot pronation and fallen arches have contributed to forward head posture long before the dawn of the digital age. Gravity stress forces, adaptive postural compensation, and altered gait patterns affect the entire kinetic chain from the ground up.
One of the first foot arches to collapse with pronation is the top or transverse arch, which distributes weight evenly across the metatarsal heads. A loss of the transverse arch can cause a lower-trunk forward lean. This often leads to overcompensation of lumbar hyperlordosis. The last adaptive link in this cascade effect is an overcorrection again in the neck and shoulders, increasing tech neck. Custom, flexible orthotics can be integral in addressing whole-body posture with three-arch support.
The connection between fallen foot arches, pronation, and forward head posture highlights the importance of understanding the body as a unified, interconnected system affecting the entire postural kinetic chain. Combined with exercise, postural retraining, and manual therapies, patients can work toward achieving better posture, reducing pain, and enhancing their quality of life.
As chiropractors, we are equipped with the tools and knowledge to address the tech neck epidemic at its roots. Our approach encompasses more than just physical adjustments. It’s about educating our patients on the importance of posture starting in childhood.
In this digital age, our responsibility extends beyond the clinic. We must advocate for a deeper understanding of gravity posture, emphasizing the importance of early intervention and holistic care. The battle against tech neck is not just about correcting posture. It’s about shifting paradigms from reactive health care to proactive wellness.
About the Author
Dr. Dan Davidson is a graduate of Palmer College of Chiropractic in Davenport, Iowa. He has been in practice for 40 years and is the owner of The Back Resort & Peak My Health Center in Salem, Virginia. Dr. Davidson also hosts the Peak My Health Podcast, where he shares tips on health, exercise, nutrition, and posture. See his upcoming CE seminars for Foot Levelers at https://www.footlevelers.com/seminars. Dr. Davidson can be reached at [email protected].
References
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Park JH, Moon JH, Kim HJ, Kong MH, Oh YH. Sedentary lifestyle: overview of updated evidence of potential health risks. Korean J Fam Med. 2020 Nov;41(6):365-373. doi: 10.4082/kjfm.20.0165. Epub 2020 Nov 19. PMID: 33242381; PMCID: PMC7700832.
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Wang H, Gao X, Shi Y, Wu D, Li C, Wang W. Effects of trunk posture on cardiovascular and autonomic nervous systems: a pilot study. Front Physiol. 2022 Oct 18;13:1009806. doi: 10.3389/fphys.2022.1009806. PMID: 36330208; PMCID: PMC9623330.
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