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Ouch! Doctors are seeing more cases of ‘text neck’ or ‘iPosture’

DULUTH, Minn. -- Texting can be a pain in the neck. "Those neck muscles, they don't just quit and let your head drop," said Dr. Edward Martinson of St. Luke's Physical Medicine and Rehab Associates. "(The muscles) just keep getting tighter and ti...

Graphic to go with story on doctors see increase in neck pain because of texting, surfing the web.

DULUTH, Minn. -- Texting can be a pain in the neck.

“Those neck muscles, they don’t just quit and let your head drop,” said Dr. Edward Martinson of St. Luke’s Physical Medicine and Rehab Associates.

“(The muscles) just keep getting tighter and tighter. That’s where the headaches come in, by having your head hang out there like that.”

It’s a text, text, text, text world. And with the communication phenomenon, experts say, comes aches and pains from the hunched-over posture generally adopted by those who text on their smart phones.

“It’s hard to say what causes any specific injury,” said Chelsea Sparrow, an athletic trainer and ergonomic specialist in the occupational medicine department at Essentia Health-Duluth Clinic. “What I’ll observe is, people will come in with thumb, neck or elbow discomfort … and they don’t know why they have it.”


But sometimes, they show her why they have it.

“They’ll say, I haven’t been doing anything different or odd, but they might sit on the table with a hot pack on their neck to treat their neck pain, and then they do this while they’re treating their neck pain.”

As she said, “Then they do this,” Sparrow hunched forward, shoulders and neck bent, as she mimicked the act of texting with her thumbs.

It’s a posture you’ve seen, perhaps in your favorite coffeehouse, or on a college campus, or exhibited by your teenage children. Chances are, you’ve done it yourself.

“I mean, it’s just a part of our culture,” Sparrow said. “You cannot get away from it. My 76-year-old grandma texts.”

Sparrow’s colleague Janalee Reineke Lyth - case manager, occupational therapist and ergonomic specialist - has her own name for the posture: turtling.

Others call it iPosture.

There’s also a name for the pain that sometimes results: text neck.


It’s widely agreed that the term was coined by Dean Fishman, a Florida chiropractor. In a telephone interview, Fishman described the patient who prompted the term.

She was 17 and was complaining about chronic headaches, neck pain and shoulder pain, Fishman said. He showed X-rays of the girl’s neck to her mother. They showed that the normal curvature of the teenager’s neck was reversed.

The mother didn’t understand Fishman’s explanations, he said.

“And I looked over at the patient and I said, ‘Well, look at her.’ The kid was on the phone and she was texting. I said, ‘She’s got text neck.’ And with that, the mother understood what I was talking about.”

That was before 2010, Fishman said, and the phenomenon wasn’t on most health professionals’ radar. But he reasoned it would only become more prevalent, and he transformed his practice to what is now known as the Text Neck Institute. It’s devoted to case studies and developing technology as well as to treating patients, he said.

In a sense, he can study the phenomenon wherever he goes.

“I kind of get a kick out of going to the Apple Store and looking at the people who work there,” Fishman said. “People who work there, they text. Their postures are usually somewhat rolled at the shoulders and heads forward.

Brad Kern, another athletic trainer and ergonomic specialist at Essentia Health-Duluth Clinic, sees the same thing.


“I used to work at a school, and you see kids at the computers and they’ve always got those rounded shoulders,” Kern said.

At 29, Kern is solidly in the texting generation. But he only occasionally texts, he said, preferring to talk to his friends on the phone.

Lyth, 62, texts only for “essential communication,” she said. Martinson, 58, texts “very little and, I’m told, very poorly.”

But for Sparrow, 31, and many others, texting is a way of life.

“Most of what human beings do now is through their smart phones,” she said. “All of my son’s hockey emails come to my phone. There’s no phone trees anymore.”

So telling people to quit texting is unrealistic, experts say.

“I don’t tell them to give it up, because that’s the primary way that I communicate,” Fishman said. “So I don’t think it’s going away, and I don’t tell people to put it away.”

But there are ways to avoid text neck and other posture-related problems.

“I’m a big advocate for trying to stretch,” Martinson said. “Usually you develop tight muscles on the front of the body from sitting forward, so we try to stretch those out. Tight muscles generally have weak muscles on the opposite side of the body, so we try to do some strengthening for the upper back muscles.”

Sparrow said the most basic exercise is to sit up straight, with your head up and your chin up, and pull your shoulder blades down and together along the back. Office workers should stop what they’re doing every one or two hours and do five to 10 repetitions, she said.

Posture while texting also can make a difference. If your head is forward at a 15-degree angle, the weight on your spine is about 27 pounds, Fishman said. At 30 degrees, the weight is 40 pounds.

“So we encourage people to put their shoulders back, put their ears over their shoulders and shoulders over your hips and then hold your device at an angle, which would be basically bringing your device to you,” Fishman said. “Don’t you go to the device.”

You can help yourself when you’re not texting, too.

“I tell people when you’re standing to put your hands behind your back,” Martinson said. “It brings your shoulders back so your posture just automatically becomes better.”

Martinson is starting to see younger patients as the effects of iPosture take hold.

“They’re still resilient enough to get by with it for a while, but as they get older I’m afraid you’ll see it much earlier,” he said. “It’s stuff we weren’t exposed to. …

“You see these things coming, and I don’t think they’re going to be good for the next generation.”

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