“Text neck? Not anymore! Not for my daughter!” claimed Mary Teresa as she celebrated the postural correction improvements of her daughter Alexandra’s second posture image. Mary Teresa was brought to tears twice in our office; tears of despair on her daughter’s first visit, and tears of joy on her report of findings.

You met Alexandra in High School Health Drama. At 16 years old Alexandra was experiencing excruciating headaches 4 days per week. Her headaches would usually come in the afternoon, making half of her school day absolutely miserable. Alexandra tried to pay attention in class, but the more she tried to concentrate the more her head would throb. All she wanted to do was go home and lay in bed each day.

Alexandra was suffering from Text Neck, a modern day health epidemic. With the correction of her forward head posture, Alexandra’s headaches went from a frequency of 4 times per week to almost nonexistent. She, like 70% of patients who present with headaches, demonstrates cervical dysfunction (Goldstein & Makofsky, 2005). Text Neck: the Health Epidemic of the Tech Era explains why forward head posture is directly related to headaches.

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With poor postural design of posture quadrant 1, patients commonly present with recurrent headaches. If forward head posture is related to cervical dysfunction and headaches, then proper posture of posture quadrant 1 is directly related to health and optimal function.

The correction of forward head posture is a key to better health in the technology era. With patients spending on average 2-4 hours per day looking down at their cell phones, there is a great need for effective postural correction strategies of Text Neck.

3 Must Do Strategies to Correct Text Neck:  

Effective correction strategies of the postural distortion pattern require bringing the head back to correct posture by reversing the postural distortion pattern. With forward head posture, have the patient translate their head posteriorly with the utilization of tractioning, reverse posture exercises, and posture habit re-education. The head posture has become misaligned anteriorly due to time, and stress. Correction will thus require time and stress in the posterior direction for complete correction.

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1) Cervical traction is a method of spinal alignment. This is the first strategy for correcting forward head posture. The force from the traction device will produce strain in the tissues that have become pathologically shortened due to the abnormal sustained postural presentation of forward head posture. A sustained period of time for traction is necessary to cause plastic changes in the posterior direction.

With text neck, the patients’ head will translate anteriorly, then bend forward into anterior flexion. To correct this alignment through tractioning, the patient draws their head posteriorly and back into extension. The patient will then hold this position in the traction device. As the patient progresses with their treatment plan and demonstrates the postural fitness necessary to perform cervical traction without any contraindications, then weighting will be applied and maintained for the set period of time.

2) Resistance exercises to build postural fitness is the second strategy. The patient will perform neck retraction exercises to draw the head posteriorly so the ear and the shoulder are in proper alignment. The patient will perform neck retractions without resistance first, then as they demonstrate the ability to perform the exercise with proper posture, they will utilize resistance.

To perform this exercise the upper thoracic and shoulders should be stabilized to allow solely the head to translate posteriorly. Stabilization can easily take place by having the patient stand against the wall with their shoulders and thoracic spine touching the wall. Placing a posture cushion or supportive block behind the patient’s shoulders will also help the patient in correctly performing these movements.

As the patient becomes proficient in this exercise, resistance can be added through the utilization of a resistance band or bungee. If using a head strap or harness it is important that the bungee be placed in the exact center of the patient’s forehead to avoid incorrect activation of diverse cervical musculature. As the patient continues to perform these exercises it will become easier. It can help the patient to have a mirror available to watch his or herself perform these exercises.   This can aid in correctly performing the movements.

3) Posture habit re-education while interacting with technology is the third strategy that is vitally important to the correction of forward head posture. What patients do outside of your office is as important as what they do while in your office. By teaching them how to have proper habits while interacting with technology you are setting your patients up for success.

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Teach your patients to bring their cell phones to eye level while texting instead of looking down. If their arms get tired holding up the phone it is an indication to take a posture break to stretch the flexor muscles that have become hunched forward from prolonged anterior head carriage. This is an alarm for them to check their posture.

Patients should also be aware of the placement of their computer screen while at work. They should be able to look forward without looking down to view the screen. Simply lifting the computer screen to eye level will help patients maintain proper posture throughout the day. Proper postural habits are essential to achieve complete postural correction.

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Written By:
Dr. Krista Burns
Co-Founder American Posture Institute
Doctor of Chiropractic
Doctor of Health Administration
Certified Posture Expert