Dean Fishman, a chiropractor in Florida, was examining an X-ray of a 17-year-old patient’s neck in 2009 when he noticed something unusual. The ghostly image of her vertebral column showed a reversal of the curvature that normally appears in the cervical spine — a degenerative state he’d most often seen in middle-aged people who had spent several decades of their life in poor posture.
“That’s when I looked over at the patient,” Fishman says. She was slumped in her chair, head tilted downward, madly typing away on her cell phone. When he mentioned to the patient’s mother that the girl’s posture could be causing her headaches, he got what he describes as an “emotional response.” It seemed the teen spent much of her life in that position. Right then, Fishman says, “I knew I was on to something.”
He theorized that prolonged periods of tilting her head down to peer into her mobile device had created an excessive strain on the cervical spine, causing a repetitive stress injury that ultimately led to spinal degeneration. He began looking through all the recent X-rays he had of young people — many of whom had come in for neck pain or headaches — and he saw the same thing: signs of premature degeneration.
Fishman coined the term “text neck” to describe the condition and founded the Text Neck Institute (text-neck.com), a place where people can go for information, prevention, and treatment.
“The head in neutral has a normal weight” of 10 to 12 pounds, says Fishman, explaining that the neutral position is ears over shoulders with shoulder blades pulled back. “If you start to tilt your head forward, with gravity and the distance from neutral, the weight starts to increase.”
A recent study in the journal Surgical Technology International quantified the problem: As the head tilts forward 15 degrees from neutral, the forces on the cervical spine and supporting musculature increase to 27 pounds. As the tilt increases, the forces increase to 40 pounds at 30 degrees, 49 pounds at 45 degrees, and 60 pounds at 60 degrees.