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Text Neck ™ : The next Epidemic Lecture By: Dean L. Fishman, B.S.E.S., D.C. Founder of The Text Neck ™ Institute.

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Presentation on theme: "Text Neck ™ : The next Epidemic Lecture By: Dean L. Fishman, B.S.E.S., D.C. Founder of The Text Neck ™ Institute."— Presentation transcript:

1 Text Neck ™ : The next Epidemic Lecture By: Dean L. Fishman, B.S.E.S., D.C. Founder of The Text Neck ™ Institute

2 Definition Medical Dictionary Main Entry: 1 ep·i·dem·ic Pronunciation: "ep-&-'dem-ik Function: adjective 1 : affecting or tending to affect an atypically large number of individuals within a population, community, or region at the same time

3 Mobile Technology Statistics Mobile phone use is skyrocketing — more than four billion worldwide, with a billion sold in 2008 alone. Google searches for mobile computing edge Software giant bets big on Android apps like ‘Google Goggles’ CNBC, Thurs., Dec. 3, 2009

4 Mobile Technology Statistics The world is becoming more mobile. The age that a child is getting a mobile phone is getting younger and younger due to affordable prices and parents wanting to stay in touch for security purposes.

5 Mobile Technology Statistics Kaiser Family Foundation released a study showing that young people within the age of 8 - 18 years spend 7 hours and 38 minutes with electronic media in an average day (53 hours over a week). Interestingly, because of multi-tasking between different media, they can pack 10 hours and 45 minutes (10:45) worth of media content into those 7½ hours.

6 Mobile Technology Statistics A study at the University of Queensland in Australia has found that text messaging is the most addictive digital service on mobile or internet, and is equivalent in addictiveness to cigarette smoking.

7 Mobile Technology Statistics More text messages are sent per phone than phone calls. The average text messages used per month is 357 compared to 204 cell phone calls. 72.2% of wireless users have paid for Short Message Service (SMS) packages. This equates to 203 million Americans. 57% of wireless users 13 years of age or greater are considered regular text message users. From a webinar hosted by Neustar, a telecommunications company

8 Mobile Technology Statistics Data released December 15, 2009, by the Census Bureau reported that Americans sent 110 billion text messages in December 2008. In the same month in 2007, Americans sent 48 billion.

9 Mobile Technology Statistics The rise in texting has had another quantifiable effect, according to the Census Bureau. Cellphone calls have gotten a little shorter. In 2008, the average call's duration was 2.27 minutes. From 2004 to 2006, it was about 3 minutes.

10 Mobile Technology Statistics Amanda Lenhart, a senior research specialist for the Pew Internet and American Life Project was not surprised that the trend is especially prevalent among teenagers. "Teens are still developing their communication habits. Adults have preset ones already."

11 Mobile Technology Statistics Google’s Vice President of Engineering and Mobile Applications, Vic Gundotra has noted that “We are seeing a very fundamental shift where increasingly, particularly among the young demographic and in Asian countries, the primary access to the Internet is not through the PC but through mobile devices.” Google searches for mobile computing edge Software giant bets big on Android apps like ‘Google Goggles’ CNBC updated Dec. 3, 2009

12 Mobile Technology Statistics In 2008 almost 162 million smartphones were sold, surpassing laptop sales for the first time. Analyst forecasts smartphone penetration will reach 13.5 per cent of new handsets sold this year but is set to triple by 2013 – to well over a third (38 per cent) of mobile devices. Informa Telecoms & Media

13 Mobile Technology Statistics Smartphone sales will continue to be immune to the global economic downturn, maintaining "robust growth" of 35.3 per cent, year-on-year. Informa Telecoms & Media

14 Mobile Technology Statistics The total smartphone market in 2014 will be 412 million units. Research & Markets

15 Mobile Technology Statistics Hand held mobile devices are performing more daily functions and are more portable than ever. Goggle’s Vic Gundotra said, "In some respects, we're past the era of the PC and into the era of extrasensory computing.” “These mobile phones have eyes. They've got a camera. They've got ears. Every one of them has a microphone. They've got skin. You can touch them. And they're increasingly augmenting our own senses." Google searches for mobile computing edge Software giant bets big on Android apps like ‘Google Goggles’ CNBC, Thurs., Dec. 3, 2009

16 Mobile Technology Statistics A study from AT&T conducted in connection with its involvement in the live broadcast of “March Madness” games via mobile phones found that nearly seven in 10 Americans (69%) are interested in watching TV programming live on a handheld mobile device.

17 Mobile Technology Statistics 1.36 trillion text messages were sent and received in the United States in 2009 –CTIA February 10, 2010 5 billion text messages were sent per day by the end of 2009 -CTIA March 23, 2010

18 Mobile Technology Statistics According to a survey by the market research firm NPD Group, RIM has sold 7.8 million BlackBerry units during the first calendar quarter of 2009 RIM zoomed past Apple during Q1, sold twice as many phones as Apple May. 4, 2009 by: Christian Zibreg According to analyst Mark McKechnie at Broadpoint AmTech, estimated that Moto would sell one million Android-based phones in Q4 2009 alone. Analyst estimates 100,000 DROID smartphones sold in first weekend By Darren Murph posted Nov 10th 2009 More Than 10 Million Nokia Smartphones have been sold Nokia Fanboy September 8, 2009

19 Mobile Technology Statistics Forrester Research expects that three million e-book readers like the Kindle will be sold this year. And by the end of next year, they expect 10 million e-book readers will have been sold. The 2009 sales projection was up 50 percent to 3 million, with 900,000 units expected to sell during the holidays. Forrester Research

20 Mobile Technology Statistics Princeton's Office of Information Technology (OIT) and the Princeton University Library are working with Amazon’s Kindle DX electronic reader in a pilot project to study if using an electronic reader can reduce the use of paper at Princeton while preserving the benefits of the traditional classroom experience. Princeton is one of five colleges and universities participating in the project, joining Arizona State University, Case Western Reserve University, Reed College and Darden School of Business at the University of Virginia.

21 Mobile Technology Statistics On March 6, 2009, Nintendo announced that it had shipped its 100-millionth Nintendo DS system. “Nintendo Ships 100 Millionth Portable Nintendo DS System”. Nintendo. 2009-03-11. 2009-03-11.

22 Mobile Technology Statistics February 13, 2009 – Sony Computer Entertainment Inc announced that the cumulative worldwide sell-in units of PSP® (PlayStation®Portable) handheld entertainment system (PSP-1000, 2000 and 3000 series) reached a total of 50 million units as of January 2009.

23 Mobile Technology Statistics Microsoft believes that in the not to distant future, TV consumption will be more portable than ever before as consumers see fewer and fewer differences between the screens belonging to their TV, the ones on their laptops and the ones on their mobile devices. Future of TV: Microsoft’s Ballmer Sees Content Everywhere: CEO Hopes to Move Early Adopting Practice to Mainstream by Brian Steinberg Published: January 07, 2010

24 Hand Held Mobile Device Demographics Smartphones: 25-34 years old NielsenWire Text Messagers: 13-27 years old Mobile Marketing Association and Pew Internet & American Life Project Surveys Kindle: 50-59 years old Kindle Culture Wednesday, April 29, 2009 PSP: 15-16 years old Sony Looks To Broaden PSP Appeal By Greg Tarr -- TWICE, 6/2/2008

25 Inside Best Buy at the Mobile Phone Counter

26 Outside the Apple Store

27 Inside the Apple Store






33 How Does This Technology Effect Our Patients?

34 Effects of Text Neck The effects of long term forward neck posture leads to "long term muscle strain, disc herniations and pinched nerves." Mayo Clinic Health Letter Vol. 18, #3, March 2000

35 Effects of Text Neck In a survey of over 6,000 cases of chronic headache sufferers, it was found that complete or segmental loss of the normal lordotic curve of the cervical spine is the most consistent feature and very often is the only abnormality found. Braaf MM. Trauma of the cervical spine as a cause of chronic headache. J Trauma 1975;15:441-446

36 Effects of Text Neck It was found that headache sufferers had a significantly forward head posture, decreased isometric muscle strength, and less muscle endurance than non-headache subjects. Those with reverse cervical curves also reported the greatest pain. Watson DH, et al. Cervical Headache- an investigation of natural head posture and upper cervical flexor muscle performance. Cephalgia 13(4): 272-284, 1993

37 Effects of Text Neck 60 female subjects, aged between 25-40 years, were divided into two equal groups on the basis of absence or presence of headache. Measurements of cranio-cervical posture and isometric strength and endurance of the upper cervical flexor muscles were compared between the two groups of subjects. The headache groups had an increased forward head posture, decreased cervical muscle strength and decrease cervical muscular endurance. Cervical Headache: An Investigation of Natural Head Posture and Upper Cervical Flexor Muscle Performance. Cephalgia Volume 13 Issue 4 Published Online: 19 Jan 2002

38 Effects of Text Neck It was noted in regard to Respiratory Dysfunction In Chronic Neck Pain Patients;... "the study demonstrated a strong association between an increased forward head posture and decreased respiratory muscle strength in neck patients." The journal Cephalalgia. 2009 Feb 2

39 Effects of Text Neck On Respiration Three muscles from the neck attach to the first and second ribs. Their job is to elevate the rib cage with inspiration, upon contraction. With forward head posture the muscles do not contract as well thereby limiting the amount of oxygen inspired. This has been shown in medical research to be a decrease of vital lung capacity of up to 30%

40 Effects of Text Neck “For every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds.” Kapandji, Physiology of Joints, Vol 3.

41 Effects of Text Neck “Loss of the cervical curve stretches the spinal cord 5-7 cm and causes Disease.” Dr. Alf Breig, Neurosurgeon (Nobel Prize Recipient)

42 Effects of Text Neck “90% of the stimulation and nutrition to the brain is generated by the movement of the spine” Additionally, Dr. Sperry demonstrated that 90% of the energy output of the brain is used in relating the physical body to gravity. Only 10% has to do with thinking, metabolism, and healing, so when you have forward head posture your brain will rob energy from your thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing. Dr. Roger Sperry, (Nobel Prize Recipient for Brain Research)

43 Effects of Text Neck Forward head posture (FHP) can add up to thirty (30) pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. FHP results in loss of vital capacity of the lungs by as much as 30%. This shortness of breath can lead to heart and blood vascular disease. The entire gastrointestinal system is affected; particularly the large intestine. Loss of good bowel peristaltic function and evacuation is a common effect of FHP. FHP causes an increase in discomfort and pain because proprioceptive signals from the first four cervical vertebrae are a major source of the stimuli which create the body’s pain controlling chemicals (endorphins). With inadequate endorphin production, many otherwise non-painful sensations are experienced as pain. FHP dramatically reduces endorphin production. Rene Cailliet M.D., director of the department of physical medicine and rehabilitation at the University of Southern California

44 Effects of Text Neck FHP has been shown to flatten the normal neck curve, resulting in disc compression, damage and early arthritis. Gore DR, Sepic SB, Gardner GM. Roentgenographic findings of the cervical spine in asymptomatic people. Spine 1986; 6:591-694

45 Effects of Text Neck Craniomadibular dysfunction, tooth wear and craniofacial growth asymmetries were found to be related to the posture of the head and cervical spine. Gonzalez H. Forward Head Posture: Its Structural and Functional Influence on the Stomatognathic System. J Craniomandibular Pract 1996; 14:71-80

46 Case Presentation 26 Year old female presented to our office with complaints of neck pain, headaches and upper back pain, as well as vision problems and shoulder pain. She texts more than she uses the phone. Sends up to 30 texts per day. Uses a laptop or PC for up to 7 hours per day. She sleeps face down, on her side and on her back. For 6-7 hours per day. She weight trains and runs. This patients angle of which she holds her hand held while texting is 17 degrees.

47 Case Presentation Before 3.5 °, 13mm After 17 °, 9mm

48 Case Presentation A 25 year old female pharmaceutical student presented to the clinic complaining of recurrent headaches, torticollis, with generalized neck and shoulder pain. She stated that she suffered for six months. She had taken Ibuprophen with some temporary relief. The patient stated that her pain radiated from the lateral cervical musculature, right side more than the left, to the right shoulder blade. She also stated that when the pain is particularly severe she also feels numbness in the area of the left trapezius muscle. When she began graduate school she began using a hand held mobile device and lap top more frequently. Her neck and shoulder pain has increased in frequency over the past year, now occurring an average of three to four days per week. The pain seems to be worse towards the end of the day and is aggravated by stress.

49 Case Presentation Before -7 °, 33mm After 15 °, 28mm

50 Case Presentation The patient is a 20 year old female who presented to the office with neck pain and intermittent shoulder blade pain. She sends up to 70 texts per day and uses a lap top or PC for 2 hours per day. She is a student and studies or reads up to four hours per day. The patient sleeps on her side, back and face down for 8 hours per night. This patients angle of which she holds her hand held while texting is 22 degrees.

51 Case Presentation Before 2 °, 13mm After 16.5 °, 8mm

52 My 2 ½ Year Old Son

53 The Text Neck APP





58 Q&A The Text Neck TM Institute 1-877-9TEXTNECK

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