Evidence of Text Neck in 7 Year Old Children!

Text Neck

Following on from my previous Blog entry on the condition called ‘text neck’ , it is interesting to see that the Daily Mail has published an article about an Australian chiropractor, Dr James Carter, who has reported seeing ‘an alarming increase’ in the number of patients coming to him with text neck within the last 2 years – and that about 50 percent of those patients have been school-aged children.

Dr Carter, and many other practitioners, have been finding very obvious postural changes associated with text neck, which lead to spinal damage and pain in people – including children as young as seven – which Carter puts down to their addictive over-use of smart phones and tablets for many hours at a time.

X-Ray of Seven Year Old Child’s Neck

These X-ray photos illustrate the damage to the neck that can result from this type of prolonged misuse. The first one is, sadly, of a seven year old boy and it shows just how compressed the cervical vertebrae are and how over-curved the neck has become, so that the head is pulled back and down. What cannot be seen in these particular X-ray photos is the way this compression continues downwards, into the rest of the spine.

Of course children are very mobile physically and it’s possible for them to assume this sort of position temporarily and then to come out of it into a more aligned poise with a more suitably lengthened-out neck. However, the more frequently such contracted positions are assumed, the more habitual this way of being becomes for the child – so the less mobile and adaptable the child’s body-use becomes and the more damage ensues .

The second of Dr Carter’s photos shows a more normal curve in the neck. This is particularly obvious at the top of the neck, which shows a space between the top vertebra and the skull – a crucial area which we need to keep freely moving, in order to enable good poise, balance and general body-use. Freeing up this area is a central part of Alexander Technique lessons.

F M Alexander’s ‘Directions’ that he formulated for us to use on an everyday basis, is one of the AT tools we can use to help us avoid this back-and-down compression. If the 7 year old child was able to give himself these directions regularly, this would allow his spine to freely lengthen out again, in a similar manner to that shown in the second photo. FM’s directions are regularly taught in AT lessons and give people a wonderful tool with which to help themselves:

Allow my neck to be free

To allow my head to go forward and up

To allow my back to lengthen and widen

X-Ray of ‘Normal’ Curvature of the Neck

Avoid Developing Text Neck

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Text Neck is Painful – Avoid it!

It was good to see some research published last year by Dr Kenneth Hansraj, in which he demonstrated how damaging it can be for us to spend time dropping the head forwards in order to use a smart phone – which many people do for several hours a day. This habit can result in people developing a condition called ‘Text neck’ and this is something that Alexander Teachers and other practitioners are seeing in increasing numbers, as people want help with reducing pain and discomfort.

The problem of text neck comes about because of the weight of our heads and the manner in which we use our bodies to support it or, most likely, do not support it efficiently.

I took this photo of some young men in London. They were all on their phones. All hunching over them in a variety of different ways. If you think about just how heavy those heads are, (see below) you can begin to sense how they drag on the neck muscles and compress the spine.

Symptoms of Text Neck:

Headaches,
Neck Pain,
Upper Back Pain
Shoulder Pain
Increased Curvature of the Spine

Add to this an increase in the number of people developing RSI and you can see that using smart phones can be a risky business, unless you are careful.

Our heads are surprisingly heavy.

An adult’s head weighs between 10 – 12 lbs, or 4.5 – 5.0 kg. Human heads are heavy!. When I give someone their first Alexander lesson, I often ask them to hold a couple of weights that, together, weigh 8.8 lbs / 4 kgs and I explain that the weights almost certainly weigh less than their heads. Most people are really shocked!

When we have a neutral, upright poise, so that the head balances freely on the top vertebra, we do not notice the weight of the head much. However, when the head and neck are dropped forwards, as in the diagram below, we do begin to notice, and the impact of that big weight increases the more pulled down we are. When someone’s head is dropped forwards to an angle of 60 degrees, the weight seen by the spine is massively increased to 60 lbs. No wonder we begin to get neck, back and shoulder ache! If this misuse and position become a habit, then we begin to damage the cervical spine with an increased curvature, which can get fixed into a very hunched postural position.

Of course this sort of habit can also develop from performing other activities whilst dropping the head forwards and down – for instance when reading books, sewing, performing craft-work or computing – I take care to think about my body use when writing this, so that I avoid contracting down over the keyboard.

How Much Time do You Spend on Your Phone? How do You Use it?

If you take note of your habits, you may be surprised by the amount of time you hunch down over your cell phone – the average is between 2 – 4 hours per day. Are you reading this Blog on your phone right now? How much tension are you using whilst phoning and texting?

Perhaps mobile phones are more of a problem than other activities, because they get taken around with people all the time and demand our attention incessantly – it is hard to escape them! Often they are work phones, so people can be stressed by being contacted by work when they want to relax, or by having work problems follow them around all day. When we are stressed, we tend to be more tense and contracted and this just exacerbates any problems we may have with the way we use ourselves whilst on the phone. This sort of thing also contributes to RSI.

So How Do You Avoid Painful Text Neck Developing?

You can probably begin to see that it is worth paying attention to your phone use, because once you are aware of your habits, you can choose to do things differently and begin to avoid building up problems for yourself.

The young man in this photo below demonstrates how we can use the Alexander Technique to be mindful of our body use and be seated in an easy but poised manner. Note how he brings the phone up towards his eyes so that he can read the screen without disturbing the balance of the head on his neck, which is able to remain lengthening in alignment with the rest of his spine. He could also text or play games in this position and could maintain this sort of body use if he were standing.

Sometimes I will work with people whilst they demonstrate how they use their mobile phone, as part of their AT lesson. This can be really helpful, as people often begin to notice habits they were totally unaware of and they are then able to be more mindful about their body use when they are out and about, texting, phoning and playing games.

As one pupil reported after starting AT lessons:

“I’m more relaxed and don’t feel so dizzy as before and I have less neck pain”

Discover how to have fun on your phone, without feeling exhausted and achy afterwards!

Photo: STAT

How Can We Maintain a Child’s Fluidity of Movement?

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Leading With the Head

I have been looking again at the excellent book ‘Body Awareness in Action’ by Frank Pierce Jones and have been reminded of the similarity between aspects of F M Alexander’s work and the research findings of a famous physiologist.

F M Alexander began to develop his idea of there being a ‘Primary Control‘ mechanism of the head and neck in relation to the rest of the body, as early as 1912. He then began using the instructions, or ‘directions‘, for pupils to allow ‘the neck to relax and the head to go forward and up‘ both as they sat quietly or when began to move – for instance to stand up. These directions were a means to help his pupils regain, or even find, the natural type of movement and body use that most children have initially but often lose. Learning how to give ourselves these directions forms an essential part of Alexander Technique lessons today.

Some of Alexander’s medical friends who knew his teaching theories, pointed him to the work of the German physiologist Prof. Rudolph Magnus, who was researching the head and neck reflexes of mammals in the laboratory. Magnus’s best known book was Körperstellung 1924 (‘Posture’) and the Magnus & De Kleijn reflexes have been named after him and his colleague.

As Dr Peter Macdonald stated in his paper published in the BMJ (Dec 25 1926) Alexander’s rather similar concept appeared to anticipate Magnus’s research which postulated that:

“The whole mechanism of the body acts in such a way that the head leads and the body follows”.

A pupil of mine kindly allowed me to use this photo of the little girl above. She so obviously leads her movement with her head and her body follows as she fluidly pulls her trolley behind her. She is alert and poised, yet she is also active and purposeful.

I doubt whether many adults, or even teenagers, would display such freedom of movement as they pull luggage around on their travels! Many would be tensely contracting down into themselves, twisting the whole body as they pulled the suitcase along.

It is possible to re-learn how to move more freely and I have found it helpful to spend some time with pupils, as part of an AT lesson, exploring how they move suitcases around, so they can think about this activity before they go off on holiday. When they give themselves the directions ‘I will allow my head to go forward and up’ so that it can lead them into their movement, their body plus suitcase, easily follow.

It is such a shame that so many people lose this easy balance and poise as they grow up and then have to re-learn it. FM Alexander always wanted to use his AT work to prevent problems of mis-use from developing in the first place. How much better if we can help children to feel happily confident in their bodies, so they are able to continue to move around easily, in a freely balanced and coordinated manner.

When the Alexander Technique becomes an everyday part of a child’s home life and school day, as in the lovely little school Educare, then it will be easier to avoid habits of distortion and tension creeping in, despite the various stresses the world throws at us and we can help children maintain their easy poise and fluidity of movement.

Alexander in Education

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Alexander Technique in Schools

There’s a great new video available on YouTube called ‘Alexander in Education’ and it is designed to promote the AT as a subject to be taught throughout general education

The AT is already being taught in a good number of primary and secondary schools, plus colleges and universities and it is really proving to be a wonderful tool for those who learn it. Not only does it help with problems such as back pain but is also reported as giving children, as well as adults, greater confidence and learning it helps to increase their attention span. But there are many many schools that do not use the AT yet and they could very much benefit from doing so.

Studying and Homework can be Stressful

Teaching children to sit, write, draw, play music and sports with awareness and ease reduces stress and discomfort, whilst helping prevent problems such as back pain from developing. This work also gives children a tool they can use throughout the rest of their lives.

The child in the photo is doing some drawing for her homework with an easy poise as she holds her pen in a comfortable manner. Unfortunately many of us lose this natural balance and way of using our bodies as we grow up, through stress, overwork, illness and accidents. Sadly, I have had several teenagers come to me for AT lessons who have already developed back pain and RSI. If the Alexander Technique was part of the school curriculum as F M Alexander wished, many children would be spared the pain of developing such problems.

F M Alexander’s Little School

Alexander opened a school in London in 1924, with the help of Ethel Webb and Irene Tasker who was a Montessori trained teacher. The children had ordinary lessons at the Little School and the Alexander Technique was embedded into the teaching, so the way the children performed their work and lived their day was a very important part of their learning experience. Unfortunately the second world war started and the children were evacuated to America and the school was never re-established after the war ended.

Today, there is just one primary school in the UK called Educare that runs along very similar lines to FM’s Little School, with the AT embedded into the way the school works and how the children learn. At the other end of learning, the AT is also embedded into the degree course at the Royal College of Music and many other institutions offer the AT alongside other lessons. It would be so good if all schools used the Alexander Technique to form the foundations, upon which all other subjects could build.

Take a look at the video Alexander in Education and do let other people know about it. Let’s get the Alexander Technique into more schools:

https://www.youtube.com/watch?v=TOMlc0f0orA

Caring for the Carers

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Caring for the Carers with the Alexander Technique

This is Carers Week in the UK and it is great to draw people’s attention to the fact that carers very often get little support for what is often a lonely, stressful, challenging and exhausting activity. The Carers Week Website cites some research that shows that, as a result of their caring responsibilities, 84% of carers felt more stressed, 78% more anxious and 55% experienced depression (State of Caring 2015). It can be tough being a carer!

Some years ago I ran ‘Stress and Relaxation‘ and ‘Caring for the Carers‘ courses in Adult Education Colleges and I was made very aware of just how difficult a life it can be for carers and how isolated they can feel. Unfortunately, carers often spend so much time caring for others that they forget to look after themselves – or even feel that they have no right to look after themselves or have time off – and this can result in their getting exhausted, unable to cope, angry, resentful, anxious, depressed or ill. Back problems are also a frequent outcome from lifting inappropriately, or from experiencing high levels of stress and tension. None of which is good for the carer, or good for the person being cared for.

There are also many people who work in caring professions and locally, there are lots of charity workers who also tend to put other people and their needs first.

“It’s Selfish to Put Myself First” – NOT NECESSARILY!

Have you ever travelled by plane and listened to the Pre-flight Safety Instructions? If so, you will have heard that it is important to put your own oxygen mask on first, before putting one on anyone else who needs assistance. People accept that idea on a plane but are often less happy to think that way at home, even though the same dynamics are true in the rest of life – you will help others far better when you look after yourself and avoid putting yourself at risk or making yourself ill from overwork.

Sometimes that means putting yourself first, for a change.

So how can the Alexander Technique help?

The AT is a wonderful tool that you can use throughout your life. Once you have learned how to use the AT during your daily activities it can, for instance, help you to cope with stressful situations, calm yourself, reduce tension and avoid injuries.

The most obvious tool you can use is the Lying Down or Constructive Rest Procedure and this can quickly help you to unwind and rejuvenate yourself, so that you can proceed with the next part of the day’s activities from a calmer and more centred place in yourself. It is also great at helping you to reduce tension and back pain.

These women were learning how to use the active rest procedure in an Intro Workshop on International Women’s Day 2015.

Calm ~ Mindful ~ Unwinding ~ Centred ~ Freeing-up ~ Alert ~ Calm

Semi-supine IWD '15 07-03-2015 12-08-30.jpg

STOP and Count to Ten

There are many other less obvious ways in which the AT can help us cope with difficult situations. For instance, the old technique of ‘stop and count to 10‘ is familiar to many as a useful anger management technique. More subtle but similar, is the Alexander Technique use of inhibition. With this we learn to stop briefly in order to avoid rushing into a habitual reaction to something, so that we can more thoughtfully choose how we want to respond. (This process is a lot quicker than counting to 10!)

Inhibition can be applied to avoiding all sorts of habits, from tightening our neck muscles as we rise out of a chair, saying ‘no’ to shouting at someone, to reacting with tension as we begin to use a computer – or even in reaction to just thinking of using one. When we are aware, we can notice all sorts of habitual reactions to both the outside world and also to our own internal thoughts. Once we have noticed them, we can learn to have more choice about whether or not we react habitually, or choose to respond differently.

Stress

Some situations are extremely stressful and we may have little chance to change things. However, we do have some choice as to how we react to stress and this can be invaluable in helping all of us, not just carers, to cope with the difficulties and challenges that are in our lives. We can use the AT as we travel on crowded transport, deal with a screaming child or try to unwind after a day’s work… you name the stress and using the AT will probably help you with it.

For instance, a pupil told me that using the Alexander Technique helped her to remain calm, still and relaxed, when cooped up in the machine to have an MRI scan, despite having thought she would feel claustrophobic in it.

Once we learn the Alexander Technique, we can use the AT during all our activities, every day. In so doing we can feel less helpless in the face of stress, because we know we have a tool we can use to help ourselves and to take care of ourselves in many, many different situations.

Next Introductory Workshop is on 4 July

Lower Back Pain linked to Chimpanzee Spine Shape?

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Research Study

A BBC article discusses a Research Study by scientists from Scotland, Canada and Iceland which has been published in the journal BMC Evolutionary Biology, which suggests that some peoples’ lower back pain may be caused by the shape of their vertebrae.

When the scientists studied the skeletons of ancient humans, chimpanzees and orangutans they found that some human skeletons that showed evidence of intervertebral disc herniation, had vertebrae more similar in shape to chimps than to other humans without disc damage. Chimps do not walk with an upright stance as we do and the argument put forward by the researchers is that in some people, the evolutionary development of the spine contains “pathological vertebrae” which “may be less well adapted for walking upright”.

Photo: BBC

It may well be that some people are genetically more predisposed to having lower back pain than others but there seems to be little mention in the research paper of the impact of our body-use and habits of mis-use that contribute to back problems such as a ‘slipped disc’, other than saying that they appear to be caused by strain and stress on the pathological vertebrae which cannot support the downward compression, so cannot protect the discs. If some people do have spines that are more vulnerable to the sort of compression and distortion that contribute to having a ‘slipped disc’, then it is surely even more important that they learn to use their bodies in the most aligned and effective manner, in order to protect the discs and prevent their herniation.

Habitual Mis-use

When we curl over, the vertebrae and discs contract down on one side and can push the soft tissue of the discs so that they bulge out, or herniate. This is not just a problem for the lumbar region of the back but we can get slipped discs in the neck and other areas of the spine as well, if they are continually compressed with habitual mis-use, or as the result of an accident. This wooden dummy does not have vertebrae but the discs of wood representing the torso can be seen to be angled, narrowed and compressed on one side, just as the vertebrae and the discs between them would be.

Monkey Position

This research paper gives a new slant on F M Alexander’s concept of using ‘monkey position’ or ‘the position of mechanical advantage’ as he called it, which allows us to bend forwards from the hip joints, thus allowing the spine to remain lengthening – which protects the vertebrae and the intervertebral discs from compression and distortion. You can see in this photo which is illustrating ‘monkey position’ the wooden discs forming the body are more evenly spaced and opened out – if these were our vertebrae, you can see that this allows more space between them, which would not compress the discs in the same way as above.

Nature or Nurture?

This debate about the impact of our genetic inheritance and the impact of our learning throughout our lives will continue. I suggest that for most conditions, it is an interplay between both that we have to live and work with. Fortunately, most of us do have choices available to us about the way we live, use, mis-use or even abuse our bodies. As the BBC puts it ‘Back pain is a very common issue in humans’ – but many hours lost at work through back pain could be avoided, if people learned how to move differently, so that they protect their backs as they sit, walk and work throughout the day. It can be done, as the ATEAM Research Trial showed, which found that Alexander Technique lessons significantly reduced chronic lower back pain and was more effective than either massage or a Doctor’s exercise prescription.

Out and About with the Alexander Technique

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The Alexander Technique is far more than ‘relaxation’ or stress management, although it can help us in both ways. When we include using the Technique during our everyday activities, it can help us unwind and to avoid slipping back into habitual reactions that create tension, distortion and discomfort in our bodies.

If you keep being aware of your use during activity and regularly practice the lying down procedure, your body- use is likely to improve and your movements will tend to become more free and easy than they have been for some time. It really can increase your wellbeing, so why not reward yourself.

Some people say that they don’t have time to practice this procedure, which is sad. If they allowed the time to do this regularly, they would realise just how enjoyable it can be useful it is as we unwind and come back to ourselves and they would also see just how much we can learn about ourselves in the process. We often work better afterwards, too.

Lying down and working on ourselves can become like a safe haven to return to in the middle of our hectic lives – or when out enjoying yourself but back pain threatens to spoil the day.

The photo was taken in the New Forest, where this man suddenly lay down in semi-supine, right in the middle of the ride, to ease his back pain. He’d only had a couple of AT lessons and was not lying with the ideal height of support under his head, so his neck is still a bit contracted and arched – but we don’t have to be perfect, anyway! It was great to see the Lying Down Procedure being used so naturally – and in such a beautiful setting. It can only improve our health and the quality of our lives.

Now I shall lie down and work on myself……

More Thoughts on the Active Rest Procedure

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Ah the joy of lying down in Semi-supine!

When we lie down in semi-supine with a book under the head and knees bent, this allows our spine to gain maximum support and our nervous system to calm down. This wooden model would not let me bring the feet any closer to its body but for most of us, this position has the feet too far out, so they will tend to slip away. Also, the weight of the legs tends to drag on the pelvis, contributing to creating an arch in the lumbar region, the lower back, which can be uncomfortable, particularly if you have back pain. If the heels are just in front of the knees, this usually works better – unless you have a restriction in your knees in which case bring the feet in as close as is comfortable for you, without forcing the position.

If you place your hands somewhere on your torso, with your elbows easing out away from your body, this allows your shoulders to drop into place more easily. Again this model would not let me put the hands on the ribcage, which is where many people find is a good place for them to be.

A variation on the lying down procedure is to place the feet on a chair, so that the legs are more or less at right angles to the body. This is great if you are finding it hard to balance the legs without using lots of muscular effort, as you just don’t have to worry about balancing them when they are supported on a chair. It can also be good to use this position if your lower back is feeling very contracted and tense. Just make sure that you are not restricting your circulation behind your knees. You can then add this variation on the lying down procedure into your repertoire of tools to use to work on yourself.

Whichever position you use, enjoy the process of unwinding and easing your body into its full length and width and experience being in a quieter, freer and calmer state. Then allow that calmness and expansiveness to still be with you when you get up from the floor and begin your next activity, whatever that is.

One pupil got up from lying down on the AT table and caught site of himself in the mirror and exclaimed “I look taller and broader than I did before my lesson!” It works…..

For more info, you might like to read the notes on the Lying Down Procedure.

Standing with Ease

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Standing with Ease Using the Alexander Technique

In Alexander lessons, we really can learn how to feel comfortable when we stand for long periods of time, rather than ending up with back pain.

When we allow ourselves to balance on our feet in a coordinated manner without bracing and locking our legs and backs, we can support the weight of our upper body whilst using far less effort. In so doing we reduce the downward pull of gravity – and we are less likely to sag.

I often used to have an aching lower back even when a child, as I trailed around shops or art galleries. Despite being trained in ballet, I still used to sink down into myself and put pressure into my lumbar spine. This would be worse when I was tired, or bored, or when I was trying to look shorter than I really was. Thankfully I changed these habits when I learned the AT, so I stopped getting that heavy back ache – and art galleries are far more enjoyable now!

This sinking down into oneself is graphically shown in a sculpture by Francesco Messina. Many people will just see a curvaceous young woman called Maria. I see a familiar, distorted pose, with the body’s weight mainly taken on Maria’s left foot, which throws her off balance and displaces her pelvis. Her weight is pushed down into the lumbar area of her back which over-arches (Lordosis) and cannot properly support her upper back and head. Her neck thrusts forwards and curves her upper back, making a pronounced ‘S’ shape (which could develop into Kyphosis)

Thumbnail image for Lugano Statue Maria Grazia .jpg

Maria Grazia by Francesco Messina – Lugano

This posture of sinking down onto one hip is frequently used, particularly by women. Standing on one foot may look non-threatening, even vulnerable and is sometimes thought of as feminine. ( But do women want to look vulnerable these days? )

If we just move briefly through this sort of off-balance position, little harm will be done – but if this is a habitual posture, we will probably end up with hip and lower back pain and problems such as Sciatica. By changing our habits in AT lessons, we can often avoid contributing to such conditions.

Maria Grazia by Francesco Messina 1967 front 10-08-2008.jpg

Sinking down on one hip, throws the body off balance

When we have to stand for long periods of time, as I have to as an Alexander teacher, it does make a huge difference to our general well-being to be able to stand freely and easily, sharing the body’s weight on both feet, with the head balanced on the neck, creating an alignment through the whole body from the ears right down to the ankle joints. In this way we can fine tune our balance, adjusting to even small changes in our body as we stand and move.

This balanced way of standing and using the body may be seen in the photo of an artist’s wooden model. I had fun trying to make it stand. It could only do so when everything was in alignment and balanced. It underlined for me just how much we as humans pull ourselves and our skeleton off balance with our poor body-use, so that our muscles have to work extra hard in order to let us stand up at all. When we are poised, our muscles work in a coordinated way and we balance more easily.

Learning the Constructive Rest Procedure

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IWD Workshop ~ Learning how to do the Lying Down Procedure

As part of any Introductory AT Workshop, I always include some time to introduce the Lying Down Procedure to participants. This is performed in a semi-supine position, which allows the back to have maximum support and the spine is as near to being in a straight line as it is likely to get.

In the first photo, you can see some of the women following my instructions and using their hands to gain a sense of their head-neck-back relationship, in order to roughly work out what height books they would need under their heads. Both myself and Deena Newman, who assisted me, then went around and adjusted the books if necessary, as different people need different height books to rest on. If the books are too low, the head drops back and down to the floor and the neck curves into a banana shape, so cannot release and fully lengthen out. However if the books are too high, the throat can be constricted and pressure can be put onto the vertebrae at the base of the neck. So it is worth taking care when choosing the height of books to use under our heads.

Once people were lying appropriately, we then gave everyone another brief experience of some ‘hands-on work’ – as you can see in the second photo, which shows Deena putting her hands on a participant’s head and neck, encouraging her to release any muscle tension and to have a ‘free neck‘. During individual lessons, this usually takes place on a table, which makes life rather easier for the teacher!

Thumbnail image for Deena Newman working with a workshop participant.jpg

Why do we use books?

Soft cushions and pads give way and get compressed under the weight of the head but paperback books give us a firmer support – without being as hard as hardback books! In the same way, we always lie down on the floor, rather than a bed, so that our bodies can have maximum support and more of a chance to let go of contractions and ease out into into a more lengthened and expansive state.

There was a brilliant and relevant quote in a recent Guardian Interview when Jonathan Price, the actor, was asked Which
book changed your life?

‘The one the teacher put under my head during the Alexander Technique sessions at Rada. I grew an inch and a half.’ Jonathan Price Guardian Interview 7 March 2015

Article on Using the Constructive Rest Procedure

If you would like to read more about using this incredibly useful, calming and enjoyable procedure, you might like to read my article on the Lying Down Procedure.

Even without going to Alexander Technique lessons, this procedure can be used for relaxation and to help you de-stress – but with the help and guidance of an AT teacher, you can learn how to make the lying down procedure far more effective! It can help you let go of tensions, calm your nervous system and importantly, can set you up to perform your next activity more freely and easily, whatever that activity may happen to be. It is a valuable tool to use throughout your life.

Introductory Workshop for Men, Women and Teens 25th April