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Do you have ‘text neck’?

Does your neck ache after gazing down at your mobile device for a long time? Do your thumbs get sore after firing off a string of e-mails on your smartphone?

Those are just two of the physical ailments caused in part by technology. Sporting such names as “text neck,” “computer vision syndrome,” “Blackberry thumb” and “iPad elbow,” these syndromes may sound phony, but they’re every bit as real – and painful – as carpal tunnel.

Here’s a look at four increasingly common ailments associated with improper or overuse of gadgets, plus recommendations for how to avoid the problems.

Condition: Text neck

Text neck is usually caused by excessive use of smartphones or tablets. Due to the popularity of text messaging with teenagers, the condition is more common in adolescents and young adults, but can be seen in anyone who spends hours looking down at mobile devices.

Think of your head as a bowling ball sitting on a spring. Tilting the ball forward for an extended period of time stresses and bends the spring, says Robert Hayden, an Atlanta chiropractor. The more this happens, he says, the greater the chance of flattening the natural curvature of the neck vertebrae. Eventually, you put added pressure on the discs of the cervical spine and more strain on the muscles and ligaments of the neck.

Solution: Stop looking down.

You can prevent text neck by taking frequent breaks and using range-of-motion exercises. Try flexing your neck by looking side to side and putting your ears down against your shoulders, Hayden says. You also can simply try holding your device higher so you’re not angling your head down to see it.

If the problem persists, ultrasound and electrotherapy can alleviate pain. Long-term remedies include resistance exercises to rebalance the muscles.

Condition: Computer vision syndrome

Overhead fluorescent lighting, the viewing angle of the display and small font size can contribute to the eye pain and strain of computer vision syndrome, according to Jim Sheedy, an optometrist and director of Pacific University’s Vision Performance Institute in Forest Grove, Ore. Undiagnosed, common eye problems like presbyopia – a reduced ability to focus on objects that are near – can exacerbate the condition.

Solution: Keep your eyes in shape.

Resolving the problem involves a two-prong approach: making the task less visually demanding and taking visual breaks, Mr. Sheedy says.

For example, turning off the overhead light and using softer desk and floor lamps can help. Also, try making the top of the display level with your eyes so you’re looking down about 10 degrees when viewing it. Adjust font sizes so you can read them easily.

To keep your eyes in shape, Mr. Sheedy recommends the 20/20/20 rule: Every 20 minutes, look away to a distance of at least 20 feet for at least 20 seconds. Such frequent breaks can help because computer vision syndrome is a fatigue problem, not an injury, Mr. Sheedy says.

Condition: BlackBerry thumb

Caused primarily by excessive texting, BlackBerry thumb is a strain of either the tendon that extends the thumb or the tendon that brings the thumb into the palm. The strain causes tiny tears to connective tissue.

The severity of the condition depends on how long, how fast and how hard you use a handheld device. But it doesn’t affect only those using mobile keyboards – it can result from any repeated finger motion.

“What happens when people don’t rest is they go into chronic phase because there’s so much scarring and trauma,” says Dorit Aaron, president of the American Society of Hand Therapists and an occupational therapist at Houston Hand Therapy in Texas. That means the pain might never go away.

Solution: Give your fingers a rest.

If you’re writing lots of e-mails on your phone or tablet, take breaks and slow down, Ms. Aaron says. Fast texters are more vulnerable because they have more repetitive motions. You also can switch to a touch screen, which may be better than a physical keyboard because it requires minimal pressure.

Condition: iPad Elbow

A repetitive strain injury, iPad elbow can affect a variety of tendons from the wrist to the elbow, depending on how you hold your tablet. “People who are using laptops and tablets often don’t focus on the ergonomics of it,” says Christopher Morris, a Kingsport, Tenn., rheumatologist. Many tablet users curl up on a couch to get more comfortable, he says, rather than paying attention to proper posture.

Solution: Try an iPad holder.

While orthopedists are still getting a handle on this particular condition, taking breaks can help reduce the pain. “The biggest thing with any kind of repetitive activity is to listen to your body,” Mr. Morris says. “If doing something for an hour straight is going to make it hurt, don’t do it for an hour straight.”

Stretching pumps irritants and inflammation away from muscles, and increases the blood supply and flow of nutrients to muscles and joints. This is important especially after vigourous activity. This process promotes tissue healing and injury repair.

Here are some more reasons why stretching can be beneficial:

1. Reduces muscle soreness after exercise
2. Accelerates tissue healing
3. Improves balance and co-ordination
4. Improves posture
5. Promotes muscle relaxation
6. Boosts your energy levels
7. Relieves back and joint pain
8. Reduces the likelihood of back pain
9. Promotes total body relaxation and a greater sense of well-being
10. Maintains lifelong flexibility

Carpal tunnel syndrome is pressure on the median nerve — the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.

Causes, incidence, and risk factors

The median nerve provides feeling and movement to the “thumb side” of the hand (the palm, thumb, index finger, middle finger, and thumb side of the ring finger).
The area in your wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow, so any swelling can pinch the nerve and cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome.

Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel.

Symptoms

 Numbness or tingling in the thumb and next two or three fingers of one or both hands
 Numbness or tingling of the palm of the hand
 Pain extending to the elbow
 Pain in wrist or hand in one or both hands
 Problems with fine finger movements (coordination) in one or both hands
 Wasting away of the muscle under the thumb (in advanced or long-term cases)
 Weak grip or difficulty carrying bags (a common complaint)
 Weakness in one or both hands

Prevention

Avoid or reduce the number of repetitive wrist movements whenever possible. Use tools and equipment that are properly designed to reduce the risk of wrist injury.
Ergonomic aids, such as split keyboards, keyboard trays, typing pads, and wrist braces, may be used to improve wrist posture during typing. Take frequent breaks when typing and always stop if there is tingling or pain.

TENNIS ELBOW

Tennis elbow is inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow. There may be a partial tear of the tendon fibers, which connect muscle to bone. The tear may be at or near where these fibers begin, on the outside of the elbow.

Causes, incidence, and risk factors

The part of the muscle that attaches to a bone is called a tendon. Muscles in your forearm attach to the bone on the outside of your elbow. When you use these muscles over and over again, small tears develop in the tendon. Over time, this leads to irritation and pain where the tendon is attached to the bone.
This injury is common in people who play a lot of tennis or other racquet sports, hence the name “tennis elbow.” However, any activity that involves repetitive twisting of the wrist (like using a screwdriver) can lead to this condition. This condition may also be due to constant computer keyboard and mouse use.

Symptoms

 Elbow pain that gradually worsens
 Pain radiating from the outside of the elbow to the forearm and back of the hand when grasping or twisting
 Weak grasp

Treatment

The first step is to rest your arm and avoid the activity that causes your symptoms. Put ice on the outside of your elbow 2 – 3 times a day.
 Take nonsteroidal anti-inflammatory medications (such as ibuprofen, naproxen, or aspirin).
 If your tennis elbow is due to sports activity, you may want to:

• Ask about any changes you can make in your technique
• Check any sports equipment you’re using to see if any changes may help.

If your symptoms are related to working on the computer ensure that your workstation is set up ergonimcally.
You can buy a special brace for tennis elbow at most drug stores. It wraps around the first part of your forearm and takes some of the pressure off the muscles.

ROTATOR CUFF INJURY

The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable. Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons.

Causes, incidence, and risk factors

The shoulder joint is a ball and socket type joint where the top part of the arm bone (humerus) forms a joint with the shoulder blade (scapula). The rotator cuff holds the head of the humerus into the scapula and controls movement of the shoulder joint. The tendons of the rotator cuff pass underneath a bony area on their way to attaching the top part of the arm bone. When these tendons become inflamed, they can become more frayed over this area during shoulder movements. Sometimes, a bone spur may narrow the space even more.

This problem is called rotator cuff tendinitis, or impingement syndrome, and may be due to:
 Keeping the arm in the same position for long periods of time, such as doing computer work or hairstyling
 Sleeping on the same arm each night
 Playing sports requiring the arm to be moved over the head repeatedly as in tennis, baseball (particularly pitching), swimming, and lifting weights over the head.
 Working with the arm overhead for many hours or days (such as painters and carpenters)
 Poor control or coordination of your shoulder and shoulder blade muscles
 Poor posture over many years and the usual fraying of the tendons that occurs with age may also lead to rotator cuff tendinitis.

Symptoms

TENDINITIS OR IMPINGEMENT SYNDROME
 Early on, pain occurs with overhead activities and lifting your arm to the side. Activities include brushing hair, reaching for objects on shelves, or playing an overhead sport.
 Pain is more likely in the front of the shoulder and may radiate to the side of the arm. However, this pain always stops before the elbow. If the pain travels beyond the arm to the elbow and hand, this may indicate a pinched nerve.
 There may also be pain with lowering the shoulder from a raised position.
 At first, this pain may be mild and occur only with certain movements of the arm. Over time, pain may be present at rest or at night, especially when lying on the affected shoulder.
 You may have weakness and loss of motion when raising the arm above your head. Your shoulder can feel stiff with lifting or movement. It may become more difficult to place the arm behind your back.

Treatment

TENDINITIS OR IMPINGEMENT SYNDROME
Treatment involves resting the shoulder and avoiding activities that cause pain. It may involve:
 Ice packs applied 20 minutes at a time, 3 – 4 times a day to the shoulder
 Taking drugs like ibuprofen and naproxen to help reduce swelling and pain
 Avoiding or reducing activities that cause or worsen your symptoms to worsen
 Pendulum exercise – This “Pendulum exercise” is used to maintain mobility in your shoulder. Bend forward from your hips and support the weight of your upper body. Let your shoulder relax and gently swing a small weight back and forth.

The Single-Leg Balance Test
The single-leg balance test required that the athletes close their eyes for ten seconds while standing barefoot on one foot, keeping the other knee bent and not touching the weight-bearing leg.

The test was considered “positive” if the athlete was unable to perform the test on either one or both legs.
The participants were followed through the sports season to record any incidence of ankle sprains during sports participation. Over a 14-week season, these 230 athletes reported 28 ankle sprains. The study results indicated that athletes with a positive single-leg balance test result were significantly more likely to be among those reporting an ankle sprain.

The researchers concluded that although the single-leg balance test served as a predictor of ankle injury, the exact mechanism responsible for this increased risk of injury remains unknown.

For more information on what exercises you could start today to prevent ankle sprains check out:

www.patriotsfc.com/docs/USSF_ANKLE_INJURY_PREVENTION.pdf

The diaphragm is the most efficient muscle of breathing. It is a large, dome-shaped muscle located at the base of the lungs. Your abdominal muscles help move the diaphragm and give you more power to empty your lungs.

With improper breathing technique, the neck and chest muscles must then assume an increased share of the work of breathing. This can leave the diaphragm weakened and flattened, causing it to work less efficiently, while increasing the stress and strain on neck and shoulder muscles. Neck pain and headaches may result overtime.

Diaphragmatic breathing is intended to help you use the diaphragm correctly while breathing to:

• Strengthen the diaphragm
• Decrease the work of breathing by slowing your breathing rate
• Decrease oxygen demand
• Use less effort and energy to breathe
• Decrease the strain on neck muscles

Diaphragmatic breathing technique

1. Lie on your back on a flat surface  or in bed, with your knees bent and your head supported. You can use a pillow under your knees  to support your legs. Place one hand on your  upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.

2. Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible.

3. Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips (see “Pursed Lip Breathing Technique”). The hand on your upper chest must remain as still as possible.

When you first learn the diaphragmatic breathing technique, it may be easier for you to follow the instructions lying down, as shown on the first page. As you gain more practice, you can try the diaphragmatic breathing technique while sitting in a chair, as shown below.

To perform this exercise while sitting in a chair:

1. Sit comfortably, with your knees bent and your shoulders, head and neck relaxed.

2. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.

3. Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips (see “Pursed Lip Breathing Technique”). The hand on your upper chest must remain as still as possible.

Note: You may notice an increased effort will be needed to use the diaphragm correctly. At first, you’ll probably get tired while doing this exercise. But keep at it, because with continued practice, diaphragmatic breathing will become easy and automatic.

How often should I practice this exercise?

At first, practice this exercise 5-10 minutes about 3-4 times per day. Gradually increase the amount of time you spend doing this exercise, and perhaps even increase the effort of the exercise by placing a book on your abdomen.

The “core” consists of a group of muscles including abdominal, hip and back muscles that stabilize the spine, pelvis and shoulder. The core provides a solid foundation for movement in the extremities. Core conditioning exercise programs need to target all these muscle groups to be effective. The muscles of the core make it possible to stand upright and move on two feet. These muscles help control movements, transfer energy, shift body weight and move in any direction. A strong core distributes the stresses of weight-bearing and protects the back.

Core Strength and Back Pain

Abdominals get all the credit for protecting the back and being the foundation of strength, but they are only a small part of what makes up the core. In fact, it is weak and unbalanced core muscles that are linked to low back pain. Weak core muscles result in a loss of the appropriate lumbar curve and a swayback posture. Stronger, balanced core muscles help maintain appropriate posture and reduce strain on the spine. Training the muscles of the core also corrects postural imbalances that can lead to injuries. The biggest benefit of core training is to develop functional fitness – fitness that is essential to both daily living and regular activities.

Getting Started

Abdominal Bracing

Abdominal bracing is a helpful exercise to learn how to maintain mild abdominal contraction in order to support the lumbar spine. To correctly brace, you should attempt to contract your abdominal muscles. Be careful not to hold your breath – you should be able to breathe evenly while bracing.

To Start:

Lie on your back with your knees and hips bend and your feet resting comfortably on the floor. To stabilize your shoulder blades, have your arms at your sides and turn them out so that the back of your thumbs are pressed against the floor. Spread your fingers out as wide as possible.

Your spine must be in a neutral position. (neutral means maintaining the natural curve in your spine).

Do not flatten your spine against the floor. Keeping this position, concentrate on contracting your abdominal musculature without “drawing in”. *Important: this involves hardening or tightening the muscles, NOT hollowing the abdominal area. You can feel if you are tensing the appropriate muscles by placing your fingers just inside your hip bones. You will feel the muscles get harder as your perform the abdominal brace.

Hold this position for 5-10 seconds to start. Repeat 3-5 times; perform 1-3 sets. Work your way to holding the brace for 60 seconds.

Once mastered, this technique can be used to enhance all core stability exercises and during daily activities such as lifting. Maintaining this position will help you get the most out of all your core stability exercises and protect your spine.

For  more information and to get more core exercises contact us at drremy@thechiropracticoffice.ca

Symptoms

Symptoms of plantar fasciitis are typically worsened early in the morning after sleep. At that time, the arch tissue is tight and simple movements stretch the contracted tissue. This makes the first few steps out of bed very painful. Pain is usually felt at the heel of the foot or within the arch of the foot. As you begin to loosen the foot, the pain usually subsides, but often returns with prolonged standing or walking.

Risk Factors

In most cases, plantar fasciitis develops without a specific, identifiable reason. There are, however, many factors that can make you more prone to the condition:

• Tighter calf muscles that make it difficult to flex your foot and bring your toes up toward your shin
• Obesity
• Very high arch or very low arch (increased pronation)
• Repetitive impact activity (running/sports)
• New or increased activity

Treatment and Prevention

You can decrease your risk of developing plantar fasciitis by:

• Wearing customized orthotics
• Ensuring supportive footwear
• Stretching (plantar fascia and Achilles tendon especially)
• Gradually increasing training intensity

Recommended treatments include:

Stretching of the plantar fascia and Achilles tendon are important in the treatment of plantar fasciitis. The goal of this stretching program is to relieve the stress put on the plantar fascia by either the plantar fascia itself being tight or the fascia beign tightened by a tight Achllies tendon, as both the plantar fascia and Achilles tendon insert onto the calcaneus (heel bone).

• Calf (Achilles tendon) stretch – Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 20seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
• Plantar fascia stretch – This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 15-20 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or walking.

Ice can also be helpful in managing this condition. Rolling your foot over a cold water bottle or ice for 20 minutes is effective. This can be done 3 to 4 times a day.

Night splints. Most people sleep with their feet pointed down. This relaxes the plantar fascia and is one of the reasons for morning heel pain. A night splint stretches the plantar fascia while you sleep. Although it can be difficult to sleep with, a night splint is very effective and does not have to be used once the pain is gone.

Plantar fasciitis can easily become a chronic condition, if you are not experiencing any results from the above, please contact your health care provider. As a chiropractor I have access to numerous modalities, including laser therapy, Active Release Technique and physical therapy, that are effective in treating plantar fasciitis.

For more information or to book a complimentary consult please contact our office at 905-820-7746 or send me an email at drremy@thechiropracticoffice.ca

Look forward to next year!!