Thoughts on care and prevention

Sweet Dreams Are Made of These

It was a bit challenging to find a song to use this time.   We’re moving up this week to neck/head posture, so the natural choice of lyric was, “Put your head up, boy, when you’re talkin’ to me, and be there when I feel the need.” Since that song has been listed in my iTunes library as “Track 1” from the album “Eric’s CD” ever since I imported Eric’s CDs about 9 years ago, I had to google the lyric to find the title. Imagine my shock and horror when Google told me that the title of the song is “Feed the Tree” and the actual lyric is “Take your hat off boy when you’re talking to me and be there when I feed the tree.” As everyone knows, to feed a tree one has to look down at the ground, and a hat has nothing to do with posture unless it’s an Easter Bonnet, so naturally I was devastated, as that line has absolutely nothing to do with what I want to write about.

Enter my 6:30 patient one night last week: Let’s call her…um…”Katy Merry” (not her real name, but that’s the one that came to mind first, for some reason, after watching my first Super Bowl ever). In telling Katy about my predicament, she immediately came up with “Heads High” (the club remix version, not the original reggae one — she was adamant about that).  I had no idea what it was about since it’s written in Reggae and I took 7 years of French, but I liked the title, so I spent  the better part of an afternoon fake-translating the reggae words. Then the voices in my head sent me to a “what do this song’s lyrics mean” website.  I’ve learned that when the voices all agree, I listen.  Let’s just say this little ditty could be about Jack and Diane, but not in a way that makes it appropriate for this topic.  Another afternoon I’ll never get back.  Thanks, Katy!

I figured I’d give Katy Merry (still not her real name) another chance:  I emailed her and told her to think twice about playing that song around the house when her son was home (I mean, to make sure she was still feeling FABULOUS after the prior evening’s appointment) and how I was back on the quest for a song, and lo and behold, out of nowhere she pulls out the Eurythmics, AND AWAY WE GO!

Everybody’s… looking at their smartphones

And there you have it – if there’s one cause that is central to the core of my being (as if the core of my being weren’t central enough, being the core, in the center…) it is the deterioration of our head and neck posture as a society with the advent of smartphones and tablets.  Well, yeah, world peace, marriage equality, climate change, hoping Cher gets better so she can finish her “Dressed to Kill” tour, yadda yadda, I’m pretty passionate about those things, too, but for today, it’s head and neck posture.

Back in the day, when we humans decided that hunting and gathering were getting boring, we moved to Walnut Grove and worked the land, all good, but then we left the little house on the prairie and landed in the office cubicle with the computer and keyboard, then we decided our carpal tunnels weren’t getting enough abuse, so we invented the mouse, and then 8 hour days weren’t enough so we invented laptops so we could work on our spreadsheets all night long after leaving work. Don’t even get me started with sitting all day at a desk (because I’ll talk about that in a future post).  And then, the bottom fell out – I’ll never forget when the first of my friends showed me the first of his iPhones.  And then all my neighbor friends got their Androids.  And then I got my first Android.  And the next day I went swimming with it in my pocket, so I got my second Android.  And then my first iPhone.  Apple and I are not a match so I went back to Android.  And then my 15th phone in 3 years.  I had a little rough technology patch there for a while.  Not all the phone replacements were my fault!!  I just can’t have nice things.

But I digress…

The advances in technology over my (incredibly short, I want to pretend) lifetime are mind–blowing.  Problem is, they’re also body-destroying.  Not a day goes by when I don’t see people sitting hunched over with their heads in their lap or standing with their heads at right angles working on their phones or tablets.  I catch myself doing it a lot, too, so I don’t say all this as judgement, just observation.  I think it’s more frustrating for me, because, as Inigo Montoya told Wesley (thinking he was the Dread Pirate Roberts), “I know something you don’t know.”   I know exactly what happens to the neck over time with forward head posture and I still catch myself doing it.

I’m going to try to not be too preachy or soap boxy, so if a picture is worth a thousand words, maybe I can shorten the time it takes to read this by a week and a half.


I’m sure you’re as jazzed as I am about that gorgeous cervical curve.  Lined up with your spine, your head weighs about 10 pounds, give or take.  I think smart people have really heavy brains, though.  My friend, Jeff, in LA is a former lawyer with a photographic memory.  Seriously, he can remember everyone you mentioned in every conversation you had with him from 10 years ago.  And he’s a relatively small guy with a small head. When he would come to see me in the office his head was so heavy that adjusting his neck was like doing bicep day at the gym.  I had to start shifting my workout schedule based on his appointment schedule.

Hmm, I seem to have digressed again… This is your head on phone:


Notice the loss of the normal cervical curve. Your head is like a TV antenna tower. Yes, those towers still exist for those of us who refuse to pay Comcast for 800 channels of nothingness. Your head and neck are the tower; the muscles of your neck and shoulders are the cords propping it up so it stays upright. The further forward your head goes, its weight becomes unbalanced and the greater the body feels the gravitational force pulling down on it. For every inch forward the body senses 10 extra pounds of force it must counteract. That force must be borne by the posterior neck muscles and shoulder blade muscles (the upper trapezius and levator scapula) as they contract to keep your head from crashing to the ground (contracting while being lengthened), or at least until your ligaments take hold, which then stretches out the back ones and shrinks the front ones.


Over time, sustaining these positions leads to Upper Crossed Syndrome and degenerative changes:


This degenerative process is often slow to progress, but it does progress unless it has a reason not to.  When it becomes symptomatic, the chronic fatigue and pain can be exhausting, significantly affecting mood and quality of life.  Progression of symptoms at this point most likely will need outside help to fix.

Geez, Dr. Joe, what a Debbie Downer you are!  Can’t you just let me enjoy my Words with Friends in peace??

I know, I’m terrible.  My friends hate hanging out with me.  It’s most likely why I’m single.

But FEAR NOT!!  All is not lost!  I’ll tell you my story but since I can’t find my old xrays it might take me those 1000 words.  I won the prize for the most forward head in chiropractic college.  Yes, there’s a tool to measure it.  I also had radiating pain down my left arm with certain head positions, my traps felt like leather, and one day at the gym my left arm didn’t raise its side of the barbell during a bench press, no matter how much I willed it to.  Thankfully, I had a spotter (who really needed to trim his underarm hair, but that’s a topic for a different blog on a totally different website).  Spending a decade working in hospitals bending over patients all day had taken its toll, especially when I switched gears and went back to school and then spent all day bending over books and slouching in lecture hall desks.  My clinician, after looking at my xrays and showing me the swiss cheese at my C4/5 and C5/6 discs, told me I had a 60 year old neck.  I’m happy to say my neck is only 38 now, which is good since I’m approaching a milestone somewhere between those two numbers, and  I am symptom free after changing my habits and getting worked on regularly, though I have lost an inch in height.  I have noticed, however, that I can feel the tension and fatigue in my neck climbing ever since my love affair with my smartphone began, so I’m doing my best to counteract that (and which is why I’m so naggy about it).

Dr. Joe,  I never really paid attention to my head posture, but I really don’t feel anything.  And it takes a long time to read and type and fix all the autocorrects in my  47 message long text conversation that could have been taken care of in a 47 second phone call. Do I really have to hold my phone up in front of my face instead of my face down on top of my phone for that long?

(This isn’t Bobby)

Well, yes, Bobby…you really should.  Especially since you’re only 14 years old and your spine isn’t done growing yet, and you’re telling it to grow into a forward position with all that texting and slumping over books and tablets with all your school work.  And just because you don’t feel anything now, if you do it day in and day out, trust me, you most likely will.  But thank you for that excellent question!

So what can I do?  Even now I’ve been sitting on this park bench with the birds chirping and the squirrels running around, reading your blog, completely riveted by every word you’ve said here, but since it’s so many words, I didn’t realize how long I’ve been sitting, and every time I pull my phone up and raise my head, after a few minutes I realize my head is in my lap again.

Again, excellent question!  For now, don’t over-stress; just try to be aware.  Start paying attention your positions through various activities, and take notice of any symptoms like soreness or fatigue that you feel, especially if they change with changing positions.  It could very well be that you don’t spend too much time in a forward head position.  Or you could be on the cusp of too much.  But then think also about your head position in other activities, like at your desk, in the car, when you walk, cooking, washing dishes, basket weaving, etc.

You could have a friend look at you from the side and after you tell him or her to stop making fun of your 1980s Anthony Michael Hall from Weird Science haircut because it’s only temporary until the top grows out some more, have him or her let you know if your head is on top of or in front of your neck (see pictures above).

If you have kids, once they become technologically aware, pay attention to how long and in what positions they use their tablets or phones.  If they’re teens, you know they’re never going to make a phone call ever again in their entire lives, so they will be texting all day long. See if you can find a non-nagging way to raise their awareness (I haven’t procreated for precisely that reason…I have no idea how to talk to kids).

One more thing: if perhaps you actually do spend a lot of time forward, and/or have a noticeable forward head, or the beginnings of that bump like thing at the top of your back where your neck begins, you might notice a bit of crankiness in your muscles as you try to make changes.  Might be a good time for assessment by your friendly neighborly chiropractor or other musculoskeletal practitioner.

We can’t avoid putting our heads forward.  We need to do it from time to time, often a lot.  The point I’m trying to make is let’s start paying attention to HOW MUCH we are putting our head forward.

Remember, the body responds to the forces placed on it.  And just because it did so well at responding to all that gravity on a forward head, that doesn’t mean it won’t respond to removing some of that force.  I believe Annie Lennox said it best, when she repeated over and over (and you thought I was a nag!):

“Hold your head up, movin’ on
Keep your head up, movin’ on
Hold your head up, movin’ on
Keep your head up, movin’ on”