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Text Neck : The next Epidemic
Dean L. Fishman, B.S.E.S., D.C.
Founder of The Text Neck Institute
Lecture By:
Medical Dictionary
Main Entry: 1ep·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
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
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.
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.
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.
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
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
Mobile Technology Statistics
The rise in texting has had another
quantifiable effect, according to the Census
Bureau. Cellphone calls have gotten a little
In 2008, the average call's duration was 2.27
minutes. From 2004 to 2006, it was about 3
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."
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
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
Mobile Technology Statistics
Smartphone sales will continue to be immune
to the global economic downturn,
maintaining "robust growth" of 35.3 per cent,
Informa Telecoms & Media
Mobile Technology Statistics
The total smartphone market in 2014 will be
412 million units.
Research & Markets
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
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.
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
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
Nokia Fanboy September 8, 2009
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
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.
Mobile Technology Statistics
On March 6, 2009, Nintendo announced that
it had shipped its 100-millionth Nintendo DS
“Nintendo Ships 100 Millionth Portable Nintendo DS System”. Nintendo. 2009-03-11. 2009-03-11.
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.
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
Hand Held Mobile Device
• Smartphones: 25-34 years old
• 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
Inside Best Buy at the Mobile Phone
Outside the Apple Store
Inside the Apple Store
Inside the Apple Store
Inside the Apple Store
Inside the Apple Store
Inside the Apple Store
Inside the Apple Store
How Does This Technology Effect
Our Patients?
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
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
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
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
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
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%
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.
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)
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)
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
• 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
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
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;
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.
Case Presentation
Before 3.5°, 13mm
After 17°, 9mm
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.
Case Presentation
Before -7°, 33mm
After 15°, 28mm
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.
Case Presentation
Before 2°, 13mm
After 16.5°, 8mm
My 2½Year Old Son
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The Text Neck APP
The Text Neck APP
The Text Neck Institute

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