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Neck or shoulder pain? Maybe your smartphone is to blame.

This is a post by Dr. Dustin Lee PT, DPT

Welcome to 2017! This past year has been very eventful for my family and me. My wife and I graduated with our doctorates in physical therapy from Emory University, we got married, we both started work, and then to cap it all off, my older brother also got married to his wonderful wife, Lindsey! There was a lot of travel involved to make this all happen, and I really enjoyed the time spent with friends and family. However, there is something that caught my attention every time I walked into an airport – everyone was on smart phones (and I don’t mean talking on them).

Standing in line to check bags = look at smart phone.

Standing in line to go through security = look at smart phone.

Waiting in line for Starbucks = look at smart phone.

Waiting on the airplane = look at smart phone.

The list goes on, but the point should be clear - people are terrible with the thought of having nothing to do. Life has become so busy that we try to fill every moment with something do – even if there is nothing to do. When someone says, “Hey, how have you been,” I am quick to tell them that I have been very busy. In reality, without access to a smart phone, I would most likely have plenty of free time to take care of the busy work that continues to pile up. I have put considerable thought into writing this blog post because not only am I pointing out my own flaws, but I am also asking you to reflect on the idea. Obviously, there will be a point in doing so, but before we get there I want you to know that I am just as guilty as any other person when it comes to always needing to stare at my smart phone, and I am ready for a change. Are you?

Facts Behind the Screen

I will be solely discussing the use of smart phones in this blog post, but just remember that there are other screens that can suck away your time, unless you make it a point to make change. I recently came across a mobile marketing report from that demonstrates how companies can capitalize on our smart phone overuse. In other words, we are using our phones so much now that corporations are studying our trends to market their products more effectively. According to the report, 2014 marked the first year that more people were using mobile devices than computers. In 2015, an adult spent an average of 2.8 hours on his or her phone per day. Ninety percent of that time is spent in apps rather than online. Within that 90%, most people were viewing social media sites (Facebook, Snapchat, Instagram, etc.), YouTube, other entertainment sites, messaging and gaming. The numbers vary, but it should also be known that the average American looks at his or her phone 35-110 times per day. 4

Fun fact of the day – nomophobia means fear of being out of mobile phone contact. How many of us have experienced nomophobia?

What I Notice as a PT

The facts and figures are eye opening, and my best guess is that these numbers have continued to grow over time. As a physical therapist, I find these numbers and observations quite alarming. Going back to the airport example, it is all too common for me to notice what this increased cell phone use is doing to people’s standing and sitting posture. Among the most common observations are seeing people holding their heads forward, hunching over from their upper backs, and rounding their shoulders. Add in the task of carrying or rolling luggage while walking, and you have the perfect storm for neck pain, back pain, shoulder discomfort and even headaches.

How Smart Phones Affect Posture

The biggest postural fault that smart phone users encounter is called forward head posture. In this posture (see left, below), the chin typically is protruding forward, the head is in front of the shoulders in varying degrees and the upper part of the back is pulled forward.

(Photo source:

It has been shown that more time spent on your smartphone leads to further forward head posture and shoulder positional faults 3. According to Jung, “Forward head posture is a common postural abnormality that predisposes individuals to conditions such as headache, neck pain, jaw dysfunction (temporomandibular joint dysfunction), changes in the length and strength of muscles, and shoulder pain and dysfunction 3.” In a study conducted by Fernández-De-Las-Peñas, those suffering from episodic tension type headaches had a higher likelihood of forward head posture, reduced neck movement and mobility, as well as trigger points of the head and neck musculature 2. Lastly, it should be known that sustained forward head posture can cause injury to the structure of the neck and lower back vertebra, as well as to the associated ligaments 1. The picture below demonstrates how much weight the muscles of the back and neck are required to hold in order to keep your head from falling forward with varying degrees of forward head posture.

(Photo source:

How I Am Changing a Habit

As stated previously, I am at fault for everything listed above at times. The irony is that I preach postural change in order to promote functional change for my patients. I would like to become a role model for my patients and have an impact on their health. To do this, I should also be changing a habit that plagues the majority of us on a daily basis. My wife and I have decided to limit our smart phone use by leaving the phone on the countertop after turning the ringer and notifications on loud. We have also decided to keep the phones at home if we are go out to do something active. The out of sight, out of mind principle applies to all of our dinners or group outings. Lastly, to avoid having smart phone use at night increase, we have been keeping our phones out of the bedroom with our alarms on loud. An added benefit to this – you actually get out of bed to turn off your alarm, therefore avoiding being a victim of snooze alarm abuse.

I hope that this blog brings some awareness to smart phone overuse and how it is potentially affecting your posture. Here are some ideas to help you break the habit and improve upon your posture. Are you up for the challenge?

  1. Put the phone down and engage with your surroundings.

  2. Limit your smart phone use to a certain amount of time per day.

  3. Place your phone out of reach. Remember: out of sight, out of mind.

  4. Turn your notifications on silent when you are working on completing a task.

  5. Leave your smart phone at the door when you walk into your house (with the ringer on loud so you can hear when someone is calling you). This is similar to having a home phone, and if you are not sure what those are, just ask someone who was born before the year 2000.

  6. Practice postural exercises. There are plenty to choose from, but here are a couple to get you started.


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7. See a physical therapist for your posture and pain complaints!


  1. Bonney, R., & Corlett, E. (2002). Head posture and loading of the cervical spine. Applied Ergonomics,33(5), 415-417. doi:10.1016/s0003-6870(02)00036-4

  2. Fernández-De-Las-Peñas, C., Cuadrado, M. L., & Pareja, J. A. (2007). Myofascial Trigger Points, Neck Mobility, and Forward Head Posture in Episodic Tension-Type Headache. Headache: The Journal of Head and Face Pain,47(5), 662-672. doi:10.1111/j.1526-4610.2006.00632.x

  3. Jung, S. I., Lee, N. K., Kang, K. W., Kim, K., & Lee, D. Y. (2016). The effect of smartphone usage time on posture and respiratory function. Journal of Physical Therapy Science,28(1), 186-189. doi:10.1589/jpts.28.186

  4. Mobile marketing statistics 2016. (2016, October 26). Retrieved February 01, 2017, from

  5. Precision Performance. Retrieved February 05, 2017, from


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