How to avoid shoulder pain when using your iPad

16 February 2014

With an increase in head and neck pain and posture issues coinciding with the rise in use of tablet devices, researchers at the Harvard School of Public Health have found that the flexible use of such technology means that there is concern for the development of neck and shoulder discomfort.

Why there’s a problem

“These devices were designed to be used on the move, for quick responses, not for hours of writing or social networking,” says Chartered Physiotherapist Sammy Margo, a spokesperson for the Chartered Society of Physiotherapy.

“People who are in jobs that don’t have computers are also affected,” says Professor Phillip Conaghan, professor of Musculoskeletal Medicine at the University of Leeds. “They can spend hours on social media sites every night, slumped on a couch or in bed,” he adds.

And Janet Wakely, Pain Nurse Specialist and author of The Smart Guide to Back Care, says, “On a train in London I counted 10 of the 14 people in the carriage absorbed, heads down, tapping on their electronic devices. The concentration required can exacerbate the problem by adding tension and pressure.”

A new kind of RSI?

BlackBerry thumb, iPod finger, mouse finger and shoulder didn’t exist in the 1980s. In 2005 The American Society of Hand Therapists issued a consumer alert, saying that handheld electronics were causing an increasing amount of carpal tunnel syndrome and tendonitis.

“Common RSI problems are tendonitis in the back of the wrist and elbow, and the biomechanical spread causes overload in the shoulders and neck, and subsequent pain,” explains Professor Conaghan.

“As a physio I’m seeing increased problems that are linked directly to using smaller devices. These days problems are much more likely to be found in the fingers, and the shoulder, neck and upper arm,” says Sammy Margo.

“Headaches and neck pain are also common. It’s ‘like a slow collision’, which occurs after prolonged periods in the wrong position,” she adds.

How much of a problem is it?

“Soft tissue pain is not sexy,” says Professor Conaghan. “And as these devices have popped up so quickly, there’s not enough epidemiological studies (i.e. big numbers of subjects examined over a long period of time) to truly evaluate their effect.”

However, Professor Conaghan concedes that there is plenty of anecdotal evidence to show that sitting with an iPad on your lap in an unnatural position has led to new types of problems. “The extent that problems occur will depend on your premorbid state,” he says. “Fit, strong and healthy people who use their limbs in activities such as swimming will have fewer problems,” he explains.

And, potentially, the variety of devices and different ways of working may in time help us to avoid RSI issues, as we slide, tap, use voice recognition and work on the move.

Tips to avoid pain

  • Posture: “Sixty per cent of the body weight is above the waist,” says Janet Blakely. “Without engaging the core, all the strain is on the lower back,” she says. So good posture – sit tall, slide your shoulder blades back and draw in the core – is vital.”
  • Get the right set-up: “Preferably buy a separate keyboard and stand,” says Sammy Margo. The Harvard study found that simply placing the tablet on a table propped at an angle in a tablet case can reduce neck strain and potential pain. “Make sure your back is supported as you sit, maybe place a cushion at the small of your back. And avoid ‘bed’ work, particularly lying on your side, in what I call the Cleopatra pose,” says Sammy Margo. Read our article on exercises for a healthy back here.
  • Take regular breaks and stretch: Take regular breaks every 15 minutes, say the Harvard researchers, where you stretch the muscles in the shoulders and chest. “Regenerate the vascular system, get the circulation going and move around to prevent the build-up of toxins which will contribute to more pain and inflammation,” suggests Janet Wakely.
  • Voice recognition: Sammy Margo recommends installing voice recognition Apps to help you avoid typing, for example, Dragon Dictation, which is also up to five times faster than typing on the keyboard.
  • Use both hands: “Balance the load,” says Sammy Margo. “Don’t dominate with one hand or another.”
  • Touch type: “Play the pad like a piano,” says Sammy Margo. Repeatedly looking between the keyboard and screen can cause problems. But make sure you touch type lightly,” she adds.

For more information on posture and back care, visit our musculoskeletal centre. Or if you a specific query, ask one of our experts on hand that can provide you with more information.