Improving Posture and Neck Pain in Desk Workers with mTrigger Biofeedback

I’m sure you’ve heard the “sitting is the new smoking” tag line before. Well, sitting in and of itself isn’t inherently bad for you. That being said, there is a link between posture, prolonged sitting at a desk, and neck pain. In the last year, 17-63% of office/desk workers have experienced neck pain.(1) In fact, neck pain (and back pain) is the leading cause of global disability in most countries.(1) This makes the need to understand and provide effective pain reducing strategies even more critical.

Physical therapy is often the first line of defense against neck pain and postural issues resulting from desk work. Recent studies using real time sEMG biofeedback have helped to inform patients of their posture and muscle activity while working at a desk, thereby shedding light on their pain and pain provoking factors.(2)

So how can mTrigger biofeedback be used to help empower patients to improve posture and decrease neck pain? In this blog we will investigate some of the research and ideas for helping desk workers with their posture and neck pain through the use of mTrigger surface EMG biofeedback.

Background

Sitting at a computer or desk for a prolonged period of time is often an aggravating factor for those suffering from neck pain. By using surface EMG electrodes placed over the upper traps, cervical and thoracic erector spinae muscles to measure muscle activity, in addition to measures of spinal posture (head tilt, neck flexion, and cervical/thoracic angle), researchers were able to investigate the nature of neck pain in desk workers.(2)

Sitting at a desk with different types of posture, upright, forward, or slouching/slumping, greatly effects the EMG activity of the upper trap and cervical muscles.(3) When sitting in a slumped posture, it leads to greater head/neck flexion, anterior translation of the head, and increased cervical erector muscle activity compared to sitting up straight.(3,4) This is called ‘forward head posture’, as demonstrated in the picture.

When placing mTrigger biofeedback on the cervical erector and upper trap muscles, notice how the muscle activity significantly increases in the cervical erector muscles when slumped, just like the study found.

Why Does Posture Matter?

In order to perform its function optimally, the head needs to be aligned vertically with the bodies center of gravity.(5) This helps to prevent excessive strain on the neck muscles.(5) When the head tips or translates forward, the moment arm at the neck significantly increases, requiring a large subsequent increase in muscle activity from the cervical erector spinae muscles to hold the head up.(5) (see picture) Therefore, as the head translates forward into the slumped sitting posture observed during sitting, driving, reading, or computer work, the sEMG activity of the neck extensor muscles also increases.(5) Consequently, forward head posture is one of the most common findings in people who suffer from neck, shoulder, upper thoracic, and scapular region pain.(5) Anatomically, this forward head posture presents as hyperextension of the upper cervical spine, increased flexion of the lower cervical spine, anterior head translation, rounded shoulders, and increased thoracic kyphosis (also seen in the picture). Over time, this position of the head may load the cervical spine unnecessarily and potentially expose the neck structures to increased mechanical demands and muscle tension.(5)

Clinical Application

Sitting with a more upright posture is not only more efficient but involves the least amount of stress on the spine and neck.(1) However, this is easier said than done. Healthy participants in one study where only able to sit in this ideal posture for 10 minutes before beginning to slouch and needing verbal or visual feedback.(1) This indicates how challenging maintaining ideal posture can be and the need for tools such as biofeedback to help desk workers optimize their posture.

The use of a small, portable, easy to use, wearable, sEMG biofeedback device, such as the mTrigger, can be used to help indicate when desk workers begin to slouch. Overall, studies have supported the use of a wearable biofeedback sensor as a means to provide real time external feedback to patients with neck pain.(1,2) Ideally, biofeedback can help facilitate active postural corrections and improve a patients conscious awareness of their body posture.(1) In one study, during a one hour typing test, participants wearing a biofeedback device were able to maintain a better sitting posture.(1) In a similar study, biofeedback led to improved head position, sitting up taller, and lower EMG activity of the cervical erector spinae muscles.(2) This simple set up can help patients become more aware of and ideally able to correct their posture during prolonged sitting. Here is an example using the mTrigger biofeedback audio function to indicate when slouching and loss of posture begin to occur.

* When setting the mTrigger device for postural cueing, adjust your time settings to reflect a long “on/contract” time and very short “off/relax” time.

Adding in a few additional exercises to help improve posture and strength is also a great idea. This is where mTrigger biofeedback can help patients understand how to stand up tall and activate the proper muscle groups during simple exercises. Often times, patients with posture related neck pain struggle to activate the posterior shoulder and thoracic/cervical muscles effectively as a result of their poor sitting posture. mTrigger biofeedback gives patients real time feedback to help them identify the correct muscle activation patterns.

If a patient is really struggling to maintain the correct head posture during a rowing exercise, try using a dual channel set up. Place Channel 1 on the scapular retractors and Channel 2 on the cervical extensors. Set the goal for Channel 1 to just above the max activation level, to encourage increased muscle activation, and the goal for Channel 2 to well below the max activation level, to promote decreased muscle activation. See more on how to do this here. Now, instruct the patient to perform a rowing exercise while increasing the meter on Channel 1, but keeping the meter for Channel 2 low and out of the green.

*Notice how with poor posture in this video, the activation level on Channel 2 is high and then the patient corrects their form and posture.

Summary

mTrigger biofeedback can be used to help improve sitting posture and reduce muscle activity in commonly over used muscles (such as the neck extensors) during computer work, sitting, and desk tasks. Biofeedback provides a means to help patients become more aware of their posture and habits while working or sitting for prolonged periods of time. mTrigger biofeedback is an excellent tool for helping empower patients to understand ways they can improve their neck pain and posture.

Reinforce Proper Movement with mTrigger Biofeedback

References

1. Kuo YL, Huang KY, Kao CY, Tsai YJ. Sitting Posture during Prolonged Computer Typing with and without a Wearable Biofeedback Sensor. Int J Environ Res Public Health. 2021;18(10). doi:10.3390/IJERPH18105430
2. Kuo YL, Wang PS, Ko PY, Huang KY, Tsai YJ. Immediate effects of real-time postural biofeedback on spinal posture, muscle activity, and perceived pain severity in adults with neck pain. Gait Posture. 2019;67:187-193. doi:10.1016/J.GAITPOST.2018.10.021
3. Cheragh ZA, Gandomi F, Sakinehpoor A. Effects of typing positions on the upper trapezius and neck extensor muscles electromyography in office employees: A single-blind cross-sectional study. Work. 2023;74(1):255-263. doi:10.3233/WOR-210909
4. Caneiro JP, O’Sullivan P, Burnett A, et al. The influence of different sitting postures on head/neck posture and muscle activity. Man Ther. 2010;15(1):54-60. doi:10.1016/J.MATH.2009.06.002
5. Alowa Z, Elsayed W. The impact of forward head posture on the electromyographic activity of the spinal muscles. J Taibah Univ Med Sci. 2021;16(2):224. doi:10.1016/J.JTUMED.2020.10.021