A New York orthopedic spine surgeon says “tech neck” driven by hours of forward-leaning phone and laptop use is turning into a fast-growing health problem for teenagers—and he argues schools should act now with education and simple in-class exercises.
A dull, persistent ache at the base of the skull. A forward-hunched posture that stops feeling like a habit and starts feeling like a default setting.
In clinics across the country, that pattern has shifted. What was once more common in older patients—or in young adults shaped by trauma—is increasingly showing up in otherwise healthy teenagers.
The diagnosis is “tech neck. ” also called “text neck.” It’s a progressive cervical strain tied to hours of forward head posture while using smartphones. tablets. and laptops. The complaint, Dr. Michael Gerling says, is quietly becoming one of the most significant musculoskeletal health crises facing adolescents in America.
The physics are unforgiving. In a neutral position, the human head weighs about 10 to 12 pounds. But for every inch the head tilts forward, the effective load on the cervical spine nearly doubles. At a 45-degree angle—the position many teenagers adopt while scrolling through social media—Gerling says the neck can be absorbing the equivalent of nearly 50 pounds of force.
When that posture lasts for hours each day, the strain doesn’t just produce discomfort. Gerling warns it accelerates disc degeneration. strains musculature. and contributes to symptoms that can ultimately lead to chronic pain. nerve compression. and. in severe cases. structural changes that require surgical intervention.
That is why, in his view, the response can’t be limited to policy patches and good intentions. It has to start in schools—especially middle school and high school. where he says students are at the most at-risk point precisely because their spines are still developing and their device usage is at a lifetime peak.
Cell phone bans, Gerling argues, are “good for kids,” but not enough by themselves. He points to studies suggesting teenagers spend more than eight hours per day on average looking at smartphones with downward neck posture. and he says many students rarely connect what happens during today’s screen time with the physical consequences that can follow.
In Delaware, he notes, there is no specific policy regarding classroom cell phone use. Across the country, many states are increasingly restricting its use, but Gerling says the education gap remains.
He calls for a nationally coordinated program built into health or physical education classes. Gerling says his institute. the Gerling Institute. has launched a national program distributing free of charge a curriculum designed for health and physical education teachers. The goal is to teach students the mechanics of their own spines and connect day-to-day smartphone use to long-term physical outcomes.
His premise is simple: knowledge changes behavior. When adolescents understand that the posture they hold during a two-hour gaming session places a load equivalent to the weight of a small child on their necks, he believes many will adjust their habits.
Physical education, he adds, is already offered in schools nationwide, which makes it an underutilized tool for postural intervention. A well-designed program. he says. should include daily cervical mobility drills. strengthening exercises targeting the deep neck flexors and upper back musculature. and posture-awareness training.
These exercises, in his description, take minutes, require no equipment, and deliver measurable clinical benefits. He points to occupational health settings for adults as proof that programs like this can work—and that the same approach can be adapted for adolescents.
The cost of inaction, Gerling says, won’t stay abstract. He warns that a generation of young people developing chronic cervical pain would place enormous demands on the health care system. while those individuals would experience reduced quality of life during what should be their most vital decades.
He also ties the argument to how society already handles other public health risks. Schools already mandate physical education and teach students about nutrition, reproductive health, and substance abuse prevention. In his view. “tech neck” should be treated with the same seriousness. with a national prevention program in every middle and high school in America—starting now. not “in the next decade.”.
Gerling. an orthopedic spine surgeon based in New York. is president and founder of The Gerling Institute and an advocate for adolescent musculoskeletal health. The central message from his clinic. he says. is that the pattern is already here—so the fix has to begin where teen routines are formed: in classrooms.
tech neck text neck adolescents cervical spine smartphones physical education public health Dr. Michael Gerling The Gerling Institute