Cell Phone Elbow

Cell-Phone Elbow

Minimize the Perils of Mobile Technology
By Chris Sorrells, OTR, CHT, CEAS
By now, most people have heard of BlackBerry thumb. Recently, there has been talk of a new repetitive strain injury called “cell-phone elbow.” As technology advances, allowing us to do more tasks on smaller equipment, our bodies often pay the cost. With a growing potential for injuries from tools we rely on, it’s a good time to educate ourselves about what we can do to minimize the risk.

Addressing Cell-Phone Elbow
Dr. Peter Evans, director of the Hand and Upper Extremity Center at Cleveland Clinic, recently coined the term “cell-phone elbow” to describe the pain and weakness some people experience from excessive phone use. These symptoms can progress to weakness and clawing of the ulnar digits, affecting daily living tasks, as well as typing and writing.

Cell-phone elbow is not a new diagnosis but simply a new name for cubital tunnel syndrome. The two biggest controllable risk factors for cubital tunnel syndrome are prolonged flexion of the elbow at greater than 90 degrees and pressure placed directly on the ulnar nerve as it passes around the underside of the elbow. With technology allowing for full Internet access, social networking and entertainment to be performed from cell phones, more people spend greater time using them. The more time spent staring at that little screen, the longer people keep their elbows bent, which diminishes blood flow to the nerve and results in injury. Compounding the problem is resting on the flexed elbow when using the cell phone at a desk or in a car, which leads to direct nerve compression, in addition to elbow flexion.

There are risks of excessive time holding a phone to the ear and looking at a screen. If you experience overuse symptoms, it is also important to analyze the other activities  that may contribute to the problem. Sleeping with the elbows bent, habitually crossing the arms, and working on a surface that is too high, pinch the nerve and should be addressed.  To eliminate prolonged elbow bending, use a headset, which free the hands to take notes or type, eliminating the need to pinch the phone between the ear and shoulder.

Avoiding Posture Pitfalls
The popularity of texting, combined with the increasing amount of time spent in front of a computer, will very likely contribute to worsening posture. Teens and young adults are particularly at risk. Many people find it challenging to maintain their posture in everyday tasks. When you add staring intently at a small screen for long periods, it is easy to fall into a slouched, head-forward position.

Sit upright with your head over your shoulders while using your phone.  If the PDA is to be used for lengthy typing, see if an external keyboard can be used. Resting the forearms on a pillow while texting or typing will also help minimize neck tension by allowing the upper traps to relax.  Look down with the eyes and gently tuck your chin to maintain a healthier posture.

In addition, make sure the screen is easy to read. Straining to see what is on the screen leads to jutting the chin forward, shifting work from the spine to the muscles to hold the head up.   Avoid using PDAs while in bright sunlight can also help.

Preventing BlackBerry Thumb
The thumbs were not made to perform repeated forceful pressing motions. Quickly using small buttons increases the tension in the muscles and tendons, magnifying risk for tendinitis. Using a device that allows you to switch between keypad and stylus spreads out the work to different muscle groups. Another way to lessen the load on the thumb is to frequently switch to the index finger to type. While a thumb wheel on the side of the device can make scrolling quicker, its overuse can lead to a host of other painful symptoms.  

If all input must be done with a stylus, change the way it is held. Instead of always holding it like a pencil, move the stylus over between the index and middle fingers at times. A larger stylus can also help lessen the strain and force.  While they describe conditions known before recent advances in technology, terms such as “BlackBerry thumb,” “Wii-itis” and “cell-phone elbow” don’t simply give new names to old problems. If these new terms help the people begin to recognize how everyday tasks can place us at risk for injury, maybe we will take ownership of our own health, instead of passively expecting others to “fix it.”  We all should move in that direction.

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