Children aged 10 are suffering pains and posture-related issues that can be “difficult” to treat, after using digital devices from a very young age and for extended periods, says a health practitioner.

Auckland osteopath Aaron Henry wants to roll-out a nationwide assessment scheme in schools, to treat and prevent poor postural health among students.

He is the owner/operator of Primary Alignment, a schools assessment and intervention programme. It aims to provide early detection of posture-related pain and discomfort, and to give suitable solutions to help young sufferers.

Henry qualified as an osteopath five years ago and soon noticed a “surprising and alarming” trend, he says.

Children who were “approaching puberty, from the ages of 10” were commonly presenting at his practice. They were requiring help with postural-related pain and levels of discomfort that would normally be seen in older age groups, he says.

“It was seeing these children, at ages that first of all surprised me, coming in with these pains and issues. I found it quite difficult to treat because, in most of these cases, the kids had been having issues for quite a while.”

Much of this was due to the posture these children were adopting when having screen time, both at home and at school.

According to a Czech study, 40 per cent of pain in children is linked to a repetitive strain-like injury to the spine, shoulders and neck areas resulting from overuse of devices. Other international studies have found that around 70 per cent of children will develop low back pain, yet only a quarter of them will be given any help, while some 15 per cent of children go on to develop ongoing and debilitating pain.

“It’s about volume,” says Henry. “By the time that we see them, by the time that they are in pain [and] start to develop symptoms, essentially it’s been a build up over a long time, of getting into these positions and doing these repetitive actions with their hands and with their spines.”

To help children like this, Henry and another osteopath set up Primary Alignment. They use both evidence-based practice as well as cutting-edge posture analysis software to objectively assess children’s physical health and posture. Henry says the software was developed for athletes to analyse their posture and movement.

The children can see themselves being analysed in real-time, and this involves them in the process and makes them more aware of their bodies and posture.

“The kids love it and they really engage with what we’re doing because of that.”

Primary Alignment also provides schools with a proactive “solutions programme” that is designed to get children moving. It incorporates elements of pilates, yoga and functional movement conditioning to help children build strength and endurance as well as focus on alignment, stability and fine motor control. Mindfulness training is also a component.

Meanwhile a school assessment looks for factors that might affect student physical and posural health. It examines a school’s physical health programmes, sport participation and classroom ergonomics.

The initiative is thought to be the only nationwide venture of its kind, says Henry. It began last year with a trial at St Andrew’s College in Christchurch, carrying out posture screening of all Year 8 and Year 9 students, around 300 children in total.

The aim is to roll it out to more schools this year, and eventually become a New Zealand-wide programme.

Physiotherapy NZ president Liz Binns, told Education Central in August that physiotherapists were also seeing children suffering from back and neck pains “that would not have been seen maybe a decade or so ago”.

In today’s Innovative Learning Environments (ILEs), it is usual for children to sit on beanbags or lie on the floor while working on devices. If they stay in a sustained posture for long periods of time it can result in pain and discomfort. The Ministry of Education provides guidelines about ergonomics, but parents have raised questions whether schools are following them.

A New Zealand study found that 82 per cent of children aged 10 to 18 had no time limit on their devices.

For anyone, “in this day and age, it is easy, both at home and at school, just to slump and get into these postures” when using devices, says Henry.

These postures include lying on the floor in a ‘banana position’ as well as text neck, also known as tech neck when the user is hunched over their phone.

A combination of three things – “the rounded spine, the bent forward head and neck, and upper back, and then the rounded shoulders with the arms forward, when you’re using a mouse or a tablet” – puts the body into a position that strains certain muscles, joints and the spine, particularly when it is for prolonged periods. Over time, these tighten so much that it becomes painful.

Despite being children, it’s still not an easy fix to treat these young bodies, he adds.

“It’s quite hard, because it’s been [happening] over such a long period of time, to easily and quickly bring them back to where they were. It’s definitely not impossible but it requires a lot more resources to be able to do that.”

Henry says that a lot of schools are taking the issue seriously and implementing restrictions on devices and various physical activity programmes.

But New Zealand is “already struggling” with how it manages work-related injuries and muscular-skeletal injuries among adults.

The total cost of musculoskeletal injuries is $54 billion annually. Some $20 billion is for work-related injuries and the majority of these are from repetitive strain injuries.

That in itself is a “huge burden” yet, at the same time, there is a generation who has started using devices from early on. The scale of the issue is unknown, he adds.

“We’re getting this generation of kids who are starting to develop these repetitive strain injuries, through the use of technology at a young age [and] this could prove quite a burden on the health system. I’m seeing this lack of management and assessment occuring for these kids and for this issue, that’s where we are coming from.”

Henry says the cost of the programme to schools is “quite a low cost… even though it’s being delivered by health professionals”.

Despite this, many schools will still be unable to take up the programme. Ideally, funding and help should be available for all New Zealand children.

“Our initial offerings need to be delivered to groups who we can assess and then we can show that to the Ministry and show them we are doing some good and how we are doing that. Then we [hope to] roll out across the country.”


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