As a physiotherapist working in private practice, I am starting to see an increasing trend of younger clients with neck pain. The youngest has been 8, but the majority are between 13-16 years of age. I believe that this is a trend that we will continue to see with potential for even younger clients. My thoughts: Some possible factors unique to Singapore, that may be contributing to this trend: 1. IT/ phones
Singapore is one of the most wired up countries in the world, having one of the highest IT penetration rates. Despites Singapore's 4 million population, it has 402,992 iPhones, 76575 iPod Touch and 1,453 iPad’s totaling 480,950 iOS devices. Singapore has the highest iOS penetration , in comparison to neighbouring Indonesia which has the lowest. (http://e27.sg/2010/06/10/highest-ios-penetration-found-in-singapore-indonesia-among-the-lowest/). According to iDA Singapore, in the fourth quarter of 2010, Singapore's household broadband penetration rate was 191%. This percentage suggests that almost every household had 2 broadband subscriptions. The mobile phone penetration rate is 143%, and 3G mobile subscription totals is an overwhelming 4.7 million. The statistics alone indicate that the Singaporean lifestyle has changed over the last 10 years. It can be inferred that almost every household will have access to a computer, a 3G mobile phone and possibly a tablet. Most children in Singapore have access to some IT and are exposed and taught to use computers in schools. This fact, combined with the popularity of social networks like Facebook and Twitter for the older kids and Club Penguin for the younger kids, as well as the myriad of free games available on the iphone and ipads, children in Singapore spend more time in potential poor postures whilst attending to these IT tasks; and more time indoors than outdoors. 2. Decrease outdoor play
Apart from the reasons mentioned above, other factors that may influence outdoor play are: The oppressive heat and humidity, With a constant daily humidity of 99% and a temperature of 33 degree Celsius it is understandable the kids prefer to stay indoors. Possibly aggravating the problem are the parents who also may not be as willing to accompany the younger ones to the park for the same reason. Secondly, the lack of open spaces available for free play. Approximately 80% of the population lives in apartments, and the majority of those living in landed properties have little garden space. The physical environment in itself is not conducive to outdoor play. It is commendable that in most housing estates, there are playgrounds for young children to play, but not much for the older kids. You will often see signs that say “no soccer allowed” in the void decks and even some open fields. With such restrictions, it is no wonder outdoor play is reduced. Thirdly, perhaps the majority of households are dual income, parents are not able to supervise outdoor play and may not want their children to play outdoors on their own. 3. Great emphasis of academic results and sport is not seen as a priority.
There is a greater emphasis on academic performance in Singapore, compared to anywhere else in South East Asia. With no natural resource, human resource remains its main driving force leaving Singaporeans no choice but to be ahead of the game. This translates to lots of pressure to do well in school as that is seen to lead to a good job with a good income, and thus growth for the economy. As a result, outdoor play or pursuing ambitions of an elite sport athlete is not a priority or possibly encouraged in a practical Singapore. Such mindsets are subsequently ingrained in a young children, and is unlikely to change anytime soon in the future. 4. Parents awareness of ergonomics
As children spend increasingly longer time studying or and at the computer, it is imperative that as parents, we realize that good ergonomics is paramount in reducing the incidence of neck and back pain in this population. The study table and chair must therefore be of the right height. The child’s back must be fully rested against the back of the chair; and feet completely supported on the floor. The table height should be lowered such that the child’s elbow can be at 90’ angle when rested on the table. When reading, the table should be inclined so that the child need not to drop their head forward to read. Investing in an ergonomic table and chair is a worthwhile investment for your child’s spinal health. If the child has to spend a fair bit of time on the laptop, buy a laptop riser, a separate key board and mouse. Using a laptop without ergonomic modification will result in excessive loading in the neck joints leading to pain. If your child is complaining of neck or back pain, consult your nearest Core concepts branch for advise and treatment.