Submission 16,225

Overview

"Texting Horns" Theory refers to a study done by David Shahar and Mark G.L. Sayers of Australia's University of Sunshine Coast which discovered that young people have been developing a "prominent exostosis projecting from the occipital squama," or a bone growth at the back of the skull above the neck, and posited that this could be a result of younger people often being hunched over looking at cell phones, causing their bodies to adjust. The study began gaining attention in June of 2019, when it was covered by the BBC and Washington Post, but its hypothesis has been debated online.

Background

On February 20th, 2018, David Shahar and Mark G.L. Sayers of the University of Sunshine Coast in Queensland Australia published a research paper titled, "Prominent exostosis projecting from the occipital squama more substantial and prevalent in young adult than older age groups."^[1] In summary, the study found that that a small protrusion at the back of the skull above the neck, usually associated with aging, is developing in people aged 18-30 at a one-in-four rate, much higher than it has been seen in the past. The paper hypothesizes that this is due to younger people often being hunched over while looking at smartphones or tablet devices (abstract shown below).

Recently we reported the development of prominent exostosis young adults’ skulls (41%; 10–31 mm) emanating from the external occipital protuberance (EOP). These findings contrast existing reports that large enthesophytes are not seen in young adults. Here we show that a combination sex, the degree of forward head protraction (FHP) and age predicted the presence of enlarged EOP (EEOP) (n = 1200, age 18–86). While being a male and increased FHP had a positive effect on prominent exostosis, paradoxically, increase in age was linked to a decrease in enthesophyte size. Our latter findings provide a conundrum, as the frequency and severity of degenerative skeletal features in humans are associated typically with aging. Our findings and the literature provide evidence that mechanical load plays a vital role in the development and maintenance of the enthesis (insertion) and draws a direct link between aberrant loading of the enthesis and related pathologies. We hypothesize EEOP may be linked to sustained aberrant postures associated with the emergence and extensive use of hand-held contemporary technologies, such as smartphones and tablets. Our findings raise a concern about the future musculoskeletal health of the young adult population and reinforce the need for prevention intervention through posture improvement education.

Developments

On June 13th, 2019, the BBC^[2] cited the paper in an article about how modern life is transforming the human skeleton. On June 20th, the Washington Post wrote an article calling the growths "horns."^[3] This and the site's tweet of the article,^[4] which gained over 1,300 retweets and 1,500 likes, helped the research spread on social media. Twitter user @SandenTotten^[5] quoted the article and linked to it, gaining over 2,000 retweets and 4,000 likes (shown below, left). User @katehinds^[6] tweeted that the article caused the WNYC news team to check the back of their skulls, gaining over 400 retweets and 1,500 likes (shown below, right).

Sanden Totten @sandentotten Welcome to the age of text neck "... Young people are developing hornlike spikes at the back of their skulls bone spurs caused by the forward tilt of the head." wapo.st/2RqzRuo 27.8 mm 1:33 PM Jun 20, 2019 Tweet Deck

Kate Hinds @katehinds Entire @WNYC newsroom touching the bases of their skulls right now. "Is this a bone spur? DO I have a bone spur? Come over here and feel this! 27.8 mm Horns are growing on young people's skulls. Phone use is to blame, research su... The growth of bone spurs at the back of the skulls of young people may be a result of an adaptation to the use of handheld devices. washingtonpost.com 11:47 AM Jun 20, 2019 Twitter Web Client

Some debated the validity of the paper's hypothesis, however. Techdirt^[7] pointed out that the paper did not actually use data to suggest smartphone use caused the growth, and only offered it as a hypothesis. They wrote, "there's a wide variety of modern human behaviors that could influence skeletal shifts, from watching television and reading books to terrible posture resulting from a lack of meaningful exercise." Paleoanthropologist John Hawkes wrote a Medium^[8] post pointing out several problems with the paper, including that it has "no table of results, so we cannot see the frequencies that the authors observed." Additionally, one figure in the paper shows that both men and women have the protrusion in high frequencies, yet the text states "males are '5.48 times more likely to have EEOP than females (P < 0.001).'" Hawkes and Vice^[9] both concluded the story is a "tech moral panic." Vice argued the protrusion was more related to bad posture as oppose to smartphone usage.