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  • Dr. Nathan Keiser

Is Screen Time Giving You A "Digital Concussion?"

Updated: May 29

When most people think of the word concussion, they picture a devastating football tackle, a car accident or in some way taking a blow to the head and neck.


As COVID continues to make its mark on global culture, we are seeing another pattern emerging.


We are 2 months into our stay-at-home orders here in the US and nearly every day in that span, I have had someone describe the symptoms of a concussion even though they have no physical injury.


“I have started getting headaches almost every day. I feel anxious and my eyes are getting blurry.”


“I’m getting really foggy by the end of the day and my neck is really stiff”


These are the comments I am used to hearing after someone has had a brain trauma. Now I am hearing the same complaints from people spending their days on zoom calls and report writing.


As the hours spent on laptops, tablets and phones rack up, more and more people are realizing how taxing screen time can be on their brains.


My colleague and kindred spirit in brain health Dr. Andrew Huberman (@hubermanlab on instagram) has relayed this phenomenon as a type of “digital concussion.”


If you are interested in maximizing your productivity without causing a digital concussion, this article gives practical solutions that you can begin to apply immediately to stem the effects of increased screen time on your brain health.


Let's take a dive into understanding why increased screen time can be so irritating to our brain and learn how even in times of Zoom calls and spreadsheets, you can build resilience against the pandemic of “Digital Concussion.”


Screen Time Places Additional Strain on Brain Pathways

Over the last decade, the amount of time we find ourselves in front of screens continues to rise as our connections to work, social circles and even family are more available through technology. Many people are quick to condemn this reality in favor of “the good 'ol days.” I can certainly relate to this argument. I much prefer to go out to dinner with people not distracted by their phone or consumed with their next instagram post, but I cannot refute the magic that is being able to say goodnight to my wife and kids on Facetime when I am out of town or connecting with old friends through text. As I write this now, I am glued to a computer screen. But as with all things, screen time is best in moderation.


In our community of people with post concussion syndrome, I recommend the following small changes that add up to big results when it comes to optimizing screen time while minimizing negative effects.


Go on a Diet

It is helpful to make the distinction between times that you are using your screen as a productive tool and when you are mindlessly browsing to fill time. The same way late night mindless snacking can ruin your physique, the minutes of mindless scrolling can add up quickly into unneeded strain on your brain.

Does this mean I’m suggesting you delete your instagram account and buy a carrier pigeon? Not at all. The key is to not engage in additional screen time mindlessly. I have had several patients that have found it useful to recognize what is considered essential screen time vs non-essential screen time. They schedule a specific amount of time for non-essential activities AFTER they are done with their essential work as long as they still feel like their brain can handle it.


If you are dealing with symptoms from working on a screen, this strategy helps in 2 ways:

  1. You make sure you are prioritizing the things you must do so you can feel fresh and healthy during those tasks.

  2. It brings awareness to the amount of time you are spending on your screen. By simply being aware of how you are using your time, you have the opportunity to step in and manage it.


So if you find your screen time snacks are overloading your system, step back and prioritize your essential use, create specific times to indulge in less productive usage and be aware of when enough is enough.


Keep Good Form

Growing up, I loved to play baseball. When my Dad taught me how to hit, he spent 3 times as long on helping me get my feet in the right position and bending my knees the right amount. Too much knee bend is a squat, too little and you’re just loitering with a bat on your shoulder. He instructed me on holding the bat the right way and getting my elbow into the right position so the bat would move smoothly through the strike zone. I was 4 at the time, so I’m confident that this was not an easy task, but he taught me to be in the right position first. As I think back to my childhood, the same lesson was repeated when shooting free throws in basketball, getting into the right stance in football or playing the trumpet in band. Even at school we learned to sit up tall and not rest our hands on the keyboard in typing class.

This idea of optimal body position for whatever your task, is known as ergonomics. When you are in your office or at school the environment is typically set up in a way that promotes good workplace ergonomics. Large companies spend a lot of money optimizing ergonomics to keep their employees healthy and reduce insurance costs, but I’m guessing ergonomics didn’t influence the interior design of your living room or kitchen table.

As many people made the switch to working at home, often the ergonomics did not follow. A perfect ergonomic workstation became feet up on the couch with the laptop in… well your lap.

While there is a sense of freedom in being able to work from the comfort of your couch, over time, poor ergonomics can turn into injury.

If you are having headaches, neck pain or eye strain while you are working, improving your ergonomics can go a long way in solving your problems.

If you are spending more than 15 minutes in one position, you should definitely consider optimizing your ergonomics.


Here are the strategies:


Plan ahead

It can be easy and tempting to sprawl out on the couch with your laptop and a cup of coffee, but before long your comfy workspace can suck the life out of your productivity. When working from home, you must design your environment to fit your needs, not the other way around.

Take the time to plan out your workspace in a way that helps you get more done and limit the toll it takes on your body and your brain.


Bones Support Weight Better Than Muscles

Create a body position that allows you to stack your ears over your shoulders and shoulders over your hips.

Stacking your ears over your shoulders allows you to bear the weight of your head (basically an 8 lb bowling ball) on your spine and vertebral discs rather than have to be constantly held up by your little intrinsic neck and back muscles. Taking the load off of your neck muscles will reduce the muscle strain that leads to tension headaches at the end of the day so you can focus on getting your work done. Taking the tension off your back muscles can reduce lower back and leg pain that is common with sitting for long periods-especially if the sitting is in an awkward position… Like bent over on your couch reaching to your coffee table while typing on your computer.

If you are in a good position, notice when you begin reaching your face toward your screen while you are working. Reaching your face toward your screen is the cue to tuck your chin back in and regain your optimal posture.


Stacking your shoulders over your hips also helps you hold your head in the right position, and has the added benefit of putting you in the optimal position for breathing. If you want to fuel your ability to sharpen your thinking and do your best work, you need to maximize the oxygen delivery to your brain. Slouched posture is not only the ticket to more back pain, it also reduces oxygen exchange in the lungs. Positioning yourself with your shoulders back and stacked over your hips, automatically puts you in a position to breathe deeply and improve oxygen delivery to your brain.


Is Sitting The New Smoking?

There has been a lot of hype over the new wave of standing desks, treadmill desks, sitting on swiss balls and the like. Is on option better than the other? It comes down to positioning. If sitting for extended time causes you to develop overuse symptoms, the position must change. If standing all day makes your leg hurt, the position must change. Reducing any one muscle or muscle group from overworking for long periods of time is the best choice. I like to give myself several options to achieve a stacked position while I work at the computer so I can have more flexibility while I write. It keeps any one system from being overworked and allows me to move into the position my body needs in the given moment. While a standing desk isn’t for everyone, standing can help you maintain your stacked posture naturally and seems to have other health benefits as well. You can improve blood flow circulation throughout your body, activate extensor muscles like your glutes instead of squishing them into a chair and it has been shown in some studies to improve all cause mortality. If you find it difficult to stand all day, alternate between standing and using a high stool such as the ergo stool from autonomous to get the best of both worlds.


Protect Your Eyes.

Imagine if you had to type out a report holding your computer in one hand and typing with the other. Not only would it be painstakingly slow, but you would have an incredibly sore arm at the end of the day. Whether we realize it or not, we ask our eyes to perform a similar feat when we work on a computer, except instead of a strained bicep, you strain the convergence and accommodation mechanisms in your visual system. Our eyes have the amazing ability to see clearly at different distances, whether our target is close up or far away. This feat is accomplished through the Near Triad Reflex.


The near triad reflex consists of three parts:

  1. Accomodation of the lens

  2. Convergence of the eyes

  3. Constriction of the pupil


Sustained screen usage forces all three of these systems to engage for an extended period of time. Just like holding your laptop all day would strain your arm muscles, focusing on a screen strains the ciliary muscles that control accommodation of the lens and constriction of the pupil and the medial rectii muscles that turn your eyes toward each other to maintain clear vision at near distances.


When the ciliary muscles fatigue, the lens cannot maintain its shape and vision becomes blurry. When pupil constriction fatigues, it is like a failing dam. More light floods into the eye causing overexposure of the retinal cells in your eye. When retinal cells are overexposed to light, it causes over-activation of the brain in the thalamus, occipital cortex and limbic system. Areas associated with symptoms of anxiety, restlessness, brain fog, confusion and fatigue.


If you are exposing your eyes to your devices and it creates fatigue in the near triad reflex, then you would benefit from giving your eyes opportunities to rest. Each of these techniques provides a small advantage in your visual system that when combined together and used over time can help you increase productivity while combating digital concussion symptoms.


Dim Your Screen.

Modern computers, phones and tablets have brilliant displays with high resolution that continue to improve year over year. While this technology gives access to beautiful imagery, over time it can be fatiguing to take in. The good news is that most of these devices also have the capacity to dim the monitor, reduce the contrast and brightness to make a more comfortable viewing experience. There are also apps like flux and Apple’s night mode that match the tone of your monitor to the ambient lighting environment. Reducing the brightness and contrast can improve your screen time capacity. To find the optimal setting, dim the screen and reduce contrast as much as you can without straining to read a normal line of text.


Create Visual Space.

Position your desk in front of a window or a large open space (indoors or outdoors) so that when you look out over your screen, you are looking out into the world. There are times when your eyes must be directed at the screen, but there are also times when you are listening to someone speak or thinking of what you would like to communicate when you don’t have to stare directly into your monitor.


Positioning yourself in front of the window, or into a large open space gives you an opportunity to take advantage of those micro-breaks in the action where your eyes can:

-move into a neutral position

-relax the ciliary muscles,

-focus at a different distance

-take in natural light and a visual scene with depth cues.


These strategies work to develop a stronger capacity for your screen time usage. With that said, recognizing your limit and taking a break is the best medicine when it comes to digital concussion. Using these techniques day by day can help you expand your tolerance, but sometimes you may be forced to push past your limits. In these cases, a retinal reset is in order.


Reset Your Retinas.

If you are able to successfully make the environmental changes to your screen time usage, but are forced to push beyond your limits for a period of time, use the retinal reset technique. The retinal reset is a tool to cut out the sources of overwhelm for your visual system. The retinal reset eliminates light stimulus so your pupils can relax and dilate-offloading the ciliary muscles, and the visual pathways to the thalamus and occipital cortex.


The retinal reset eliminates visual targets so the muscles of your eyes can rest into a neutral position. This is especially useful if you are looking at images in near vision that force your eyes into a sustained convergence.


The technique itself is quite simple and only takes 5-10 minutes. Find a space that can be made completely dark. This could be any space without windows such as a bathroom or even a walk in closet. You can simply go into this room, block out all the light and sit or lay down with your eyes OPEN. Spend a minimum of 5 minutes relaxing in this space. This is also a good time to stack slowed nasal breathing practice or meditation, or you can just let your mind wander. The point is to do it in the dark with your eyes open and relaxed.


While working from home or spending long periods of time looking at a screen may be the new normal, Digital concussion symptoms are not. Use these techniques to reduce negative effects of working at home, boost your productivity by not overwhelming your brain and enjoying the opportunity to stop and smell the roses.


If you find these strategies helpful, you should also read The 5 Mistakes That Slow Concussion Recovery.

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