When my daughter started middle school, her backpack was bulging with heavy books, notebooks, and supplies. By the end of the day, her back ached. We decided it was time to take action to reduce the stress on her back.
When used correctly, backpacks conveniently carry the day’s necessities on the body’s strongest muscles, the back and abdomen (American Academy of Orthopedic Surgeons, 2004; Gavin, 2004). However, when backpacks are too heavy or worn incorrectly they can injure muscles and joints, especially to growing children and teens (AAOS; Dobbs, 2004). Medical experts report that, “this can lead to severe back, neck, and shoulder pain” (AAOS) from strains and sprains on the back and shoulders, and even contusions and fractures (National Safety Council, 2004).1 An estimated one half of U.S. school children carry too much weight in their backpacks (Dobbs, 2004) and the number of backpack related injuries in children is increasing (NSC).
Parents can follow the following guidelines to help their family use backpacks safely and prevent injuries.
First, choose the right backpack, one that fits right and has wide, padded shoulder straps and a padded back, a waist belt and is light weight. The pack should fit the child, not be bigger than the length of the child’s torso (American Academy of Pediatrics, n.d.; California Physical Therapy Association, 2003). Some experts also suggest compression straps on the sides or bottom of the backpack tighten to compress and stabilize the contents of the backpack (NSC, 2004).2
Second, make sure the student is wearing her or his backpack right (Dobbs). The weight should be distributed evenly and pressure on the back and shoulders minimized (California Physical Therapy Association, 2003). Always use both shoulder straps and adjust them so they are snug but not too tight and the arms and shoulders move freely (AAOS; AAP; Dobbs). The pack should be close to the body and about two inches above the waist so it rests evenly in the middle of the back (California Physical Therapy Association, 2003).
The third precaution is to pack light and right. The backpack should not weigh more than 15% percent of the student's body weight, “the maximum safe weight for children recommended by most experts” (California Physical Therapy Association). Pack only what is needed. Spread the weight among the compartments, with “heavier items closest to the center of the back” but not poking out (AAOS). 3
There are other precautions your student can take:
- Don’t bend over at the waist when wearing or lifting the pack.
- Bend using both knees and squat if necessary.
- Do back strengthening exercises, and stay fit.
Encourage your child to use a locker if available. Talk to the school about buying a second set of textbooks for students, distributing the homework load, and permitting students to stop at their lockers during the day (AAOS).
Backpacks with wheels may be a good option when there is a heavy load (AAOS). However, wheeled backpacks may be difficult to get up and down stairs, or get in the way in crowded halls.
How do parents know if their children aren’t being injured? She or he should be walking normally. Signs of a too-heavy load include struggling to put on or take off the pack, stooped posture, pain when wearing the pack, tingling or numbness in the arms, red marks on the shoulders (Gavin; NSC). If these problems continue after adjusting the pack, see your family doctor or pediatrician.
- Injury occurs in several ways. When a backpack is too heavy, it pulls a person backwards, and the person may lean forward to compensate. Bending forward at the hips and arching the back can compress the spine unnaturally (Gavin, 2004). Over time, the shoulders can become rounded and the upper back, curved, and the child or teen can develop shoulder, neck, and back pain (Gavin). In addition, tight narrow straps may interfere with circulation and heavy weight may cause stress or compression to the shoulders and arms. When nerves are compressed, the child may experience tingling or numbness in the arms and hands (Gavin, California). When wearing the backpack over just one shoulder, the child or teen may lean “to one side to offset the extra weight” (Gavin). This can result in lower and upper back pain, shoulder and neck strain, and poor posture (Gavin; AAOS).
- Reflective material also helps keep the child is visible to drivers at night (California Physical Therapy Association, 2003).
- To check the fit of your child’s backpack, see these illustrations from the California Physical Therapy Association.
American Academy of Orthopedic Surgeons, 2004. Backpack safety.
American Academy of Pediatrics (2005) Back to school tips.
American Academy of Pediatrics (n.d.). Backpack safety.
California Physical Therapy Association (2003). Is your child’s backpack making the grade?
Dobbs, M. (2005). Backpack safety—Lighten the load!
Gavin, M. (2004). Backpack basics. Teen Health. Retrieved June 13, 2006
National Safety Council (2004). Backpack related injuries in children. National Safety Council. Retrieved June 13, 2006.