Each school year millions of children walk to, from, and around school carrying backpacks filled with books and materials. Parents should be aware that overly stressing the back with a heavy backpack could cause back pain in their child.
Following a few guidelines and using common sense can help avoid this type of back pain.
How Kids’ Backs Respond to Backpacks
Using a backpack allows a child to carry a number of schoolbooks and items in a practical way, distributing the heavy load across the strong back and shoulder muscles. The risk, however, is overload, which can strain the back, neck, or shoulders.
The back will compensate for any load applied to it for an extended period of time. A heavy weight carried in backpacks can:
- Distort the natural curves in the middle and lower backs, causing muscle strain and irritation to the spine joints and the rib cage
- Lead to rounding of the shoulders
- Cause a person to lean forward, reducing balance and making it easier to fall
Habitually carrying backpacks over one shoulder will make muscles strain to compensate for the uneven weight. The spine leans to the opposite side, stressing the middle back, ribs, and lower back more on one side than the other. This type of muscle imbalance can cause muscle strain, muscle spasm, and back pain in the short term and speed the development of back problems later in life if not corrected.
A heavy backpack can pull on the neck muscles, contributing to headache, shoulder pain, lower back pain, and/or neck and arm pain.
Medical Research on Backpacks:
While the medical literature on backpacks is often inconclusive, and sometimes contradictory, a review of current medical literature suggests several general conclusions:
- Carrying heavy backpacks, or carrying them in a way that strains the back, is a frequent cause of back pain in children and adolescents
- The back pain caused by back packs is short term (e.g. muscle strain) and alleviated with a short period of rest or reduced activity; any type of back pain that persists is uncommon and should be evaluated by a medical professional
- Several authors suggest limiting the backpack weight to 10-15% of the child’s body weight is reasonable.
Look for backpack design features that help reduce the chance of back pain:
- Lightweight material (canvas as opposed to leather)
- Two padded, wide (2-inches), adjustable shoulder straps on the backpack
- Padded back
- Individualized compartments
- Hip strap, waist belt, or frame to redistribute the weight of the backpack from the shoulders and back to the pelvis
- Wheels so that the backpack can be pulled rather than carried
- Consider using a separate bag for the child’s laptop or other heavier electronic items
Teach your child how to properly load and wear the backpack to avoid back pain:
- Always use both shoulder straps and wear the backpack on the back rather than over one shoulder
- Pack heaviest objects into the backpack first so they are carried lower and closest to the body
- Fill compartments so that the load is evenly distributed throughout the backpack and items do not shift during movement
- Pack sharp or bulky objects in the backpack so they do not contact the back
- Adjust the straps to fit the backpack snugly to the child’s body, holding the bottom of the backpack 2 inches above the waist and keeping the top just below the base of the skull; do not carry the backpack low near the buttocks
- Lift the backpack by using the leg muscles and keeping it close to the body, not by bending over with arms extended
- Do not lean forward when walking; if this is necessary, there is too much weight in the backpack
Maintain a mindset to watch the weight carried in the backpack to reduce back pain:
- If the child complains of discomfort, reduce the weight in the backpack immediately
- Consider applying a guideline backpack weight limit as a percent of the child’s body weight. The American Physical Therapy Association suggests 15-20%; the American Chiropractic Association advises 5-10%
- Coach your child to carry only those books needed in the backpack, leaving unnecessary items at home and making frequent trips to his/her locker during the day
- Teach your child to clean out the backpack at least once a week
Become a Proactive Parent on the Issue of Backpacks and Back Pain:
- Ask your child if they feel any back aches or pain
- Help your child choose the smallest backpack that will meet his/her needs
- Talk to teachers about how to minimize the need for children to transport heavy books back and forth daily in their backpacks; keep one set of books in the classroom for daily work while leaving heavy books at home; make photocopies of homework chapters and assignments that are easily carried
- Attend PTA meetings and discuss any proposal by school administrators to remove lockers or to reduce time between classes making it difficult to store unneeded books and materials
Finally, there are a number of alternatives to traditional backpacks on the market. These include saddle bags, rollerbags, backpacks with inflatable lumbar support and straps, totally inflatable backpacks, and molded backpacks.