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It is expected that school-aged children use backpacks to carry books and other supplies to and from school. It is even common to see preschool and kindergarten children wearing backpacks that appear to be nearly half their size! When appropriately used, a backpack allows a child to carry necessary items to school safely and conveniently. However, questions about the proper weight of backpacks, and their potential to cause or contribute to back pain and other conditions have been the source of widespread concern and uncertainty. Do backpacks cause pain? Are some children at greater risk than others? How much weight should a child carry in a backpack? What type of backpack is best? Are there ways to wear a pack that helps prevent potential problems? These are just a few of the questions parents are asking as they send their children off to school with bulky backpacks.
How serious is the problem?
Back, neck and shoulder pain are common in adults, and there is evidence that the prevalence of those complaints have increased in adolescent and younger individuals. There is strong speculation that this may be due, at least in part, to heavy backpack usage.
Several studies have identified significant association between backpack use and back pain in children, however research to date has not completely clarified that association. Greater likelihood of pain seems to be correlated with heavier weight and younger age. Girls appear to be more likely to experience back pain with backpack use than boys.
Effective tactics to reduce the likelihood of back pain in adolescent children are the availability of school lockers and placing limits on backpack weight. While all the answers are not yet known from a strictly scientific standpoint, there are a few widely accepted principles that may help guide the concerned parent.
What are the issues?
Carrying any load on an individual’s back increases stress on the neck, shoulders, back, hips and other body regions. Heavy loads alter the normal curves of the spine, promote forward rounding of the shoulders, and upset a child’s balance, making falls more likely. This can cause, or at the very least contribute to, back issues in children. Pre-existing issues, weakness or postural problems may be further stressed by the additional weight of a heavy backpack. Even minimal loads, if worn improperly, can cause problems.
Here are some things you can do:
- Select a proper backpack.
- Limit the load.
- Assure appropriate positioning and distribution of the load.
- Adequately secure the load to prevent unexpected shifting.
How should one select a proper backpack?
The correct backpack makes a big difference. The variety of sizes, shapes and features provide lots of choices, but has a tendency to be a little daunting.
- The first aspects to look for in a backpack include one that is structurally-rigid to support the intended contents, which are often heavy textbooks. Search for multiple compartments that allow for effective positioning of items and prevent them from shifting.
- It is not recommended to choose a backpack that is wider or longer than your child’s torso because a backpack that is too large will not fit securely, promotes poor body mechanics and will likely get filled to an excessive weight.
- The straps are another important part to look for. Straps should be wide to help distribute the load, shaped to fit securely in front of the shoulders and adjustable to for proper positioning. Padding in the straps and back will limit shifting and provide comfort by reducing impact on pressure points.
- While it might seem that rolling packs eliminate the issues associated with wearing a backpack, they often need to be lifted and carried over curbs and stairs. This involves moving a heavy object in abnormal ways, so they are generally not the best alternative unless you have no other substitute because your child is unable to carry a backpack.
How should a backpack be loaded and worn?
While there are no clear-cut limits on weight, it is best to keep the pack as light as possible. The American Chiropractic Association (ACA) suggests a maximum of 10 percent of the child’s body weight. When loading the backpack, the heaviest items, such as large books, should be placed in the front of the pack, closest to the child’s back, to keep the center of gravity as forward as possible. Backpacks should be worn with both straps over the shoulders to distribute the weight symmetrically. Adjust straps to prevent the load from pulling backward or hanging low on the back.
Mild discomfort associated with backpack wearing is usually self-limiting and short-lived. It will typically resolve with rest and may be addressed by reducing or redistributing the load. More severe or persistent pain should be evaluated by a chiropractic physician or other qualified health care professional.
American Chiropractic Association: http://www.acatoday.org/Patients/Health-Wellness-Information/Backpack-Safety
National Safety Council: http://www.nsc.org/learn/safety-knowledge/Pages/backpack-safety-for-kids.aspx