Back-to-school health: Avoiding backpack induced back pain

Do you know how much your child’s backpack weighs? If it’s more than 15 percent of his or her body weight, then it could hurt your child’s back. Millions of students in the United States carry backpacks to and from school, often overloaded with books, sports equipment and more. Weight of the backpack isn’t the only issue; how the bag is worn can also lead to back problems. Backpacks should be worn on both shoulders for equal weight distribution, and the height should fall two inches below the shoulder blades and sit at waist level.

Pierre d’Hemencourt, MD, of Boston Children’s Division of Sports Medicine, answers a few questions about children and backpack safety.

Can heavy backpacks really cause back problems for my child?

This issue is a bit controversial because there’s no specific proof heavy backpacks are a direct cause of back problems. During adolescence kids are going through growth spurts and so their bones and posture are susceptible to many things, from sport injury to lugging overly heavy backpacks. However, the American Academy of Orthopaedic Surgeons and the American Physical Therapy Association have set out guidelines that should be used with backpacks to reduce the risks associated with them.

What problems could potentially be caused by heavy backpacks?

With a heavy backpack, many children end up leaning too far forward, rolling their shoulders and giving themselves a more rounded upper-back posture. They then tilt their head up so as to be able to see properly. This posture strains the back and neck muscles, and can possibly cause nerve damage in the neck. The child might also lean backward from the weight, which can alter the sway of the back and cause stress fractures in the spine. If they wear their bag only on one shoulder, they might walk tilted to one side and experience neck pain. In addition, if the straps on the bag are too small they can dig into the neck and shoulder muscles and potentially cause nerve damage in that area.

How will I know if my child is experiencing back problems?

The biggest warning sign is if she is complaining of back pain. Another is if her posture changes once she has her backpack on. For instance, if she leans forward, backward or to the side, that means something is wrong. In addition, excessive redness on pressure points such as her shoulders means the bag is too heavy.

What should my child do to avoid backpack induced back pain?

Start by making sure the child has the right kind of backpack. It should have padded shoulder straps, which distribute the weight in the bag evenly over his shoulders, as opposed to having small straps digging into the shoulders. Also, a bag with a waist belt helps distribute the weight through his hips, as well. The straps should be adjusted so that the bag rests at the middle of the back. If they are too tight, it will be difficult to get the bag off, and if they are too loose, it will result in your child leaning back too far. A bag with a padded back can also be beneficial in removing some of the pressure. Bags with rollers are another possibility, though if your child’s school has a lot of stairs it won’t help him out much.

Can these back problems be corrected?

Dr. Pierre d'Hemencourt

If caught early enough and habits are changed, back pain can be reduced or eliminated. If your child has had a previous back injury and lightens his backpack load, pain from his previous injury can be reduced, as well. If you suspect your child is having back problems, take him to your doctor to see what therapies or changes are needed to ease him of any pain. Carrying heavy loads can cause bigger problems down the road if not corrected early on.