Backpacks Can be a Pain in the Neck

by Dr. William Phillips, Chief of Orthopedic Surgery at Texas Children’s Hospital
tttdocMany parents are surprised to learn that a lot of children are carrying backpacks that are far too heavy, increasing exposure to injuries. With the beginning of the school year right around the corner, back-to-school shopping is in full swing. When it comes to choosing a backpack, parents should remember that the decision is not all about which color is the prettiest or which character is the coolest; it is about choosing a backpack that will help evenly distribute the weight of the contents for a child.

Many parents are surprised to learn that a lot of children are carrying backpacks that are far too heavy, increasing exposure to injuries.

A loaded backpack should be light enough for a child to walk or stand up straight without leaning forward or to the side. Backpacks should be no heavier than 10 to 15 percent of a child’s body weight. That means that if a child weighs 80 pounds, the backpack should weigh no more than eight to 12 pounds. Also, a backpack should never hang more than four inches below the waistline. The lower the backpack, the more weight there is on the shoulders which can cause children to lean forward when walking.

When carried correctly, a backpack is easier on the back and shoulders than carrying a briefcase or purse. This is because the strongest muscles in the body, the back and the abdominal muscles, support the weight of the load. A backpack worn using both the shoulder and hip strap is less likely to cause neck and shoulder pain because it helps distribute weight more evenly across the body.

To help your child avoid the neck and back strain caused by heavy backpacks, try these tips:
• Buy a backpack with padded shoulder straps and a hip strap
• Pack heavy items in the pack closest to the body
• Teach your child to lift heavy objects by bending at the knees and lifting with both legs
• Use both backpack shoulder straps over both shoulders; slinging it over one shoulder increases the risk of back and shoulder pain
• Adjust straps to fit snugly around your child’s shoulders and hips with weight carried no lower than two to four inches below the waist
• Carry a smaller load, if possible
• Encourage your child to participate in a regular exercise routine to gain overall strength and stamina

A backpack that is carried incorrectly, or is too heavy can lead to spondylolysis (a stress fracture in the back) or apophysitis (an inflammation of growth cartilage) and posture problems.

Children who are trying to compensate for the weight while lifting a heavy backpack tend to lean too far forward and roll their shoulders. This can cause a rounded upper-back. If they are hunched over, they can strain their necks while lifting their heads up to see properly. A strained neck can lead to sore muscles and cause nerve damage in the neck. If children are leaning too far backward from the weight of the backpack, the arches of their backs can be altered, causing cause stress fractures in the spine. If a backpack is worn on one shoulder, a child might walk hunched over to one side and experience neck pain.

Children do, sometimes, have to carry home heavy loads of books and binders, so it is important for parents to watch for warning signs. If your child starts complaining that his or her back is hurting or of sore muscles in the back, try weighing the backpack. If the child is carrying too much, ask his or her teacher for ways to reduce the weight. See if it is possible to keep a set of textbooks at home, which will help reduce the weight and ultimately help relieve pressure on your child’s back.

Dr. William Phillips is chief of orthopedic surgery at Texas Children’s Hospital.

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