Backpack Pain

Many students can suffer lasting effects of carrying weighted down backpacks.

Dr. Ryan Knight from Knight Family Chiropractic is here with a few tips for parents and kids.

Backpacks 101
by Dr. Ryan Knight, Knight Family Chiropractic

In the world of our school kids, books rule. They're not just carried to school on the street or bus, but they also patrol the hallways, used from class to class within the school building itself. The omnipresent backpack or binder can cause "functional scoliosis" or a dysfunctional spine for the modern student.

The American Academy of Orthopedic Surgeons reported that 58% of its responding members have noted mounting evidence of how backpacks are hurting the backs and shoulders of American children. Especially noteworthy are muscle fatigue problems not usually seen among students. This is not just noteworthy, say experts, it is truly alarming. Dr. Gregory Lutz, Chief of Physiatry at the Hospital for Special Surgery in Manhattan and an expert on musculoskeletal spine and back problems remarks that "excessive loads can create injury to the lumbar discs even at younger ages."

Also sounding the alarm is the Consumer Product Safety Commission. According to CPSC data 10,062 young children, ages 5 to 14, went to emergency rooms with backpack-related injuries in 1998 alone. Incidence of troubles with backpacks dropped relative to the kids among teens, who suffered just 2,719 incidents. It seems that backpacks might be especially hazardous to younger children. With new backpack or back restrictions in most schools, the younger kids are the primary ones still carrying them.

Problems don't just begin when the tikes haul their gear in the packs. In fact, just putting on the backpack seems to start the injury express on the tracks. There is a youthful tendency to slip one of the two back straps on, and then swing the bag into place to fasten the other. This causes injuries. And very often, kids don't adjust the straps properly, so the weight is distributed unevenly. Dr. Knight describes a condition known as "head forward posture" characterized by leaning or stooping forward and “poking” the chin. "Patients will present with headaches, aching in the neck and between the shoulders>” adds Dr. Knight.

Most children that carry backpacks carry too much weight. It's not uncommon to see 90-pound girls or boys carrying 30-pound bags, a three-to-one weight ratio which is not allowable except in boot camp in the United States Marine Corps. Dr. Knight maintains that "prevention strategies are to keep the weight of the backpack to less than 15% of total body weight". Shifting back weights in the packs are also a culprit. The dynamics of gravity are bad enough, but when students run, leap, bend over and backwards, or remove the backpacks during the day, you have a recipe for trouble.

Most students take off their backpacks to deposit or remove books, usually in between classes and before the bell. This complicated and risky maneuver takes place in a beehive bustle of changing classes, usually in a crowded space with many distractions. Even mere transit has its problems, with backpacks strung hazardously across the shoulders, and balanced with a minimum of care at the very best.

Some medical and backpack experts are cynical, noting that when properly used, strapped and balanced, backpacks should cause little concern and fewer injuries.

But there are good rules to follow to keep your student injury free:

* Kids should make use of a hip strap. This bears more weight.
* Straps should be ergonomically designed and wide.
*Place the heaviest loads closer to the back.
*Use both straps.

Dr. Knight recommends wearing the straps on both shoulders to distribute the weight evenly as well as having straps that are well padded.

It is extremely helpful that many schools now offer an alternate set of books kept at home so less is carried on the bus. It might also be helpful to pack books tightly and neatly, thus avoiding awkward and hazardous shifts of materials within the backpack itself.

So while America gears up for better schools and smarter students, it would also be advisable to pay more attention to the logistics of learning...backpacks and the like.
"A reasonable recommendation is a 10-15% cutoff weight for bodyweight," he says. "This will help reduce the risk of injury related to falls and relieve pain that comes from wearing giant backpacks loaded with school supplies."
With 10% as the more conservative target, here's a breakdown by body weight for measuring how much your child should be lugging around in his backpack:
Child's Weight Backpack Weight
50 pounds 5-7.5 pounds
75 pounds 7.5 -11.25 pounds
100 pounds 10 -15 pounds
125 pounds 12.5 -18.75pounds
150 pounds 15-22.5 pounds

Online backpack calculator; link:

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