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School’s in Session: A Spine Expert’s Backpack Safety Tips

POSTED BY Dr. Andrew Casden, Orthopedic Surgeon
September 23, 2019  
Five ways to keep your child’s spine healthy and injury free.


Back pain in kids is on the rise – with one-third of all children reporting some episode of back discomfort, according to a recent study of 3,669 American youths. The reasons are many, such as overuse issues from competitive sports and a general increase in average BMI. But there’s also another culprit, and unlike the others, this one is fairly easy to rectify: making sure your kids carry lighter backpacks to school.

Drive by any school and you’ll see kids carrying backpacks that are the wrong size and design for their small frames. You’ll see children craning their necks forward to try to balance the load, a tendency further exacerbated if they happen to also be texting on their phone. When a heavy backpack is incorrectly placed on the shoulders, the weight’s force can pull a child backward. To compensate, the child might bend forward at the hips or arch the neck. This can make the spine compress unnaturally, leading to shoulder neck and back pain.

Your child won’t develop scoliosis or curvature of the spine from wearing a heavy backpack – those are myths. But he or she could develop bad posture and be plagued with pain that’s completely avoidable with some simple modifications:

Practice the 10% rule

A child’s backpack should not exceed 5 to 10 percent of their body weight to protect the spine. So, a 60-pound, eight-year-old girl should be carrying no more than three to six pounds on her back. With the average hardcover book ranging from two to seven pounds, you can see how quickly things add up. Girls are more prone to report back pain than boys, likely because of their smaller frames. Make a point to place your child and their backpack on a bathroom scale from time to time, to make sure they aren’t exceeding the recommended safe limits.

Help them wear it well

Some children, whether for style or convenience, tote their packs on one shoulder, but doing so causes an imbalance and strain on one side of the body. Properly fitting backpacks should be worn close to the body using both straps, so weight is evenly distributed. Chest and lumbar straps are additional ways to spread the load out more evenly. The pack should rest in the middle of the back and not sag down to the buttocks. Picking up a pack properly is essential as well. Children should grab the pack with both hands and bend at the knees when lifting to their shoulders. Put heaviest items like computers and books in the biggest pocket close to the back, with school supplies, calculators and personal items in the smaller, outer pockets.

Get organized

Encouraging children to make good use of locker storage is one way to ensure lighter loads. Yet, some older kids may choose not to use lockers, and some schools no longer allow them for safety reasons. Help to emphasize the importance of being well organized and leaving books that aren’t immediately needed at home or in lockers, even if it means a few extra minutes to get to class. These days, there are a number of online shops that rent textbooks fairly inexpensively, so consider keeping a second set at home.

Shop for function, not style

Does your child gravitate toward the camouflage print or sports team backpack? Backpacks are often chosen as an expression of individuality. More important is how it’s made and designed. The lighter the better – leather might look more fashionable, but they are generally heavier than canvas or polyester. Make sure the shoulder straps are wide and padded, as packs with narrow straps can dig into the shoulders and affect circulation and nerves. Waist belts also help to distribute weight more evenly across the body – as do multiple compartments. Avoid roller bags – they are heavy to pull up stairs and many schools don’t allow them because they are a tripping hazard.

Know when to see a doctor

If you see your child struggling to get their backpack on or off, or leaning forward to carry the backpack, they probably need to lighten up. If they have been complaining about pain in their neck, back or shoulders, including numbness or weakness for several weeks, it may be time to speak with a doctor.

Photo of Dr. Andrew CasdenDr. Andrew Casden is Chief of Orthopedic Surgery and Spine Surgery at White Plains Hospital, experienced in both traditional and minimally invasive spinal surgery. To make an appointment in the West Harrison location, call (914) 946-1010.

Tags: back pain, backpack safety, orthopedics, pediatrics, spine care
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