Back Pack Troubles for Children and Adolescents Dr. J. Shawn Leatherman

Are you sending your child off to school with a backpack tossed over his/her shoulder? Most parents in America are without any consideration for the problems that can result. Although backpacks have become as common as pencil and paper, you need to think twice about what may be occurring. While carrying a backpack may seem harmless, it can cause health problems, including back and neck problems which may or may not be painful.

Backpack Injury on the Rise: Research reveals an alarming danger with improper childhood backpack use. According to the U.S. Consumer Product Commision, of the 6,512 children treated in hospital emergency rooms in one year for injuries related to backpacks, 54% involved children aged 5-14. In 2002 & 2003, approximately 21,000 emergency room visits were attributed to bags and backpacks. Not only does acute injury occur, but also long term damage. A study conducted by the American Academy of Orthopaedic Surgeons adds to the growing body of research on the negative impact of backpack use. Investigators surveyed more than 100 physicians at Children's Memorial Hospital, Chicago, Illinois and Alfred I. DuPont Hospital for Children, Wilmington, Delaware. The study revealed that backpack injuries are on the rise. In total, 58% of the orthopedists reported seeing patients complaining of back and shoulder pain caused by heavy backpacks. More than 70% of the orthopedists surveyed indicated that heavy backpacks can become a clinical problem in school-age children if not enough attention is made to decrease some of the weight being carried in the packs. For example, carrying 12 pounds in a backpack and lifting it 10 times per day equals 120 pounds lifted each day. That is equivalent to 21,600 pounds in a school year (nearly 11 tons), or 6 full size automobiles. Now imagine this load being carried on only one shoulder.

You don’t need to be a scientist or physician to understand the effects of backpacks on children. Visit a local school and watch the kids struggle to walk while bent sideways or flexed forward under the weight of an overloaded backpack. You can easily realize the inherent dangers on the structure of the spine. Carrying a heavy load that is distributed unevenly or improperly, day after day, week after week, will impart stress to the spinal column and the long-bones, in the legs of a growing child. Consider the phrase, “As the twig is bent, so grows the tree.”

Back Packs Affect Teen Postures: In the November 1st, 1999 edition of the journal SPINE, association of poor posture was studied in relation to back pack wearers. What postural influences do backpacks have on teenagers' spines? To answer this question, researchers evaluated the head-on-neck posture of 985 high school students, aged 12 to 18 years. Specifically, the investigators assessed the craniovertebral angle of subjects wearing backpacks, and not wearing backpacks. The study found that backpack use significantly altered head-on-neck posture in every age group studied. This finding was most pronounced in younger students. Additionally, Simmons College reported in February of 2001, “55% of students carry more than the recommended 15% of body weight in their backpacks.”

A cure for the Back Pack Blues: Neck and back pain is pervasive in our society. Much of this is brought on by bad habits that were started during our younger years such as inappropriate back pack usage. Slinging a backpack over one shoulder or allowing it to ride low on the back may provoke serious postural and vertebral misalignments. These misalignments restrict normal movement, reduce function, affect balance, symmetry and spinal health, which predispose ailments such as neck pain, back pain and headaches. Chiropractic physicians have long recognized the hazards of improper loading of the spine, and as specialists in spinal biomechanics need to educate on the proper usage of back packs. In an effort to reduce backpack related injuries and to ensure the health and safety of your child, follow the preventive measures listed below.

1. The max weight of your child’s LOADED backpack should never exceed 15% of his/her body weight. (American Pediatric Association) This includes the weight of the backpack itself. Too much weight causes the child to lean forward and round the shoulders in an attempt to manage the load leading to postural abnormality and stress on the spinal column, muscles, discs, and ligaments.
2. Insist on your child wearing BOTH shoulder straps to eliminate asymmetrical loading of the torso.
3. Make sure the backpack rests firmly against the back with the top just below the base of the neck.
4. Look for wide and padded straps. This helps to increase surface area and disperse weight while decreasing pressure on the shoulders and the nerves around the arm pits. In addition padded waist straps will keep the weight close to the body and aid proper balance.
5. Teach your child to load the backpack as evenly as possible. Keep the heaviest items centered and closest to the body. Lighter items are to be placed to the sides and top.
6. Lifting technique is important. Always bend at the knees, use both hands, and lift with the legs not your low back. Carefully place the backpack on one shoulder at a time and never sling it over the shoulders.
7. Adjust the straps properly. A secure backpack is snug but not too tight, hugging the chest wall, with the buckle of the strap being approximately two inches below the armpit.
8. For older children, encourage them to make frequent stops at their locker daily to replace books that are not needed, and reducing the overall load carried.
9. Talk to your child about the importance of using a backpack correctly. A child who is educated and understands the importance of ergonomic factors early in life can apply the knowledge at school, home, and later in life, reducing the effects of poor postural loading of the torso and spine.

Additional Parameters and Ideas: It may be advisable to talk to your child’s teachers and administrators at school. It might be possible for students to have two sets of textbooks, one to be left at school, and one for home usage which will eliminate the need for unnecessary transportation of study materials. Many classrooms have utilized lighter-weight workbook materials and handouts to minimize the daily carried loads for students. Lastly, you may want to look at stroller bags such as airline carry-on luggage. They are frequently large enough to handle a student’s need without the burden of heavy lifting and roll with ease. These bags fit into many school lockers and they are easier to transport. As always check with your local school officials for any policies and/or regulations you may need to follow, and measure the size of your child’s locker beforehand.If your child has already been subjected to improper backpack usage or has already complained of neck and back pain, it is important to address the underlying causes. Subtle spinal disorders, postural abnormalities, and asymmetric fixation or movement disorders of the spine, often go unnoticed until the problem has been made worse or chronic. Because of this, it is especially important to call your chiropractic physician if your child is experiencing any pain or discomfort in the shoulders, neck, legs, or back. Don’t ignore this potential threat to your child’s developing skeletal structure and health. Spinal correction is specific, gentle, and more effective when addressed early on, and home exercise routines can be developed to strengthen your child’s spine to aid in the prevention of further problems. Backpacks with air cells are available to lessen the impact of weight placed on the shoulders, as well as the back musculature.

For any additional information please feel free to call the doctors at Suncoast Healthcare Professionals. 850-864-0800