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Is Your Child's Backpack Too Heavy?

Is Your Child's Backpack Too Heavy?

An overloaded book bag could lead to long-term pain problems.

Between jam-packed lunches, heavy textbooks and tons of carefully labeled school supplies, your child’s backpack can get pretty full, pretty fast. But before they trudge to the bus, you may want to eliminate some of that excess equipment. Each year, thousands of US children are treated for book bag-related injuries, some worthy of a trip to the emergency room.

"The most common injuries are muscle strains of the neck, shoulder and back," says Abdurrahman Kandil, MD, an orthopedic surgeon with StoneSprings Orthopedics in Dulles, Virginia.

Overloaded bags are also responsible for some adolescent back pain, which can increase the likelihood of chronic back pain in adulthood. One 2017 study of 4,005 children between the ages of 8 and 13 found that 32 percent of the students sampled experienced back pain.

Read on for tips on lightening the load—and avoiding too-early trips to the orthopedist.

Long-term problems with backpacks
There are a number of reasons your child might experience pain or injury due to a book bag; maybe it’s packed improperly, worn on one shoulder or just too hefty. Contact sports, poor posture or inactivity can contribute to pain problems, as well. 

While backpack-related strains aren't typically long-lasting, children who tote heavy backpacks for an extended period of time may develop poor posture, which can linger for years to come, according to Dr. Kandil. A well-fitting backpack can help alleviate this particular problem, but it’s not the only risk associated with a massive book bag.

Carrying a pack improperly or lugging one that's too bulky can also put extra pressure on a child's developing spine. Book bags weighing more than 10 percent of a child's body weight may increase the risk for deformities, according to one small 2015 study of 7-year-olds. The research looked at just 109 children, so it's tough to know if the findings are broadly applicable, especially to kids who are older or younger.

It should be noted, as well: Not all spine curvatures in young children are the result of weighty bags, according to the American Academy of Orthopedic Surgeons. And backpacks—no matter how heavy—do not lead to scoliosis.

Expert-approved ways to prevent injury
Backpack-related injuries aren't inevitable, but preventing pain takes a bit of preparation. Try these tips:

Buy the right book bag. When you're on the hunt, there are a few features to keep in mind. Backpacks should be lightweight and equipped with a cushioned back and two thick, padded straps. "Sometimes we see numbness or tingling associated with very thin straps," Kandil says. This isn't uncommon if there's a lot of weight focused on a small area of a child's shoulder. Kandil also recommends investing in a pack with a waist strap, which helps keep it closer to the body and decreases the load on your child's back. Multiple compartments can help distribute the weight in the bag, too.

Pack it properly. A lighter backpack is always better, but "evenly distributing the weight decreases the amount of strain to the neck, shoulder and back muscles," says Kandil. Make sure to use all of the bag's compartments. If your young one must transport heavy items, like bulky textbooks, position them in the middle of the bag, near the bottom.

Know when it's too heavy. Even if it's packed to perfection, a heavy knapsack can still be dangerous. Weight recommendations for your child’s backpack vary between 5 to 20 percent of their body weight. The American Academy of Pediatrics puts a safe load between 10 and 20 percent of a child's total weight, while the American Chiropractic Association suggests no more than 5 to 10 percent. It's best to keep things as light as possible, though—so use the bathroom scale as your guide. Clean the bag out weekly with your child to help prevent overloading.

Sport it just right. Encourage your young one to use both shoulder straps and the waist buckle. Tighten the pack so the bottom of the bag sits at the waist. "The general recommendation is not to have the lower part of the backpack hanging more than 4 centimeters below the waistline," Kandil says. To avoid strain, he also recommends picking up the pack by bending at the knees rather than the waist and using both hands.

While it can be tempting, a rolling backpack may be ineffective at preventing injury, since many children carry them the wrong way traveling up and down stairs. Using rolling bags in a crowded hallway can also pose a tripping hazard. "My general recommendation is to wear an appropriately sized, lightweight, well-padded backpack on two straps with a waist belt," Kandil concludes.

Medically reviewed in June 2018. Updated in August 2019.

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