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Children's Health & Safety Association

Issue 43: July 2018

Friday, 30 August 2013 14:11

Everything You Need to Know about Backpacks

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August 10, 2013 – From a child's perspective, backpacks have to look cool or make a social statement and according to the parent's prerequisites, they have to provide safety from injury and at the same time be very comfortable.

The shoulder straps of last year's backpack may need refitting or you may be considering purchasing a new backpack for your child's upcoming school year.

Children suffer from back and joint pain through poor posture and sports activities and some children experience chronic backaches due to the heavy school backpacks they tote around all day long to, from, and during school. Doctors and physical therapists recommend your children carry no more than 10% to 15% of their body weight in their backpacks. As a rule, this amounts to about 2 to 4 kilograms (about 5 to 10 lbs.) for elementary students and about 7 kilograms (about 15 lbs.) for older students.

To Prevent Injury
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ü Keep the weight manageable. A full backpack should never weigh more than 15% of your child's weight.

ü Using both shoulder straps centre the backpack between the shoulder blades. This will ensure that the weight of the backpack will be evenly distributed and promote good posture.

ü Straps should be at least 2" wide. Backpacks with tight, narrow straps dig into the shoulders and can interfere with circulation and nerves which can contribute to tingling, numbness, and weakness in the arms and hands.

ü Using only one strap loads the entire weight of the backpack over one shoulder resulting in back pain and strain to the neck, shoulders, joints and muscles. Leaning forward may affect the natural curve in the lower back, and increase the curve of the upper back and shoulders.

ü Tighten the straps so that the backpack is close to your child's body. The straps should hold the backpack 2" above the waist.

ü Organize the backpack so that all the compartments are used. This will not only distribute the weight of the backpack evenly but also provide easy access for many choice items.

ü back3Maintain good posture at all times - standing tall with your head and neck aligned with your shoulders. Keep your shoulders back and down.

ü Practice squeezing your shoulder blades together and then rotate your palms to face outwards. Hold for 30 seconds and repeat five times.

ü Keep the heaviest items closest to the back and near the bottom of the backpack. If the heaviest items are at the top, it can throw your child's balance off. The backpack itself should rest below the bottom of the neck and above the curve at the bottom of the spine.

ü Practice proper posture. When reaching down bend both your knees and as well, when you are picking up your backpack, bend both knees. Do not bend over at the waist when wearing or lifting a backpack.

ü When you have an opportunity to take your backpack off - do it! Give your back and muscles a break!

ü Stop often at your school locker. Do not carry all of the books through the course of the school day.

ü School backpacks are for schoolwork. Carry only those items that are required for the day. If possible, leave books at home or school.back4

ü Kids who wear their backpacks over one shoulder may think they look 'cool' now but they won't think that later on when they are in constant pain.

ü If you have the opportunity - pack light!

ü Organize your backpack weekly and remove all unnecessary items.

ü Kids who carry large backpacks are not aware that when they turn around or move through tight spaces, i.e. in the aisle on the school bus, sidewalks, streetcars and subways, they can knock people over including children that are not in their view. It happens to me all the time!

ü Carrying a heavy backpack changes the way children walk and increases the risk of falling, particularly on staircases or other places where the backpack places the student off balance.

The Spine

back5The spine is made of 33 bones called vertebrae, and between the vertebrae are discs that act as natural shock absorbers. When a heavy backpack is incorrectly placed on the shoulders, the weight can pull a child in a backward position. To compensate, a child will bend forward at the hips or arch the back which can cause the spine to compress unnaturally. The heavy weight might cause some children to develop chronic shoulder, neck, back and joint pain.

Purchasing a Good Backpack

Today backpacks come in all sizes, colours, fabrics, and shapes and when used properly they're incredibly handy. Backpacks often feature multiple compartments that help students stay organized while they tote their books, binders, papers, running shoes, gym clothes, and other school supplies from home to school and back again. Before you purchase the hottest new backpack for your child take into consideration the following:

ü The backpack should be proportionate to the size of your child and not chosen to simply carry more items.

ü The adjustable, padded, shoulder straps (at least 2" wide) should fit comfortably and not dig into the shoulders, allowing the arms to move freely. The shoulder straps should be adjusted so that the bottom of the pack sits 2" above the waist.

ü The bottom of the backpack should rest in the contour of the lower back and be positioned evenly in the middle of the back and not allowed to sag toward the buttocks.

ü The waist belt sends the weight of the backpack down through the legs and it maintains the central position keeping the backpack closer to the back.back6

ü Choose a backpack that is made of lightweight material so it won't increase weight to your child's load.

ü A padded backnot only provides increased comfort but also protects your child from being poked by sharp edges or objects (pencils, rulers, corners of notebooks, etc.) inside the backpack.

ü Multiple compartments help distribute the weight more evenly.

ü Consider compression straps – on the sides or bottom of the backpack to help compress the contents of the backpack and stabilize the articles.

ü Consider reflective material – for visibility during the fall and winter months.

Tips for Parents
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ü Encourage your child or teenager to tell you about pain or discomfort they may be experiencing.

ü Listen carefully and respond immediately when your child complains of pain associated with carrying their backpack, instruments and sports equipment. Take your child to see your family chiropractor, a physical therapist or family doctor.

ü Talk to the school or your teachers about managing homework and the books required therein.

ü Ensure the school allows students to stop at their lockers throughout the day. Team up with other parents to encourage positive changes.

ü If your child has back pain that does not improve, consider buying a second set of textbooks to keep at home.

ü Use your bathroom scale to weigh the backpack.   A child who weighs 80 pounds shouldn't carry more than 8 to 12 pounds in their backpack. Even less would be better!

ü Although packs on wheels (luggage bags) may present a healthier, alternative option for students who have to lug around really, heavy backpacks keep in mind they are very difficult to pull up the stairs and manoeuvre during inclement weather. Many schools don't allow packs on wheels because they pose a tripping hazard in the hallways so please do check with your school before you make a purchase.

ü Have your child evaluated by a paediatrician. Although back pain is becoming more common in older adolescents, it is not as common in younger children and may be a sign of a more serious problem, such as spondylolysis, spondylolisthesis, disk herniation, diskitis, a sport's injury, or a tumour or infection. Don't assume that your child's back pain is caused by a heavy backpack, especially if the pain is severe or persistent or if it lingers even after you lighten the load of your child's backpack.

ü The most common symptom reported from backpack injury is rucksack palsy. When pressure is placed on the nerves in the shoulder this causes numbness and/or tingling in the hands, and in extreme cases, nerve damage. Encourage your child or teenager to tell you about numbness or tingling in the arms or legs, which may indicate a poorly fit backpack or too much weight is being carried.

ü If the backpack seems too heavy for the child, have them remove some of the books and carry them in their arms to ease load on the back.back8

ü Watch your children put on and take off their backpack to see if they struggle.

ü When and if possible, purchase books on CD-ROM or include curriculum on the school's website.


The American Academy of Orthopaedic Surgeons (AAOS) and the Pediatric Orthopaedic Society of North America (POSNA) urge parents and kids to consider safety first to avoid backpack-related injuries.

“Backpacks are designed to distribute the weight of load among some of the body’s strongest muscles,” said orthopaedic surgeon and AAOS spokesperson Michael Wade Shrader, MD. “But, when worn incorrectly, injuries such as strains, sprains and posture problems can occur. While some of these injuries can be minor, others can have a lasting effect on kids, and follow them into adulthood.”

According to the Consumer Product Safety Commission (CPSC), more than 24,300 people were treated in hospitals and doctors’ offices for injuries relating to backpacks in 2012, and more than 9,500 of those injuries were children and adolescents from 5 to 18 years of age. I was unable to acquire any form of national, statistical information as it pertains to Canadian children suffering from injuries relating to backpacks.

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