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Three children walking down the street, each wearing a brightly colored backpack.

Healthy Backpack Habits

A backpack is one of the best ways to tote homework, but an overloaded or improperly worn backpack will get a failing grade. 

Worn correctly and not overloaded, a backpack is supported by some of the strongest muscles in the body: the back and abdominal muscles. They work together to stabilize the trunk and hold the body in proper postural alignment. 

Improper backpack use, however, can cause injury – especially to children with young, growing muscles and joints. The American Physical Therapy Association recommends a child’s backpack weigh no more than about 10% of his or her body weight.

Injury can occur when a heavy load causes poor postures, such as arching the back, leaning forward or, if only one strap is used, leaning to one side. Over time, these positions can cause compression and/ or improper spinal alignment, and may damage the disks between the vertebrae that provide shock absorption. 

A too-heavy load can also cause muscles to work harder, leading to strain and fatigue, and can leave the back more prone to injury. A heavy load may also cause stress or compression to the shoulders and arms. When nerves are compressed, the child may experience tingling or numbness in the arms. 

Backpack Safety Tips

  • Wear both straps. Using only one strap, even with backpacks that have one strap that runs across the body, causes one shoulder to bear the weight of the bag. By wearing both shoulder straps, the weight of the pack is better distributed, and balanced posture is improved. 
  • Ensure a good fit. Pay close attention to the way a backpack is positioned on the back, and the size of the backpack should match the size of the child.
    • Shoulder straps should fit comfortably on the shoulder and under the arms so that the arms can move freely. 
    • The bottom of the pack should rest in the contour of the lower back. 
    • The pack should “sit” evenly in the middle of the back, not “sag down” toward the buttocks. 
  • Check the load. Place the heaviest items closest to your child’s back. 

Healthy Backpack Features 

  • Padded back - Reduces pressure on the back and keeps the pack’s contents from digging into your child’s back.
    • Padded, contoured shoulder straps – Reduces pressure on the chest and shoulders.
    • Waist belt – Helps distribute some of the load to the pelvis. 
    • Compression straps on sides/ bottom of backpack – When tightened, these compress the contents of the backpack and stabilize the articles. 
    • Reflective material – Makes the child visible to drivers at night. 

If heavier loads are truly necessary, backpacks with wheels may be a good option. However, wheeled backpacks may present problems, such as getting up and down stairs or trying to fit into cramped locker spaces. If a wheeled backpack is chosen, be sure the extended handle is long enough so your child is not forced to twist and bend, and that the wheels are sufficiently large so the backpack doesn’t shake or topple. 

Watch Out for These Signs

Make sure that your child stays injury-free by asking about and looking for the following signs that the backpack is too heavy: 

  • Pain when wearing the backpack
  • Arm tingling or numbness
  • Red marks on the shoulders

Urge your kids to tell you if they are in pain or have discomfort before a problem becomes serious. If you have questions, reach out to a family medicine provider.

Jeanne DeKrey, PT, DPT, PRT
Jeanne DeKrey, PT, DPT, PRT

Jeanne DeKrey, PT, DPT, PRT is a physical therapist at CHI St. Alexius Health.

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