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Health & Exercise Forum

Backpack Safety

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Aug 30, 2010


Dr. Mackarey's Health & Exercise ForumEach year, as students prepare to return to school from summer vacation, the subject of backpacks arises. The good news is, when compared to purses, messenger bags, or shoulder bags, backpacks are the best option to prevent lower back pain (LBP). The bad news is, most of the 40 million students in the USA using backpacks, are doing so incorrectly.

A recent study conducted at Simmons College Physical Therapy Department in Boston found more than 33% of children had LBP that caused them to miss school, visit a doctor, or abstain from activity. Also, 55% of children surveyed carried backpacks heavier than the 10-15% of their bodyweight, which is the maximum weight recommended by experts. Additionally, the study noted that early onset of LBP leads to greater likelihood of recurrent or chronic problems. Backpacks that are too heavy are particularly harmful to the development of the musculoskeletal system of growing youngsters. It can lead to poor posture that may lead to chronic problems.

The following information on backpack safely is based, in part, by guidelines from The American Physical Therapy Association. Parents and teachers would be wise to observe the following warning signs of an overloaded and unsafe backpack:

Backpack Warning Signs:

  • Change in posture when wearing the backpack
    • The weight of the pack forces the child to tip forward to compensate.
    • Weak or poorly fitted straps force the child to tip to the side to compensate
  • Struggling when putting on or taking off the backpack.
    • Due to a pack that is too heavy or straps that don’t fit properly.
  • Pain when wearing or after wearing the backpack
    • Due to a pack that is too heavy or straps that don’t fit properly
  • Tingling or numbness – in the arms or hands
  • Red marks – under the armpits or on the back

Consider the following suggestions to promote backpack safely and prevent back injury.

Backpack Safety Tips:

  1. Limit Weight of Pack to 10-15% of Body Weight: (100lb child = 10-15lb pack)
  2. Padded Adjustable Shoulder Straps: Use both straps to distribute weight evenly. Using one strap may look cool but it will lead to back pain.
  3. Waist Belt: An adjustable waist belt will distribute pack weight from back to hips and legs
  4. Pack Weight Distributed to Small of Back/Hips – using adjustable straps. Not all the weight is on shoulders and upper back .
  5. Wheeled Backpack – if unable to make above adjustments. This is an option for some children; however, you may have problems carrying/lifting it on the bus etc.
  6. Purchase Extra Set of Books And Use Your Locker: Get a list from teachers and use the internet to buy extra books to leave at home. Also, put unnecessary books in your locker between classes
  7. Remove Pack When Possible: while waiting for bus, hanging out between class, etc.
  8. Put Pack On/Off From Chair/Table/Bench – Not Floor. It is much easier to lift a pack up from a table and put it on your back than bending over to get it from the floor
  9. Stand Erect and Arch Small of Back: The correct posture while carrying heavy items is to make a hollow or arch the small of your back.
  10. Perform Posture/Stretching Exercises: Pinch shoulder blades together and extend and arch your spine backwards intermittently throughout the day – especially every time you take your pack off.
  11. Consider a pack with multiple compartments: Use several compartments to carefully load your backpack and distribute the weight more evenly.
  12. Use a backpack with reflective material to enhance visibility.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of  Scranton, PT Dept.