[originally published in KCN, September 1999]
As we approach the beginning of yet another school year, I’m reminded of a growing concern that is circulating throughout our health care community. The concern I’m speaking of is that we are simply putting too much weight on our children’s shoulders. And while those in the various mental health professions would certainly support this statement, I’m looking at this problem more literally. The “weight “ I’m referring to is physical, and it comes from the overstuffed backpacks that our children lug to and from school everyday. Our children are becoming virtual pack mules, if you will, placing undue stress on their developing spines and thus giving birth to a whole host of future, and sometimes immediate, spinal and muscle related problems, including the obvious — back pain.
It is estimated that our children will improperly lift and carry 22,000 pounds of weight in their backpacks by the time they graduate high school. They say that in the past ten years, the average weight of the typical teen’s backpack has tripled, and last year alone, emergency rooms across the nation saw over 3,300 backpack related injuries. One only has to wonder just how many children with backpack related injuries didn’t go to the emergency room! With the recent elimination of student lockers in some schools for security, space, and/or drug-related reasons, combined with the trend of manufacturing larger backpacks by the school supply industry, not to mention that bag weights typically increase with greater homework demands as one progresses through the school system, this problem only seems to be getting worse — making some experts claim that improper backpack usage is reaching epidemic proportions among school-aged children everywhere.
In a study out of Auburn University, David Pascoe, professor and exercise physiologist, found that out of 421 college students surveyed, 414 of them experienced some sort of soreness, pain, or numbness related to wearing their backpacks. But this problem is not just limited to college students, as a similar study by the same author focusing on children between the ages of 11 and 13, revealed. The study found that these younger students complained of similar symptoms: muscle soreness (67.2%), back pain (50.8%), numbness (24.5%), and shoulder pain (14.7%). Dr. Pascoe notes that these problems most often occur when loads are excessive or the backpack inadequately distributes the weight. In his survey he found that the majority of students (65.5%) described their book bags as “heavy,” while a fair percentage (29.5%) stated their bags were of “medium weight.” Only a mere 4.9% said that their backpacks were “light.” And to further inflame the problem, 73.2% of the students surveyed use only one strap, carrying their backpacks off one shoulder. Unfortunately, while wearing a backpack this way might look “cool” [I know, I was a student once too], it places an unnecessary stress and strain on the body through the significant elevation of the supporting shoulder and the resulting compensatory spinal deviation that’s necessary to balance the load. Dr. Pascoe warns, “The potential for acute or long-term injury resulting from weight-bearing carriage using only one strap and bags without frames that do not distribute the weight to the hips may be considerable.” He continues, stating, “The ramifications of this weight-bearing induced stress, often applied asymmetrically, is a serious issue when considering children and youths who are experiencing physical growth and motor development.”
If you’re thinking the answer to this problem might be to simply not wear the bag on the back, a Scandinavian study snuffs it. They actually found that students who hand-carried their backpacks experienced more pain that those that wore it the way it was designed. So what can we do provide some relief to this mounting problem? Well, for starters, we need to decrease the weight that our children are toting around. As I was searching for information on the Internet while preparing this article, I stumbled across a pediatric discussion forum for doctors. It seems that about two years ago the topic of backpack injuries surfaced briefly. One of the entries was an unusual case about a 14-year old girl who fractured her big toe by dropping her backpack on it. So, rule number one: if your backpack is heavy enough to break your toe — it’s too heavy. Perhaps a more sensible guideline,however, is that which is offered by the American Chiropractic Association (ACA): they recommend that a child’s backpack weigh no more than 5-10% of their body weight. If you think this is a bit light, this is actually law in some areas of Brazil. A backpack that is any heavier will cause your child to begin bending forward in attempts to support the weight of the bag on their backs rather than on their shoulders through the straps.
The ACA also recommends a backpack with individualized compartments to help position the contents more effectively while ensuring that your child’s sandwich isn’t flattened in the process. When packing a backpack make sure pointed or bulky objects are packed away from the area that will rest on your child’s back. An uneven surface rubbing against the back could cause painful blisters. It is also very important that both shoulder straps be worn to balance the load on the spine and should ideally contain padding to increase comfort and prevent digging into your child’s shoulders. The shoulder straps should be of the adjustable variety, so the backpack can be fitted to your child’s body. Shoulder straps that are too loose can cause the backpack to dangle uncomfortably and cause spinal misalignment and pain. Taking all this into consideration, if the backpack is simply too heavy, talk to his or her teacher and find out whether heavier items can be left at school, while lighter hand-out materials and workbooks be brought home instead. Another idea that many of my colleagues resorted to while in chiropractic college was the use of a luggage dolly — not very traditional, but maybe your child can spearhead a new trend. Finally, the ACA recommends helping your child to understand why a correctly worn backpack is so important to his or her health today and in the future.
This is definitely a hot topic, and I predict you’ll be hearing more about it. If you’re a web surfer, there’s a backpack safety website (www.backpacksafe.com) complete with safety recommendations, photo-diagrams, and Pete the (talking) Posture Parrot. Another interesting website I suggest you check into is www.rakgear.com. This site sells a revolutionary “back friendly” backpack, known as the “RAK GEAR,” designed by a concerned father in Rhode Island. The backpack effectively distributes the weight of its contents using a specially designed shelving system. What impressed me most about this product, however, was that it was endorsed by the Chiropractic Society of Rhode Island. Their official endorsement reads: “It has been our conclusion that the RAK GEAR helps to improve carrying posture and helps to reduce the excessive stress on a child’s spine, neck, and shoulders by using a rack system that evenly distributes the weight of school books and other related items.” In addition, the site also contains a few articles on backpack injuries as well a rather technically written endorsement as to the backpack’s effectiveness from a gentleman who holds both a chiropractic and a physical therapy degree. Wickford Backpack Company makes the RAK GEAR and can be reached at (800) 708-1653. The backpack sells for a little more than your average bag purchased at Target, but when you consider just how important this backpack issue really is, it’s a worthy investment.
If your child is experiencing any pain or discomfort in the shoulders, arms, legs, or back, a visit to your local chiropractor would also be a worthy investment. Studies are showing that 25-33% of our nation’s adolescents are experiencing “standard adult low back pain.” Do not take your child’s complaints of pain or discomfort lightly, because one thing is for sure, pain at this age is definitely not normal and is a clear sign that an underlying problem exists. Even if the pain eventually “goes away on its own,” you can be sure that the problem hasn’t — and will likely affect your child’s health in one way or another. If your child is “lucky” and these sorts of symptoms haven’t surfaced yet, but you’re concerned because he or she has been exposed to backpack stresses, a spinal checkup makes sense. Doctors of chiropractic can often find little problems that will likely amplify into larger ones later in life if neglected. Doctors of chiropractic are licensed and trained to diagnose and treat patients of all ages and will use a gentler type of treatment for children. In addition, your chiropractor can also prescribe exercises designed to help children develop strong muscles, along with instruction in good nutrition, posture, and sleeping.
It’s unbelievable, but the statistics are that 80% of our adult population is bound to experience back pain at some point in their lives, and 50% will experience back pain this year alone. Low back pain is the most common health problem experienced by working Americans today, and it is a condition that costs our nation’s economy at least $50 billion a year in lost wages and productivity. Unfortunately, much of this suffering in our adult population can be traced back to bad habits initiated during our younger years — such as carrying overweight backpacks to school. It’s time we do something about it.
Sources used for this article:
American Chiropractic Association. Going back to school can be ‘”back-breaking’”work: don’t let a heavy backpack ruin your child’s day. For Your Health.
American Chiropractic Association. Improper use of backpacks leads to chronic back pain. For Your Health.
Article on backpack injuries. http://www.kidsource.com: Los Angeles, Aug 29, 1997.
Backpack Overload: Is your child’s burden too heavy? Providence Journal, September 3, 1998.
Backpack Safety America website. http://www.backpacksafe.com/.
Burch, K. Re: School backpack injuries. October 1997 PedTalk List Archives. http://www.pcc.com/lists/pedtalk.archive/9711/0045.html
Guerra, M. Re: School backpack injuries. October 1997 PedTalk List Archives. http://www.pcc.com/lists/pedtalk.archive/9711/
Maurer, E. ed. A weighty issue: backpacks & back pain. Journal of the American Chiropractic Association. Feb. 99.
Palmer, M. Teen overload equals more work. What’s working in chiropractic practice building. July 1999.
Pascoe, D. Impact of book bags on gait and cycle posture. American College of Sports Medicine Annual Meeting. 1994.
Pascoe, D. Influence of carrying book bags on gait cycle and posture of youths. Ergonomics. 40 (6): 631-41. 1997.
Rak Gear website. http://www.rakgear.com/. Wickford Backpack Company. P.O. Box 1476. North Kingstown, RI 02852. (800) 708-1653.
Rondberg, T. Introducing backpack safety America. The Chiropractic Journal. May 1999.
Trousller. Back pain in school children: a study among 1178 pupils. Scandinavian Journal of Rehabilitation Medicine. 26: 145-46. 1994.
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