On Monday, I had the pleasure of walking my son, Edwin, into his Kindergarten classroom for the first day of school. How is he this old already!? On the way to the school, I told him how he may get worried, or scared, or that he may need help with something, and if this happened...if he had any problems at all, to simply find a teacher and ask for help.
His response? "Dad, I didn't have any problems in 4K."
Whoa. Maybe it's Dad who is having problems with the idea that Edwin is in Kindergarten already!
And now, here I am finding myself dropping Eddy off at school for perhaps the final time. He’s 15 and a sophomore, which means on his first day of school next year he will likely be driving himself. Yikes. Good thing I’m not getting any older!
When dropping Eddy off, he wears his school backpack on his back, and then wears his sports backpack on his chest. It takes a lot of gear to be a kid in school these days…which brings me to the topic for this column a whole decade after I walked Eddy to Kindergarten: Backpacks.
American kids are suffering from back pain and neck pain earlier in their lives and in larger numbers than ever before. And if you're a parent of school-age children, it's important for you to know that overweight, improperly designed, and misused backpacks may be one of the big reasons for this growing problem.
This isn't really news. The truth is that healthcare researchers and practitioners around the world recognized the issue quite a while ago and have continued to call attention to it. The American Academy of Orthopedic Surgeons recommends that a backpack should not be any heavier than 15% of a child's body weight, but:
- In 1999, researchers in Italy reported that about 35% of Italian schoolchildren carried more than 30% of their body weight at least once a week-actually exceeding the limits recommended for adults. The average sixth grader's backpack was the equivalent of a 39-pound burden for a 176-pound man or a 29-pound burden for a 132-pound woman. And of those children carrying heavy backpacks to school, 60% had experienced back pain as a result.
- As early as 2001, researchers at Simmons College in Massachusetts found that 55% of the 345 children they studied were carrying backpacks that exceeded the recommended weight limit, often by a substantial amount. One third of those students said that they had already experienced back pain.
- A 2012 study by researchers in Spain found that 61.4% of 1403 students between the ages of 12 and 17 carried backpacks that weighed more than 10% of their body weight and that those carrying the heaviest backpacks had a 50% higher risk of back pain.
More than Just a Short-Term Health Risk
With an estimated 40 million school-age children carrying backpacks in America, it's not at all surprising that there are some book bag-related injuries every year. Since 2000, the U.S. Product Safety Commission has reported that children and their backpacks make roughly 7,000 trips to the emergency room annually. However, many observers believe that the real toll is actually far higher, since the vast majority of such injuries go unreported, and many kids are treated by a family doctor or not treated at all.
It's not clear how many acute injuries actually result from wearing backpacks as opposed to tripping over them or being hit by them. However, doctors who treat back problems regularly-especially chiropractors like me-see worrying signs that heavier backpacks are setting the stage for more serious health issues in the future, including chronic back, neck and shoulder pain. Some chiropractors estimate that as many as 75% to 80% of the teenage patients they treat have postural problems directly related to overweight backpacks, and this heavy burden on their backs only worsens the postural issues that are prevalent when combined that with the posture many kids take when looking down at their phones or tablets, and you can see where serious issues begin to arise.
How to Choose the Right Backpack and Use it Correctly
A good quality backpack with proper ergonomic features doesn't have to be expensive. They're available at many sporting goods stores and discount outlets. Consider the following when looking at what your kids are using:
- Get the size and fit right first. The right backpack should fit between the top of your child's shoulders and lower back. Bigger is not better, since having more space available creates the potential for a heavier backpack.
- Find one with shoulder straps that are wide, padded and adjustable. These distribute the weight more broadly across the shoulders and chest while allowing the backpack to be fitted snuggly to your child's body.
- For older students, consider a backpack with chest straps and a hip belt. Chest straps and a hip belt redistribute weight even further and bring the pack closer to the wearer's body.
- Look for a padded back that will add comfort and protection.
- Choose a backpack with multiple smaller compartments. These help distribute the weight inside the bag and keep it stable.
Once your child has the right bag, it's just as important to encourage him or her to use it correctly. Chiropractors and physical therapists generally agree that means wearing it on both shoulders with the straps tightened, so that it hangs no more than four inches below the waist.
Recognizing the Warning Signs
If you see any of the following signs, it may be time to lighten the load, help your child choose a different backpack, or talk about how it's being used.
- Pain in the back, neck, shoulders or knees
- Red marks left on shoulders by backpack straps
- Tingling or numbness in the arms
- Trouble getting the backpack on or off
- Bending forward or "hunching over" to shift weight from the shoulders to the back
Asking for Help
Under normal circumstances, using a backpack shouldn't cause any pain or discomfort. If your child is showing signs of back, neck or should pain, we encourage you to call or visit our office today. In fact, there may be an underlying problem that is worsening the situation, such as a scoliosis or an asymmetry in shoulder strength from one side to the other. In addition to addressing any current problems that your child may be experiencing, I often recommend an exercise program designed to strengthen muscles and improve posture and coordination.
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