A Heavy Burden

Photos | Stephanie Dunker Eli Dunker demonstrates improper backpack fit — the pack is too large and the straps are too long.

Photos | Stephanie Dunker
Eli Dunker demonstrates improper backpack fit — the pack is too large and the straps are too long.


It’s that time of year again, when kids of all ages are donning their backpacks and returning to the classroom. There are a lot of challenges facing students including new classes, teachers, homework and quizzes.

Some kids, however, are facing a different kind of challenge: back pain because of backpacks that are too heavy. Wearing a heavy backpack can cause both postural changes and compressive forces through the spine that put students at risk for back injuries.

In a 2004 study, researchers at the University of California at Riverside looked at 3,500 students ages 11 to 15 who used backpacks. Most of kids who participated in the study (64 percent) reported some back pain. Of those that did report some back pain from their backpacks only about 12 percent rated their pain as “not bad,” but about 88 percent reported their pain as being “bad” or “very bad.” Twenty-one percent reported pain that lasted longer than six months and 16 percent missed school, gym class or extracurricular activities because of the pain. Seventeen percent sought medical attention for their symptoms. Most of the kids studied reported recurrent episodes of pain. Girls were more likely than boys to have backpack-related back pain. Pain was also greater in students who carried a backpack that weighed greater than 20 percent of the student’s weight. For example, a 100-pound student carrying a backpack that weighs more than 20 pounds would be at greater risk for back pain.

Here are some warning signs that you or your child’s backpack may be causing problems:

Back pain is present when the back pack is on.

There is a change in the wearer’s posture while the backpack is on (bending forward to counter balance the heavy weight in the back).

The student struggles to put the backpack on or take it off.

The student experiences numbness or tingling in the arms or hands while wearing the backpack.

The straps leave red marks or indentations on the wearer’s skin.

There are several steps that can be taken to decrease the risk of back pain if you or someone you love uses a backpack:

When allowed, use a rolling pack.

The bottom of the backpack should hit above the waist.

The pack should have padded straps and belt(s).

The backpack should be worn on both shoulders.

All straps on the back should be snug.

Place the heavier books in the back of the pack so they are closer to the body.

Use proper body mechanics when lifting the pack or putting it on/taking it off.

Carry only what’s necessary. Remove items that are not needed each day.

If time allows, pick up and drop off books at your locker in between classes.

In some cases it is best to purchase a second set of books to keep at home.

Taking good care of your back in general will help prevent injuries of all types. Drink enough water, exercise, use good body mechanics and posture, and don’t smoke. Your physical therapist can show you exercises to prevent or decrease backpack back pain.

Source: Siambanes, D. Journal of Pediatric Orthopedics, March/April 2004; vol 24: pp 211-271. News release, University of California, Riverside.

Editor’s Note: Stephanie Dunker co-owns Urbana’s Sage Orthopedic Physical Therapy with her husband Dr. Jeremy Dunker. The Dunkers write Vital Signs on a bi-monthly basis for The Town Courier.

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