As another summer ends and the new school year begins, school-aged children are burdened not only with new intellectual stresses, but physical stresses as well.  The backpack that they throw on every morning, which often stays with them all day, can be a significant source of physical strain that can have both short and long-term consequences.  Many kids carry backpacks around that are too heavy, too large, and are not adjusted or carried safely.  These factors often lead to neck and back pain including muscles strains, headaches, and numbness as well as awkward postures that can be damaging to the spine.  A recent poll of Ontario chiropractors found 76% agreed that improperly used and overloaded backpacks are a leading cause of neck and back pain in their school-aged patients.  In response to this, the Ontario Chiropractic Association runs a yearly backpack safety campaign with tips and suggestions to help you “pack it light, wear it right”.

Choosing A Backpack
Not all backpacks are the same, so it is wise to evaluate what you’re setting your child up with.  Choose a backpack that is proportional to the child’s size: the bag should not extend beyond the top of the child’s shoulders or below the top of the hipbone.  The bag should be made of lightweight material such as canvas or vinyl (instead of leather) and have shoulder straps that are padded, adjustable, and at least two inches wide.  It should have a padded back for comfort and protection, as well as a waist or hip belt, which you may be surprised to learn will distribute 50 to 70 per cent of the bag’s weight off the shoulders and spine onto the pelvis.  Many newer bags also come with wheels and pull handles for easy rolling.

Using A Backpack
A load is easier to carry the closer it is to your centre of gravity, so pack the largest items close to the body, and evenly distribute the weight.  Pack odd-shaped items on the outside so they don’t dig into the back.  Perhaps the most challenging thing to do is to pack only what is needed, and not overload the bag.  This is especially true as the school year progresses, and items are added to the backpack without removing other unnecessary items first.  Children’s backpacks should never exceed 15 per cent of their body weight, or 10 per cent if they are elementary school age.  For example, a 90-pound child should not carry more than 14 pounds in their backpack.  This can be equivalent to a large textbook, a laptop, and a pair of sneakers, so it is worth actually using a scale to get an idea of just how much your child is carrying.

Carrying a Backpack
Even the best backpack is only as good as it is carried, and all the padding and straps can’t work if they’re not used properly.  Slinging the backpack onto one shoulder causes the spine to lean towards the opposite side, placing stress on the joints and muscles in the mid- and lower-back, especially if the load is heavier.  Alternatively, a backpack that is too heavy or carried too low will cause you to lean forward and carry the full weight on the upper back.  These prolonged and repetitive stresses can cause pain now, and may increase the likelihood of back problems later in life. 

Backpacks should be worn with both shoulder straps adjusted so the pack fits snugly to the body, while still allowing you to slide a hand between the bag and the back.  Using the waist strap, as well as a chest strap, helps hold the load in place and transfers some of the load off the spine and onto the hips.  Especially if the backpack user is small, or the load particularly heavy, squat or kneel to pick the bag up and place it on a chair or table at waist-height before slipping it on.  Avoid twisting when lifting, bend the knees to lift with the legs, and put on one shoulder strap at a time before adjusting them to fit the body.  When used correctly, backpacks should be an effective way for kids to carry what they need without being a pain in the back.