Choose a backpack that makes the grade

How often have you seen children struggling to try to carry their school backpack? This is an everyday occurrence. Kids manage to lug around various heavy books and objects throughout the day.


Backpacks may be contributing to back pain.

As we know, back pain is a widespread problem for adults. What is less well known is that this problem has extended into younger age groups including adolescents. The occurrence of low back pain in children has been reported to be between 30 to 50 per cent.

Although there is debate, some have suggested that backpacks may be contributing to back pain in children. This concern has caused many organizations to recommend limiting the loads of children to between 10 and 15 per cent of the child’s body weight.

There has been research on backpack injuries presenting at hospital emergency rooms. It was found that the most common injury location was the head/face (22 per cent) which were mostly cuts, followed by hand (14 per cent) injuries such as punctured fingers from pencils by reaching into the pack.

The back was the sixth most common injury accounting for only 11 per cent of injuries with lumbar strain being the most common back injury. Of the back injuries, only 59 per cent were actually due to carrying the pack. Neck injury occurred in six per cent of all injuries with neck strain being the most common injury.

Interestingly, this acute injury study suggests that improving backpack carring habits would reduce only 23 per cent of all injuries. On the other hand, recommending children put their backpacks in a safe place so they don’t trip over them or use them as a weapon to hit another child could reduce greater than 40 per cent of backpack injuries!

Of course this study ignores children with backpack injuries that go to their family doctor or chiropractor instead of the emergency room.

Backpack carrying has been shown to be a large portion of the daily load of the spine in schoolchildren. The backpack load borne by schoolchildren often exceeds, proportionally, the legal load-bearing limits set for adults in the workplace.

There appears to be a consensus that an appropriate body weight limit lies between 10 and 20 per cent of the body weight. However, the majority of these studies has only looked at children between the ages of nine and 11 years and has relatively small numbers of subjects. It is likely that younger children should carry an even smaller load.

It has been thought that backpack use could be a cause of back pain and disability in children. Although a certain amount of loading stress to the child will strengthen the musculoskeletal system, excessive stress can lead to overuse injuries. Children are at a greater risk than adults for overuse injuries because their skeleton has a high amount of cartilage.

As for the backpack design, it has been determined that carrying a two-strapped bag produces fewer changes in posture compared to a single strap bag.

Postural changes in the spine occur when heavy backpacks are carried. Parents are often concerned that scoliosis (curvature of the spine) may be caused or aggravated by backpack use.

Although adolescents with back pain stand a greater risk of experiencing back pain as adults, there is no evidence that structural spinal deformity can result from backpack use.

Check points

? Parents should check how the backpack is packed to prevent stabbing injuries.

? Children should not carry more than 10 per cent of their body weight.

? Use both backpack straps to assist with evenly distributing the weight. Shoulder straps should be wide and preferably with comfortable padding. Do not only use one strap.

? Keep weight evenly arranged. The closer to the back and preferably to the center of mass, the less lifting force required.

? Consider a backpack with a hip strap or pelvic strap which could also reduce the load on the back and shoulders.

? Carry the load in the backpack around the waist level but not below.

? Consider the possibility of a backpack on wheels.