Wishing I could convince my teen to put her backpack away, rather than dumping it on the living room floor, I grabbed a strap and hefted.
"What have you got in here?" I demanded, opening the bag to search for rocks, bricks or a cast-iron pan. The pack seemed to contain everything but the aforementioned items: a MP3 player, extra sweatshirt, geometry tools, paper, binder, notebook, pens and books - lots of heavy books.
A 1999 report in the British medical journal Lancet found that the average student carries a backpack weighing 25 percent of his or her body weight. The recommended maximum is 15 percent - "and even that's pushing it," says Stuart Weinstein, M.D., a pediatric spine surgeon and past president of the American Academy of Orthopaedic Surgeons (AAOS).
In fact, kids push it so far that more than 10,000 of them suffered backpack-related injuries in 2003, according to the U.S. Consumer Product Safety Commission (CPSC). Most often, these injuries involve strains to the shoulder, neck and back.
Dr. Weinstein has seen an increasing number of children ages 10 and up with backache and chronic back pain during the past 10 to 15 years. Much of it, he says, is related to overuse.
This isn't news to most parents.
"My high school son's backpack is so heavy I cannot physically pick it up," says Carla Louis, a mother of four. "He is in mostly AP/honors classes, which have the huge college texts." In addition, his locker is on the opposite side of the school from most of his classes, so he can't use it to unload his heavy books very frequently.
Gregg Carlon recently took his 10-year-old son to visit the pediatrician about back trouble. There was no permanent damage, "but the doctor advised me against too much weight in the backpack," Carlon says.
The Pack and Its Use
As kids gear up for the new school year, keeping the backpack load light is the simplest thing you can do to save your child's back. And any load will be easier to handle with a good quality pack worn properly. The AAOS suggests getting one made of dense material, with two well-padded shoulder straps. The pack should fit snugly, and the bottom should rest in the curve of the lower back for proper support.
The straps should be settled on both shoulders to distribute the weight evenly across the back. "It only takes a second to put it on the other shoulder," Weinstein says of kids' habit of carrying their packs slung over just one shoulder.
Even when the pack isn't strapped on, the weight presents a hazard. Kids, says Weinstein, tend to bend at the waist to reach down and pick up their packs, rather than squatting down and using the strong muscles of the legs to lift the weight.
Styles and Options
Rolling packs - the ones you pull around like a suitcase on wheels - can be a great solution, Weinstein says, unless your child's school has stairs or overly crowded hallways.
"By the time they get to high school, there are way too many students to be able to navigate a rolling backpack," says Deanne Chaffy, a mother of three. "My 18-year-old daughter said it was like trying to drag a reluctant pig on a leash."
And then there's the coolness factor.
"I offered my kids those backpacks with wheels," Carlon says, "but they refused. The girls can use them, but only a handful of the boys do it."
Because of kids' penchant for slinging backpacks over just one shoulder, a model that passes the coolness test is the one-shoulder style "sling" pack. But chiropractor Susan Burian warns that no single-shoulder bag makes the load safe to carry. "No backpack is effective if you only have it on one shoulder," she says.
One frustrated dad, Troy Christy, created a new backpack feature to help his kids - and children everywhere.
"I saw my son and daughters getting off the bus, and they were coming up the driveway bent over in pain," Christy says. "I thought, -there's got to be a way to take the weight off these kids' backs.'"
His solution: the LiftPack. It features an adjustable pump-up air bladder that cushions the back and shifts most of the weight to the base of the spine.
I ordered the pack, and when it arrived, my daughter gamely agreed to give it a try. It helped that the pack looks like most of the popular models on campus, and has a handy headphone portal for her MP3 player. At school, she conducted an experiment with friends, deflating the pack and having each try it on without the air and then pumped up. All agreed that the pump made a big difference. And my daughter is still using it.
"They're actually great packs," says Burian, who sees teenagers, and even a few younger kids with back pain, in her practice. "It's very comfortable, it supports the back, and promotes better posture because it makes you stand up straighter."
What Parents Can Do
Along with providing a quality backpack, the American Occupational Therapy Association (AOTA) suggests that you check your child's pack to make sure everything in there is really necessary. Seems like something your kids should already be doing, right? Yet, after my daughter had transferred just her necessities to her new pack, her old bag still contained five pounds of stuff.
So clear the clutter, then help your child load the pack:
• Place heavy items at the bottom of the bag, in the center, with the rest of the load evenly distributed.
• Use the pack's handy compartments to divide the contents and keep everything from sliding to one side.
• To trim the load of books, consider photocopying or scanning several chapters for future homework assignments, so the books can stay at school.
What Schools Can Do
Your child's school can also help reduce the backpack burden. Some schools don't allow students to carry backpacks from class to class. This is partially due to lack of space in hallways and classrooms, and the considerable amount of space the full backpacks themselves take up.
Schools can also set schedules so that students attend classes in longer time blocks and give teachers the discretion to allow students to visit their lockers between classes.
The AOTA suggests that schools can also help by encouraging students to:
Alternative course materials can also help. Some texts can be ordered as paperback rather than hard cover. Some materials can be photocopied, posted online or provided on a CD-ROM.
How much does all this matter?
We don't yet know the long-term impact, Weinstein says, because backpacks haven't been around for very long. "But if you start having chronic back pain as a teenager," he says, "it doesn't bode well for the future."
Christina Elston is a health writer and editor for Dominion Parenting Media, L.A. Parent and Parenthood.com.
© Parenthood.com, used with permission.
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