It has become a picture that parents are most proud of – their child heading to the school bus, looking forward to their first day of school. They are well-prepared, with pencils, erasers, notebooks and backpacks in tow.

Backpacks can be very useful for your children. Many of them come with multiple compartments that help kids stay organized by keeping important books and papers in place. Backpacks are better than shoulder bags or purses for carrying these supplies, since the back and abdominal muscles (the strongest muscles in the body) are used to support the weight of the pack. However, to take full advantage of these benefits without the disadvantage of feeling overburdened or in pain, it is important that children use backpacks properly. This means watching the weight of the pack and carrying it correctly.

Wearing backpacks improperly or carrying ones that are too heavy put children at increased risk for spinal injury. Postural compensations carrying the heavy loads are causing what chiropractors term repetitive stress injury to many children. 

According to the American Chiropractic Association, young children are suffering from back pain much earlier than previous generations, and the use of heavy backpacks is a contributing factor. Heavy backpacks can cause a child to hyperextend, or arch, his or her back, or lean the head and trunk forward to compensate for the weight of the bag. These postures can stress the muscles in the neck and back, increasing the risk of injury and fatigue. The natural curves in the upper, middle and lower back can become distorted, which will cause irritation to the spine. A rounding of the shoulders could also result if a back has to compensate for a heavy load.

Wearing a backpack on one shoulder may cause a child to lean to one side in order to compensate for the extra weight. The middle back, ribs and lower back can become stressed on the side of the body opposite of where the backpack is placed. Carrying the pack on one shoulder may also cause upper back pain and a strain in the shoulders and neck.

There are methods for preventing posture problems and other condition associated with toting a heavy backpack. The number one preventative method is to the limit the weight of the backpack. Many healthcare professionals agree that backpack loads become a health problem when they reach 15% or more of your child’s body weight. For example, a child weighing 50 pounds should carry no more than 7.5 pounds in their backpack; children weighing 100 pounds should carry no more than 15 pounds on their back; and children and adolescents weighing 150 pounds should not carry more than 22.5 pounds. A recent study has revealed that 55 percent of students are carrying backpacks weighing more than 15% of their weight.


As you prepare your child to head back to school, here are some tips on how to ensure that his backpack is safe, as well as ways to be proactive when it comes to the amount of weight your child carries to and from school everyday.

• Wear both straps and avoid the one-strap styled back packs. Uneven distribution of the load causes postural compensations and spinal stress.
• When putting on and removing backpacks, bend at the knees or have the pack at a higher level such as on a desk or table. Sudden twisting motion adds to the potential of injury.
• Arrange the backpack so it rests evenly and snuggly in the middle of the back. Shoulder straps should be adjusted to allow the child to put on and take off the backpack without difficulty and permit free movement of the arms. Straps should not be too loose, and the backpack should not extend below the lower back.
• Keep the load at 10-15% or less of the student’s bodyweight. Carry only those items that are required for the day. Request additional textbooks to be kept at home instead of hauling heavy books to and from school.
• Clean out the backpack once a week to remove any unnecessary items that can create more weight.
• Organize the contents of the backpack by placing the heaviest items closest to the back.
• A padded back and wide shoulder straps will reduce pressure on the back, shoulders, and underarm regions, and enhance comfort.
• Hip and chest belts help to transfer some of the backpack weight from the back and shoulders to the hips and torso.
• Reflective material enhances visibility of the child to drivers in the evening hours.

If you begin to notice the following signs, it may be an indication that the backpack is too heavy or not positioned correctly on the back:

• Postural adaptations when wearing the backpack such as: excessive leaning forward, spinal tilt to one side or an elevated hip supporting the excess weight
• Difficulty when putting on or taking off the backpack
• Pain or discomfort when wearing the backpack
• Tingling or numbness in arms and even into fingers
• Redness or soreness in neck, upper back and shoulder muscles
• Lower back pain with either gradual or sudden onset

Every child has a desire to have the “coolest” backpack, but if it’s not functional then it’s doing more harm than good. A great compromise is to find a backpack that is aesthetically pleasing to your child as well as provides him/her comfort each school day!