Follow these backpack tips to help protect your child’s back

Dr. Jared Daniel — a dad of teens — wants to prevent lower back pain in kids

A mom helps her daughter put on her backpack.
A mom helps her daughter put on her backpack.

It’s at the top of your child’s school-supply needs. It’s on the back of your child heading off to school. But it may be at the bottom of your child’s health concerns.

Perhaps it’s time to pay a little more attention to the backpack your child carries day in and day out for most of a year. When you lift it up, do you ever wonder if they’ve started a rock collection in there? Does it seem like they bring their entire locker home every night?

If you think it’s heavy, imagine how it would feel to be your child carrying a backpack around from one class halfway across the school to another, all day long. Using only one strap, or letting the backpack hang far below the lower back, makes it even harder to haul.

That backpack could even cause lower back pain or strained shoulder muscles. When Jared Daniel, M.D., a pediatric orthopedic specialist at Sanford Health, talks with families about that possibility, he’s not just speaking as a doctor. He’s also speaking as a father.

“I have two teenagers,” he said, “and there’s been times I’ve picked up their backpacks, and I’m like, ‘Holy cow, this is so heavy. What do you all have in here?’”

But Dr. Daniel has advice for parents trying to keep their kids from tipping over from the weight of their backpacks.

The right backpack — and how to pack it

A well-designed backpack has two wide, cushioned shoulder straps with no tears, Dr. Daniel said. This helps distribute the weight across a child’s chest more evenly. If the backpack includes a strap across the abdomen, that helps keep the weight even closer to a child’s core.

Choose a backpack appropriately sized for your child, and be sure it fits snugly, with the straps adjusted equally. The backpack shouldn’t dangle down their back and past their bottom.

Dr. Daniel recommends that a loaded backpack weigh 15% of the child’s body weight or less.

Place the heaviest items low and in the center of the backpack, keeping them closer to the child’s body.

Although a less popular choice, backpacks with wheels do take the weight off a child’s back, Dr. Daniel said. But fashion tends to be a fact of life for school-age students. Dr. Daniel has seen reluctance firsthand when he requires students who have had spinal surgery to use rolling backpacks for a period of time afterward.

Maybe don’t carry the whole locker at once

Students in middle and high school are more apt to overload their backpacks than younger kids. They often have homework that requires hauling textbooks home, and they move from class to class to class in school. Items needed for extracurricular activities, such as sports uniforms, add to the mix.

Still, if parents have concerns that their child’s backpack is too heavy and may be causing back pain, Dr. Daniel has tips for students to minimize the amount — and weight — of all that stuff.

  • Instead of bringing every textbook home, think about which ones you absolutely need for the night’s homework.
  • If you have block classes, just take to school the books you need for one day’s classes and leave the rest at home.
  • Work with the school or teacher to get a duplicate copy of a textbook, so you can keep one at home and one at school. Or get access to an online version of the textbook.
  • If you have time, go to your locker in between classes to switch out books rather than carrying them all with you.
  • If you need to bring clothes and shoes for a sporting activity that day, consider whether you can just keep them at school, or haul them to school in a separate duffel bag, or keep them in the car if your parents are transporting you between school and the activity.

“It does require a little bit of responsibility for the adolescent, too, to know what they need each day,” Dr. Daniel said. “I think a lot of us fall into the standpoint of, ‘I need everything, just in case,’ but try to be a little bit more proactive in regards to, ‘What do I all need for that day?’”

Getting to the source of pain

About 30 percent of adolescents have back pain at some point, Dr. Daniel said. “The biggest challenge that you have is finding the source of the back pain.”

In his practice, Dr. Daniel sees overuse injuries among students who play a single competitive sport year-round or nearly year-round. Heavy or poor-fitting backpacks and overuse injuries are the most common causes of lower back pain among adolescents.

If kids complain about back pain, parents can ask them questions to try to identify the reason. If they suspect it’s due to the backpack, they can try to minimize the weight and go from there.

“Start with the simple things first. Not every child that has back pain needs to see a specialist. But if it’s something that’s constant, you’ve tried to make some of the modifications to minimize any additional stresses on their back and that’s not working, then a lot of times, we have the children start with their primary care doctors. Make sure globally it’s not something else,” such as a kidney issue, Dr. Daniel said.

One thing it’s unlikely to be: scoliosis, or curvature of the spine. Scoliosis typically doesn’t cause much back pain, Dr. Daniel said, and he refutes the myth that wearing heavy backpacks can lead to scoliosis. Backpacks may cause pain, and possibly poor posture, but they won’t lead to a deformity.

What if your child’s first choice isn’t the best choice in backpacks? Dr. Daniel reverts to dad mode to answer a fashion vs. health dilemma.

“I usually tell moms and dads, hang in there,” Dr. Daniel said. “I’m in the trenches with you right now, trying to navigate how to get your kids to understand that sometimes health is more important than fashion.”

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Posted In Back to School, Children's, Orthopedics

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