Although there are very few studies and the medical literature does not agree
on specific guidelines for backpack safety to avoid back pain, parents can
use common sense to reduce the chance that their child or teen will suffer back
pain due to carrying a backpack.
Look for backpackdesign features that help reduce the chance of back pain:

* Lightweight material (canvas as opposed to leather)

* Two padded, wide (2-inches), adjustable shoulder straps on the backpack

* Padded back

* Individualized compartments

* Hip strap, waist belt or frame to redistribute the weight of the backpack
from the shoulders and back to the pelvis

* Wheels so that the backpack can be pulled rather than carried

Teach your child how to properly load and wearthe backpack to avoid back pain:

* Always use both shoulder straps and wear the backpack on the back rather
than over one shoulder

* Pack heaviest objects into the backpack first so they are carried lower
and closest to the body

* Fill compartments so that the load is evenly distributed throughout the
backpack and items do not shift during movement

* Pack sharp or bulky objects in the backpack so they do not contact the
back

* Adjust the straps to fit the backpack snugly to the child&rsquos body,
holding the bottom of the backpack 2 inches above the waist and keeping the top
just below the base of the skull; do not carry the backpack low near the
buttocks

* Lift the backpack by using the leg muscles and keeping it close to the
body, not by bending over with arms extended

* Do not lean forward when walking; if this is necessary, there is too much
weight in the backpack

Maintain a mindset to watch the weightcarried in the backpack to reduce back
pain:

* If the child complains of discomfort, reduce the weight in the backpack
immediately

* Consider applying a guideline backpack weight limit as a percent of the
child&rsquos body weight. The American Physical Therapy Association suggests
15-20%; the American Chiropractic Association advises 5-10%.

* Coach your child to carry only those books needed in the backpack,
leaving unnecessary items at home and making frequent trips to his/her locker during
the day

* Train your child to clean out the backpack at least once a week

Become a proactive parent on the issue of backpacks and back pain:

* Ask your child if they feel any back aches or pain

* Help your child choose the smallest backpack that will meet his/her needs

* Talk to teachers about how to minimize the need for children to transport
heavy books back and forth daily in their backpacks; keep one set of books in
the classroom for daily work while leaving heavy books at home; make
photocopies of homework chapters and assignments that are easily carried

* Attend PTA meetings and discuss any proposal by school administrators to
remove lockers or to reduce time between classes making it difficult to store
unneeded books and materials

Finally, there are a number of alternatives to traditional backpacks on the
market. These include saddle bags, rollerbags, backpacks with inflatable lumbar
support and straps, totally inflatable backpacks and molded backpacks.

By: John J. Triano, DC, PhD
September 19, 2000