Thought Bytes...
November 2004

Is a backpack hurting your children?

The girl I watched walking to meet the school bus had to stoop forward to keep her backpack from flipping her on her back like a turtle. She was so petite, and the backpack was probably close to a third of her body weight.

I was quite interested in the Alberta College of Chiropractor’s commercial on the issue of backpacks and children this past autumn. They made several good points about backpacks:

• Make sure the weight is well distributed
• Try to limit the contents to 10-15% of the child’s body weight
• Use a pack with broad, padded shoulder straps
• Make sure it is worn with the straps on both shoulders.
• Get one with a waist belt to transfer the load onto the hips

I don’t dispute any of these points (although I think the weight limit may be a bit unrealistic). Unfortunately, the commercial concluded with the children merrily running out of the house to catch their bus with the backpacks flapping on their backs because there were no waist belts.

This brings up several points. First, how far are kids carrying their backpacks? At the recent ergonomics conference in Windsor, one of the presenters found that only 1% of the children in his community actually walked to school – most were driven either by their parents or by school bus.

Secondly, my concern is about the weight limit. According to the suggestions on a variety of web sites, a 60 lb. child’s loaded backpack shouldn’t weigh more than 9 lbs (that being 15% of 60 lbs). Their lunch plus a couple of books would take up that load allotment. If a child carries the bag as far as the school bus, weight isn’t much of an issue. But a child carrying a heavy bag for a long distance needs to learn to minimize the load in the bag and optimize how the load is carried. But if the walk is short, they may be able to carry more. In ergo-speak, if the exposure to the load is short, then the tissue tolerance may be higher.

One web site said to get a backpack with lots of small compartments. That is fine if the backpack is made of a lightweight material – otherwise, the fabrics begin to add up to a heavier starting weight. While a few supplemental compartments is helpful to keep the bits and parts organized, I would rather that extra weight go into a padding layer between the contents and the child’s back.

Another site suggested asking the teachers if you could buy a second set of textbooks so that the kids didn’t have to carry everything home! Yah, right. Many families can barely afford the first set. The families with more money that have their kids involved in sports activities to counter the effects of our otherwise sedentary students that would be the ones that can afford a second set of texts. The impoverished ones will still have to carry the heavy load.

(Yet another web site suggested using a backpack with wheels and an extendible rolling handle. I have no objection to this idea – but it would be almost impossible to use in the winter.)

I would love to see the kids using both shoulder straps and a hip belt. But, kids will be kids – they will shortcut your best efforts. We have to train them to use a backpack correctly right from the start. By the time they get to junior high, peer pressure may have less influence if the correct use has become ingrained. Once they hit that stage when aliens / individuality / hormones invade their bodies, we poor parents have little influence. (I say this from the perspective of watching the kids in the junior high school across the street).

Don’t get me wrong – I believe that children do experience back pain associated with carrying excessive loads. And, I heartily endorse efforts to reduce the risk of back pain by buying good quality backpacks and teaching kids how to wear backpacks properly.

But maybe the culprit is also a factor of our children’s sedentary lifestyle. The aforementioned study* on children and backpacks also found a significant correlation between body mass index (a ratio of height over weight) and the incidence of backpack low back pain in children. That means that the more overweight a child is, the more likely they are to experience pain from wearing their backpacks. Yet another reason to get our children active...

In the meantime the research continues, so follow the advice of the Chiropractors, L.L. Bean and others when selecting backpacks and teach the children to wear them properly. That means:

• Adjust the backpack straps so that the pack is close / hugs the body
• The bottom of the pack should be at or slightly above the waist
• Use both straps so the weight is distributed evenly, promoting balanced muscle development
• Use a padded hip belt so the weight is transferred to the stronger pelvis and legs
• Teach kids to put the pack on by starting the pack on a table or chair so that they don’t
twist with the load.
• Put heavier objects close to the body and lighter objects further away or higher up.

* Grenier, S., Potvin, S., O’Brien, T., Labrosse, E.: Exploring the Link Between Low Back Pain and Backpacks in Children, ACE Conference, Windsor, ON – October 20, 2004

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