Choosing and Using School Backpacks

Laura Mitchell's picture
By Laura Mitchell on August 8, 2019

Groups of kids at bus stops and walking to school are a familiar sight this time of year. A closer look at some will show the origins of back pain—overfilled backpacks draped on one shoulder hanging loosely away from the waist.

When used correctly, backpacks can be a good way to use strong back muscles to carry school supplies. But used incorrectly, they can injure muscles and joints, leading to posture problems and back, neck and shoulder pain.

Julie Zielinski, M.D., is a pediatric orthopaedic surgeon at Carilion Clinic’s Institute of Orthopaedics and Neurosciences. Some of her patients have spent years overloading their backpacks and wearing them incorrectly.

“Appropriate loading and wearing is very important,” she said. “I’ve seen kids under 60 pounds carrying 30-pound backpacks.”

The American Occupational Therapy Association recommends that backpacks carry a maximum of 15 percent of a child’s body weight. That means no more than nine pounds of books in that 60-pound child's backpack.

Zielinski notes that some schools now issue students iPads and other lightweight technological tools, minimizing the weight they have to carry throughout the day.

Which Pack to Use
The American Academy of Pediatrics (AAP) recommends looking for a lightweight backpack that has wide, padded shoulder straps; padding across the back; and a waist strap. A crossbody bag can also be a good alternative for carrying books and supplies. Even bettera rolling backpack.

school children carrying backpacks incorrectly on one shoulder
When you sling a backpack onto one shoulder, your spine leans the other way and your back muscles work unevenly to compensate. Avoid back pain, neck pain and headaches by carrying backpacks evenly on both shoulders.

How to Use It
To prevent injury when using a backpack:

  • Use both shoulder straps to evenly distribute its weight
  • Tighten the straps and use the waist strap so that the bottom of the pack rests in the curve of your lower back
  • Pack as lightly as possible, carrying only the items you need each day
  • Load the heaviest items closest to your back (the back of the pack)
  • Bend at your knees when standing up
  • Stop regularly at your locker to drop off or exchange heavier books

Dr. Zielinski offers additional tips for preventing back pain, with or without a backpack. When using a computer:

  • Use it on a desktop rather than a laptop on the couch
  • Have the top level of the monitor at eye level
  • Adjust the seat so that your arms are at 90 degrees
  • Take frequent breaks

“Take a five- to 10-minute break every hour, stretch back, arch backward, do side-to-side stretches and twist around in the chair,” she said. “It’s also a good idea to focus on something else in the room to give your eyes a break.” 

Watch for Back Pain
The AAP reminds parents not to ignore any back pain in a child or teenager. Younger children generally volunteer information, but adolescents and teens are more likely to suffer in silence. Parents can help by encouraging them to report numbness, tingling or discomfort in their arms or legs.

“For a teenager, the parents would watch for altered gait or to see if there is more of a limp,” said Dr. Zielinski. “If they are fidgeting more in their chair, that could also be a sign of back pain.”

She recommends contacting the child’s health care provider when recommended changes to the backpack do not provide relief.

“We would want to see the child any time pain keeps them from participating in activity,” she said.