Backpack Awareness: Pack it Right, Wear it Light

Aching backs and shoulders? Tingling arms? Weakened muscles? Stooped posture? Does your child have these symptoms after wearing a heavy school backpack?  Carrying too much weight in a backpack or wearing it the wrong way can lead to pain and strain.  Parents can take steps to help children load and wear backpacks the correct way to avoid health problems.

As parents, we want to protect our children from pain and injury.  Little did we know that something as inconspicuous as a backpack could harm our children.  Backpacks that are too heavy and/or worn incorrectly can potentially lead to severe and/or chronic back problems.

More than 79 million students in the United States wear backpacks.  Thousands of backpack-related injuries are treated in hospital emergency rooms, doctor’s offices and clinics.  About 55% of students carry a backpack that is heavier than the recommended guideline of 10% more than the total body weight.  In one study with American students ages 11 to 15 years, 64% reported back pain related to heavy backpacks.  21% reported the pain lasting more than 6 months.  Nearly 8 out of 10 middle school students who changed how they loaded and wore their backpacks reported less pain and strain in their backs, necks and shoulders.

Here are some guidelines that parents and children should follow regarding backpacks.

Loading a Pack

• A child’s backpack should weigh no more than about 10% of his or her body weight. This means a student weighing 100 pounds shouldn’t wear a loaded school backpack heavier than about 10 pounds.

• Load heaviest items closest to the child’s back (the back of the pack).

• Arrange books and materials so they won’t slide around in the backpack.

• Check what your child carries to school and brings home. Make sure the items are necessary for the day’s activities.

• If the backpack is too heavy or tightly packed, your child can hand carry a book or other items outside the pack.

• If the backpack is too heavy on a regular basis, consider using a book bag on wheels if your child’s school allows it.

Wearing a Pack

• Distribute weight evenly by using both straps. Wearing a pack slung over one shoulder can cause a child to lean to one side, curving the spine and causing pain or discomfort.

• Select a pack with well-padded shoulder straps. Shoulders and necks have many blood vessels and nerves that can cause pain and tingling in the neck, arms, and hands when too much pressure is applied.

• Adjust the shoulder straps so that the pack fits snugly on the child’s back. A pack that hangs loosely from the back can pull the child backwards and strain muscles.

• Wear the waist belt if the backpack has one. This helps distribute the pack’s weight more evenly.

• The bottom of the pack should rest in the curve of the lower back. It should never rest more than four inches below the child’s waistline.

• School backpacks come in different sizes for different ages. Choose the right size pack for your child as well as one with enough room for necessary school items.


Ian Barlow, OTR/L is an occupational therapist with 13 years’ experience in South County.  He is the founder of Barlow Rehab, an outpatient physical therapy and occupational therapy clinic in Narragansett, RI.  For more information, call 401-792-0900 or email at [email protected]

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