Tips for toting school gear without physical injuries
Mark D. Widome,MD
Today Show Contributor
Is the back a good place to carry books?
Yes. The vast majority of students in elementary school, high school, and on college campuses
opt for backpacks, as opposed to hand-held book bags. It is not only a fashion
statement, but a logical choice for a way to carry a heavy load.
are both strong and flexible. Remember that the spine is not a single bone,
but rather it is a stack of bony doughnuts, with the spinal cord running up
and down through the central spinal canal. The bones of the spine - or vertebrae
- don't simply sit on top of one another, but rather fit neatly together, like
a loose-fitting three-dimensional puzzle, allowing us to bend forward, backward,
or to either side. Additionally, there are soft "spongy" discs between each
of the vertebrae; these serve as shock absorbers, adding to the spine's strength
remain neatly stacked when we walk, run , jump, swim, do gymnastics - and when
we carry a backpack - because strong ligaments and supporting muscles hold everything
in place. These bones, ligaments, muscles, and "shock absorbers" are usually
strong enough and large enough to carry geometry, Spanish, U.S. history, and
spiral notebooks. But they can't carry everything.
How much weight, and where to carry it
Muscles and ligaments
let their owners know when they are asked to do too much. The results of carrying
too much weight for too long is muscle soreness and strained ligaments, causing
back discomfort anywhere from the shoulders to the lower back. A recent survey
of 100 doctors conducted by the American Academy of Orthopedic Surgeons revealed
that more than half of these specialist had seen kids with back or shoulder
pain related to backpacks.
While larger, stronger
backs can carry more weight, there seems to be no clear consensus about how
much weight is too much. It depends in part on how efficiently the weight is
carried - choosing a good backpack and using it correctly - and we'll get to
that in a minute. But many of the surveyed physicians felt that carrying about
20 percent of a child's body weight on her back should be the limit.
I think 15 percent
of a child's weight is a good guideline for the maximum weight of a child's
backpack. That would suggest that an 11-year-old who weighs 80 pounds should
limit the backpack to 12 pounds. While a few more pounds probably wouldn't hurt
a strong child, the bottom line is whether a given load is causing a particular
child discomfort. In general, your body is pretty good at telling you when you
are asking it to do too much.
Can carrying too much weight cause serious problems?
There is no evidence that carrying a backpack, or even carrying a backpack that
is too heavy can cause any serious back problems: curvature of the spine, other
spinal deformities, or even poor posture. Improper use of a backpack can cause
muscle strain, and muscle strain hurts, but it heals, particularly in children,
where almost everything heals more rapidly than in adults.
What if my child has back pain?
Pain across the
shoulders or diffusely in the lower back at the end of the school week may well
be due to carrying a backpack that is too heavy. A good sign that the backpack
is the cause is that the discomfort will be gone or nearly gone by Monday morning.
However, it is possible to have a more serious back problem and incorrectly
attribute the discomfort to the backpack.
Back pain in a
child or teen-ager that is persistent for more than three days - particularly
three days of having given up the heavy backpack - deserves a least a call to
the child's physician. Pain and/or tenderness in one discreet area of the back
deserves particularly close attention to make sure that it doesn't represent
an infection or a stress fracture. Stress fractures are particularly likely
in young people who are gymnasts, football players, or wrestlers: activities
that put extra stress on the bones and ligaments of the
If your child's
back pain is associated with fever, inability to bend in any direction, pain
shooting down the buttock or back of the leg, or a limp, then don't assume that
it is muscle strain from the backpack. Get the opinion of your pediatrician.
The same holds true if the pain is persistent or recurrent. But for the shoulder
and back pain that is transient and goes away over the weekend, the real solution
is to lighten the load.
What to look for in a backpack
in lots of styles with lots of features, some functional and some cosmetic.
For comfort, look for a backpack with wide, heavily padded shoulder straps that
are easy to adjust. Built in back supports, "lumbar pillows," and waist and
side straps may be useful in keeping the backpack correctly close up against
the back and keeping the weight evenly distributed. Backpacks with separate
compartments also allow to evenly distribute the load. The best way to evaluate
a backpack is to try it on for comfort. Put a few books in it to see how it
feels and fits when "loaded."
Using backpacks correctly
should be worn over both shoulders, otherwise, a single shoulder is being asked
to carry the weight that should be shared by both shoulders and the back. The
shoulder straps should be adjusted so that the pack is close against the back.
For heavier loads, a "hip strap" can distribute some of the weight from the
shoulders to the hips. Keep the heaviest items closest to your back (put them
in the pack first), and evenly distribute the load on the right and left.
... and using them safely
According to the
Consumer Product Safety Commission, there were over 12,000 visits to emergency
rooms in 1998 for backpack-related injuries to 5- to 18-year-olds. It is interesting
to speculate about the nature of these injuries. It is also interesting to note
that more and more schools across the country are "banning" backpacks from hallways
and classrooms. School officials cite overcrowding and safety concerns as reasons
for insisting that the backpacks stay in the lockers during the school day.
With heavier and bulkier backpacks in ever more crowded hallways and classrooms,
one wonders how often a child will turn quickly and swing his 20-pound backpack
into a fellow student. In classrooms, and especially in labs, there is often
no place to put the backpacks except in the aisles, causing kids to trip and
fall, and raising serious concerns for the fire marshal.
that they need their backpacks to carry books to class because they don't have
time to go to their lockers between classes. But if backpacks are to be in the
classroom, it seems reasonable to insist that children carry in their packs
only what they need - to conserve both weight and space. Backpacks need not
contain snacks, Snapple, athletic equipment, CD players, and other nonessentials
that add to their bulk. Smaller backpacks should fit under seats and desks,
leaving aisles clear.
And finally, backpacks
should contain no loose or dangling cords, strings, key chains, or pieces of
clothing. Catching a cord in a closing door could make you trip and fall. Catching
a cord in a school bus door could be tragic.
When not to use a backpack
Backpacks are for
walkers and hikers. When children are on wheels - bikes, skates, or boards,
filled backpacks can be hazardous. Packs make kids top-heavy, less stable, less
able to maneuver, and more likely to fall. In automobiles, heavy backpacks can
become flying missiles in crash; keeping on the floor or throwing them in the
trunk makes sense. Kids should relinquish their backpacks before using swings,
slides, or other playground equipment.
about backpacks may be found at Consumer Reports Online, for Kids.
Mark D. Widome, M.D. Dr. Widome is a general pediatrician and professor of pediatrics
at Penn State's College of Medicine in Hershey, Pa. Dr. Widome writes frequently
on topics of interest to parents.
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