Ouch! Lifting the Burden of Heavy School Backpacks

HOUSTON (Aug. 15, 2011) — With children soon to start school, physical therapists at Quentin Mease Community Hospital, the Harris County Hospital District’s dedicated physical medicine and rehabilitation facility, want parents to know the dangers and preventable steps of poorly used or overloaded backpacks.

Saving children the pain now can keep them from developing neck, shoulder or back pain as adults, they report. Nationwide, about 10,000 school-aged children annually visit doctors or emergency centers complaining of backpack-related injuries. 
 
“With more than 40 million American students carrying backpacks in school, it’s no wonder that this is a concern for parents, teachers, school administrators and healthcare professionals,” says Sara Zehr, PT, DPT, physical therapist, Quentin Mease Hospital.
 
When used properly backpacks are a popular and practical way for students to carry their books and supplies during the school day. When used incorrectly they can cause injuries to muscles and joints that can lead to severe back, neck and shoulder pain, as well as alterations in posture and body mechanics. 

Dana Tew, PT, DPT, board-certified orthopaedic physical therapist, Quentin Mease Hospital, says backpack education consists of three areas: recognition when a backpack is too heavy; identification of desirable backpack features; and instructions in the proper way to pack and wear a backpack. 

Backpack too heavy?
 
A backpack should not exceed 10-15 percent of a child’s total body weight. Yet most experts cannot agree on what is considered the maximum safe backpack weight for children to carry and the percent body weight calculation does not take into account a child’s height, body fat or overall muscle strength. 

The American Physical Therapy Association and American Academy of Orthopaedic Surgeons recommend these weight limits: A 60-pound child should carry a maximum of 5 pounds; 60- to 75-pound child, 10 pounds; 100-pound child, 15 pounds; 125-pound child, 18 pounds.

Five warning signs that a backpack is too heavy:
• Struggling to put on or take off the backpack
• Pain when wearing the backpack
• Tingling or numbness in the shoulders, arms or hands
• Red marks left on shoulders by shoulder straps
• Noticeable changes in posture 
 
Choosing backpack features

Desirable backpack features include:
• A backpack should match the length of the child’s torso. The pack should not be larger than the child’s back. For a proper fit, measure the back width from one shoulder to the other, then measure the length of the back from shoulder line to waist line and add 2 inches.
• A padded back is recommended to reduce pressure and to enhance comfort so that contents do not put added pressure on the child’s back.
• Two contoured and wide padded shoulder straps are recommended to reduce pressure on the torso and shoulders by equally distributing weight.
• Use hip and chest belts when the load is heavy to transfer weight from the back and shoulders to the hips and torso.
• Choose a backpack with multiple compartments so weight can be distributed equally and items are easier to find. 

Wearing and packing it properly
 
Other items to consider when carrying and packing a backpack are:
• Pack heavier items at the bottom or closer to the back.
• Pack flat items where they will rest on the back, with bulky items away from the back.
• Use both shoulder straps.
• Tighten the shoulder straps so the backpack hangs slightly below the shoulders with no more than four inches hanging below the waist line.
• Use the waist and chest straps.
• Consider using separate lighter packs for separate activities.

The majority of adolescent cases of back and/or shoulder pain should resolve within a week or two. Any symptoms that persist beyond a couple of weeks should be treated to prevent more chronic problems and occurrence of future problems later in life. The Harris County Hospital District recommends parents seek a physical therapist for an evaluation when back, neck or shoulder pains are disruptive to a child’s daily school or home life.

For more information on backpack safety, visit www.moveforwardpt.com.



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