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Backpacks & Teens: Reduce Physical Stress, Discomfort

By Shannon Martyn, Physical Therapist

The alarm clock goes off and the sun is rising for the start of a new school year. Backpacks have become such a common way to carry items needed for classes, sports and after-school activities that they have become the last step in the hurried process of getting dressed for the day. Backpacks are a great way to store the essentials to get through the day but can also be a source of stress and discomfort if worn incorrectly.

Teens are especially likely to need to transport large books, sports equipment and extra personal items in their backpacks. Backpacks are designed to distribute the weight of these items along some of the body’s strongest muscles of the trunk. When worn improperly, heavy backpacks cause a forward trunk lean, positioning of the head in front of the shoulders instead of directly over shoulders, and rounded shoulders, which are all signs of poor posture. These changes in posture cause increased strain on the weaker muscles of the neck and shoulders. Postural changes associated with wearing heavy loads on the back can also decrease the natural curvature of the spine and increase stress and pain in the back. In more severe cases, heavy loads can cause traction injuries of the nerves that travel from the spinal cord through the shoulder and may cause symptoms such as numbness, cramping, and pain in the arm. Traction injuries result when nerves are stretched beyond their normal limits. These symptoms are usually temporary but may result in long-term problems.

Recent research indicates that neck and back pain is on the rise amongst teenagers.1 Back pain in children and teens can also increase their risk of having back pain as adults.2 There are several simple steps that teens can take to decrease the chance of developing neck, shoulder or back pain as a result of improper backpack wear. Please share the following with the children and teens in your lives:

1. Limit the Load: Carry only what is necessary for that day. If possible, carry books for one or two classes and leave the rest in the locker. The American Academy of Pediatrics recommends limiting the weight of a backpack to no more than 10-20% of the student’s total body weight.3

2. Strap Up: Always wear both shoulder straps to distribute the weight equally. Wearing only one strap causes the upper trunk to lean to the opposite side and causes the shoulder under the strap to raise, increasing strain on the muscles supporting the shoulder. Tighten the straps so that the backpack hangs close to the body and look for straps that are wide and padded to decrease wear on the shoulders. Waist straps help decrease the load borne on the shoulders and can help to prevent traction injuries when carrying particularly heavy loads.

3. Organize: Backpacks that have several compartments help distribute the weight throughout the backpack. Always pack the heaviest items closest to the center of the back.

4. Safety: Most injuries seen in the emergency room related to backpacks are not spinal but are caused by falling, tripping and improper lifting techniques.4 Always store backpacks out of walkways and high traffic areas to avoid tripping on straps. Also, always remember good body mechanics when lifting, especially heavy objects! When lifting, keep a straight back, lift with your legs, and avoid trunk rotation. Lift the object first and turn using your feet once you have returned to an upright position.

Sources:
1, 4 American Academy of Pediatrics, http://www.aap.org/advocacy/backpack_safety.pdf

2 Marsh, Andrew B. BSPT, Cert MDT; DiPonio, Lisa MD; Yamakawa,Karen MS; Khurana, Seema DO; Haig, Andrew J. MD. American Journal of Physical Medicine & Rehabilitation,Volume 85(6), June 2006, pp 509-515.

3 Korovessis, Panagiotis MD, PhD; Koureas, Georgios MD; Zacharatos, Spyridon MD; and Papazisis, Zisis MD.  European Spine Journal, Volume 30, Number 2, pp 247-255, 2005. Lippincott Williams & Wilkins Inc.

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