Preventing kids' injuries from heavy backpacks

July 10, 2003 -- As parents and kids make their lists for the August back-to-school sales, one item to consider should be a backpack — on wheels, says Nancy J. Bloom, DPT, a physical therapy instructor at Washington University School of Medicine in St. Louis.

Kids backs are primarily bearing the weight of their schoolbooks. Bloom says that because young bones are growing all the way through high school, heavy backpacks need to be a major concern. She notes that there are a few important things that kids can do to lighten their load and avoid injury.

To avoid injury, children should carry their backpacks over both shoulders to balance the load.

Overloaded backpacks have received a good deal of attention in recent years. In fact, the California legislature passed a law last year requiring maximum weight standards for elementary and secondary school textbooks. Other states, including Georgia, Illinois and Tennessee, have considered similar legislation.

Bloom says it's not that books are necessarily heavier than they used to be, but she believes that children are carrying more books than they used to.

Bloom says it's important that children only carry the books they need and that they carry their backpacks over both shoulders to balance the load.

"The tendency I've seen is that they don't want to get home and not have a book that they might need. So rather than really organize themselves before they leave school to go home, they bring everything. They're probably just packing more than they need.

"Kids typically grab their books, stick them in the bag, and then throw the bag over one shoulder and walk with it more like a purse as opposed to a backpack," says Bloom. "So that puts all of the weight on one side, and that may lead to problems.

"Repeatedly carrying a backpack weighing over 10-15 percent of bodyweight may lead to back problems," Bloom continues. "Also wearing the backpack for extended periods of time such as walking home from school or around campus may increase the risk of injury.

The extra stress may lead to muscle fatigue or strain and contribute to faulty alignment, Bloom says. Any area of the back (cervical, thoracic or lumbar) or shoulder region could be affected. It seems less likely, she adds, that the peripheral joints such as the hip, knees, ankles or elbows would be injured.

According to the U.S. Consumer Product Safety Commission, doctor's offices, clinics and hospital emergency rooms treated more than 13,260 injuries from backpacks in the year 2000 (the last year for which those statistics are available). Bloom believes that injuries also can occur from tripping over backpacks lying on the floor. She suggests proper storage of backpacks while not in use.

Bloom says to prevent back or shoulder injuries from heavy books, children may want to use a backpack with a waist strap to provide extra support and more balance for the weight. Backpacks with padded, wide straps and a padded back is also a good idea. The straps should be adjusted to fit snugly.

Neatly packing the books with the heaviest ones closest to your back also can help, Bloom adds. But if the backpacks are simply too heavy, she says one solution might be a backpack with wheels.

"They are a good alternative for a child who has problems. Children are so in to what their peers do, if they were the only one in the school with a rolling backpack, they might feel odd and not want to do it for that reason. But they're making rolling backpacks, and they're becoming more popular. A backpack with wheels would be a really good solution."