Backpack Safety Tips for Back and Neck Health

Dr. Karen Jacobs’ top 6 backpack safety tips to help prevent back and neck pain, plus advice about packing your backpack, and how to be a happy camper!

Ah, back to school shopping. New sets of flashy folders. Packs of markers in every hue. And a backpack to haul it all. Your child’s eyes might ignite when he sees a flimsy superhero backpack—or your teenage daughter may beg for one with so many compartments it could hold enough food for a year. But, parents should be involved in choosing a backpack, because picking the wrong one could result in some serious back or neck discomfort or pain for your child.
three kids walking, each with a different color backpackWhile backpacks might not be directly responsible for spinal injury, they may cause discomfort or pain in children when worn incorrectly. Can Backpacks Really Do Major Spinal Damage?
At this point, the research isn’t showing a direct correlation between incorrect backpack use and long-term back injury. That’s because there are no related longitudinal studies (studies that track a child all the way through adulthood). However, you can read about some of the most recent backpack research in Packing Pain: Study Reveals New Insights About Backpack Pain.

“Children may report having discomfort or pain, but with no longitudinal studies on backpack use, we are taking the evidence-based literature and extrapolating what we see,” says Karen Jacobs, OT, OTR, EdD, CPE, FAOTA, clinical professor of occupational therapy at Boston University’s College of Health and Rehabilitation Sciences: Sargent College. “The only thing the literature is showing is if a child has back issues as a teen, that it may continue when they are an adult. But, we can’t say that’s only caused by backpack use.”

Jacobs notes that while backpacks might not be directly responsible for spinal injury, they may cause discomfort or pain in children when worn incorrectly. Wearing a backpack that is too heavy, the amount of time carrying a backpack, the distance walked, inadequate distribution of weight in the backpack, and poor placement of items in the backpack can be contributing risk factors for discomfort, fatigue, muscle soreness, musculoskeletal pain (especially in the lower back), respiratory problems, and other issues. That’s why many health advocacy groups, and professional associations recommend backpacks weigh 10% of the child’s total body weight.

With back to school just around the corner, now is the perfect time to establish some sound ergonomic backpack habits.

Top Tips for Backpack Safety
Jacobs says parents need to select the right backpack that fits the child and child’s needs in school. “Take control over what backpack is picked,” she says.

Below are Jacobs’ top 6 tips for picking a backpack that won’t saddle your child with discomfort or pain:

  1. Backpacks aren’t one size fits all. The back of the backpack should fit the back of the child. So, the height of the backpack should extend from about 2 inches below the shoulder blades to waist level or slightly above the waist. It’s important to remember when choosing a backpack for a child's use, the one used the year before may no longer be the right size.
  2. Padding protects. Choose a backpack with padding across the back of the bag and along both shoulder straps.
  3. Choose breathable materials. Leather backpacks might be trendy, but they also weigh more than breathable materials. Also, buy a weatherproof pack that won’t be weighed down or damaged by rain and other elements.
  4. Hip straps are a big plus for older kids. As kids get older, they haul heavier items, like thick textbooks and notebook computers. A hip strap is an excellent way to support your back by allowing your hips to carry some of the weight.
  5. Keep compartments under control. More compartments mean more stuff. Young children should be able to get by with one main backpack compartment, whereas older children typically need more. Help your child understand the essentials that need to be carried daily, then pick a backpack accordingly.
  6. For added safety. Pick a pack with reflectors to protect children when walking in the dark as the seasons change from fall to winter. Also, don’t add your child’s name or initials to the front of the backpack, as predators may use that to call your child’s name. If you want to label your child’s backpack, put any identifying information on the inside of the backpack.

Once you’ve found the right backpack, Jacobs shares her best advice to use it properly throughout the school year:

  • Don’t fill your water bottle at home. Carrying a water bottle with you is a great habit, and many backpacks have mesh compartments to hold a water bottle. Instead of filling the water bottle before school, bring an empty water bottle and fill it at school to lighten the load.
  • Heaviest items go in first. Lay out all the backpack items and determine the heaviest. The heaviest should go in first and be in the back of the backpack. Pack all other items around that heaviest item. Side compartments are ideal for small, loose items (like pens and clips). 
  • Wear your backpack only when needed. For example, if you’re waiting for the bus, take your backpack off, keeping it close to you on the ground or on a bench.

Happy Campers: A Note on Camping Backpacks
If you’re going on an end-of-summer camping trip, Jacobs says the same rules apply for camping backpacks as they do for school: Be bare bones with compartments and make sure the pack is padded. But, she says hip and chest straps are essential with camping backpacks.

“People on the weekends go hiking and suddenly become warriors: They put as much as they can in their pack,” Jacobs says. “Make sure you carry only what you need, and be sure you use your backpack’s hip and chest straps.”

Jacobs says the hip and chest straps take weight off your shoulders and back, and redistribute them onto your hips—an area better able to support that weight.

“The bottom line is are you comfortable?” Jacobs says. “Part of the whole aspect of being in nature is being healthy—and you’re not healthy if you’re not comfortable.”

2017’s National School Backpack Awareness Day Is September 20
Each September, the American Occupational Therapy Association (AOTA), along with occupational therapy practitioners, educators, parents, and students, marks National School Backpack Awareness Day. This year’s event is September 20, and the day aims to educate the public on backpack safety through backpack weigh-ins, backpack check-ups, activities, and special events. Check with your local school district to see if events are being held near you.
AOTA Dinosaur wearing a backpackUsed By Permission. The American Occupational Therapy Association, Inc.Instilling Healthy Habits with Backpacks
Jacobs shared that backpacks have developed a bad reputation due to overpacking and ill fit, but they can help support physical fitness in kids. By conveniently and comfortably holding all the items a child needs, backpacks encourage walking—whether to and from school or simply between classes. By ensuring a backpack is a good weight and supportive, you can look forward to a healthy school year ahead.

Updated on: 11/07/17
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Causes of Upper Back Pain

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