Question of the Week

August 22, 2005


The new school year is here. For many, this means getting a new backpack and filling it with new supplies, new books, and all the electronic necessities one needs to make it through the school day.

"Compared to shoulder bags or purses, backpacks are better because the strongest muscles in the body - the back and the abdominal muscles - support the weight of the packs. When worn correctly, the weight is evenly distributed across the child's body, and shoulder and neck injuries are less common than if the child carried a briefcase or purse. As practical as backpacks are, though, they can strain muscles and joints and may cause back pain if they're too heavy or are used incorrectly."

So, backpacks "can strain muscles and joints and may cause back pain..." How bad could that be?

"'If we don't correct the backpack issues that are causing children back pain, the issue will become magnified in years to come,' Wilmarth said. According to Wilmarth, injury can occur when a child, in trying to adapt to a heavy load, uses faulty postures such as arching the back, bending forward, or leaning to one side. These postural adaptations can cause improper spinal alignment, which hampers functioning of the disks that provide shock absorption. A backpack load that is too heavy also causes muscles and soft tissues to work harder, leading to strain and fatigue. This leaves the neck, shoulders, and back more vulnerable to injury."

Students need to carry school supplies and books. As damaging as they can be, backpacks seem to be the best way to carry what school demands with the least amount of injury and/ or pain. So what can be done?

The American Academy of Pediatrics recommends:
"* Choose a backpack with wide, padded shoulder straps and a padded back.
* Pack light. Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back. The backpack should never weigh more than 10 to 20 percent of the student's body weight.
* Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles. Wearing a backpack on one shoulder may also increase curvature of the spine.
* Consider a rolling backpack. This type of backpack may be a good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried up stairs, and they may be difficult to roll in snow."

Those are nice thoughts... that may work for some people. But what about small students who need to carry a heavy load, or those in schools without lockers, or those days when every teachers seems to give homework that requires bringing home the book?

"September 21 st is National School Backpack Awareness Day. Each year over 5,000 school children go to emergency rooms because of injuries related to over-weighted backpacks and in a recent study 60% of school age children reported chronic back pain related to heavy backpacks. Occupational therapists recommend that a student's backpack weighs no more than 15% of their body weight. On September 21 st occupational therapists around the area will be weighing in backpacks at schools to make sure students are not carrying too much. Look out for occupational therapists in your local school, and remember, "Pack it Right, Wear it Light!" to prevent injury. For more information on National Backpack Awareness Day and how occupational therapy can help you or your family, visit the American Occupational Therapy Association website at"

The American Occupational Therapy Association (AOTA) wants to help students carry books and supplies safely and in such a way as to reduce the instances of injury. At the same time, "AOTA recognizes that schools are under tremendous pressure, with limited resources, to educate children about far more than the traditional academic subjects. However, there are some things that teachers and school administrators can consider that will help reduce backpack loads to the recommended 15% or less of a child's weight...."
(Recommendations can be found at the above site)

Questions of the Week:
The American Occupational Therapy Association poses the following questions: "What can be done on a physical level, such as providing lockers or cubicles where books, supplies, and athletic equipment can be safely stored? ... What can be done to lessen the backpack burden at the curricula level?"

In addition, what do you and your peers need to know about choosing a backpack and wearing it properly? What role should schools (teachers and administrators) be expected to take in reducing the load? What responsibility should students assume in order to assure that they are carrying books and other supplies in a way that will not injure them? When is a backpack too heavy to carry, and how do you transport your materials if what you need is heavier than what you can safely carry?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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