Backpack Buying 101: How to avoid 'backpack back'

Children with backpacks

Back-to-school time can be a pain in the backpack.

Holly Benjamin, MD, FACSM, can tell at a glance if a child is lugging an over-stuffed backpack. The heavier the pack, the poorer the posture.

“The littler kids often arch their backs, like they’re being pulled backwards,” said Benjamin, Professor of Orthopaedic Surgery, Rehabilitation Medicine & Pediatrics at UChicago Medicine. “Older children hunch forward, trying to help carry the load. They have rounded shoulders and they shuffle when they walk.”

A teen who slings his bag over his right shoulder may think he looks cool, but his body language broadcasts strain and pain. “When he hunches his right shoulder to offset the weight – like a woman with a heavy purse – he’ll actually lean to the right,” Benjamin said.

The American Academy of Pediatrics recommends that a school-age child’s bookbag weigh no more than 20 percent of the student’s weight. Orthopaedic expert Benjamin suggests that 10 to 15 percent is a safer bet.

When cases of “backpack back” spike every fall, she weighs her young patients’ bags to demonstrate the pressure on their bones and joints. The knapsacks “are typically in the 30- to 35-pound range,” she said. “The heaviest I weighed in clinic was 50 pounds.”

Heavy backpacks as well as poor carrying habits can contribute to, and might even cause, a variety of back injuries ranging from muscle strain and bulging discs to stress fractures. Short-term symptoms include an aching neck, back and shoulders. Too-heavy loads also can compress nerves, causing arms, hands and fingers to tingle or go numb. Long-term consequences range from a permanent slouch to musculoskeletal damage.

Benjamin urges schools, parents and students to join forces to lighten loads and ease the backpack burden. Teachers might distribute photocopies of book chapters in class, assign reading in online books, and have extra copies of large textbooks in the classrooms so that students don't have to haul their heaviest books around all day. Administrators can provide extra time for students to stop at lockers to swap out morning books for afternoon books. Parents can nix non-essential electronics. Students can use study time to do homework in school and avoid lugging books home. Finally, Benjamin suggests that physical education or health classes incorporate posture exercises to teach students about better posture and spine health.

Her other backpack buying and wearing tips include:

  • Choose a lightweight, comfortable backpack. Sporting-goods stores often feature ergonomic designs, and you can ask the staff to recommend the right size and fit.
  • Ask for a backpack with compartments. These features enhance organization, prevent contents from shifting, and help distribute weight more evenly.
  • Make sure shoulder straps are well-padded and adjustable.
  • Make sure the chest or waist strap is adjustable and cinches correctly. These belts hold contents closer to the child’s back for better balance.
  • Look for backpacks with chest straps for extra support.
  • Pack as lightly as possible. Does your young scholar really need to haul a laptop, tablet, cell phone and three chargers every day?

Benjamin, who has three teens, is no stranger to eyerolls when she dispenses backpack advice. She has heard excuses both at home and at work, including: “I can’t use a wheeled backpack because it’s impractical on stairs”; “I don’t ever have enough time to go to my locker between classes”; and, “I don’t want to look funny using a chest and waist strap.”

One tactic: If the kids are “slouchy,” give them physical “homework,” i.e. exercises to improve their posture and strengthen their core and back muscles. They just may lighten up.

Holly Benjamin, MD

Dr. Holly Benjamin is a specialist in sports medicine and non-surgical musculoskeletal injuries.

Learn more about Dr. Benjamin