Back-To-School Backpack Basics

August 29, 2005-- Posted at 3:40 PM CDT

 (HealthDay News) -- As children begin to head back to school, experts urge parents not to neglect an often overlooked safety concern -- improper backpack use.

Backpacks may be one of the most efficient ways for children to carry their belongings to school, but improper use could lead to injuries such as back and neck pain and, in severe cases, nerve damage. To avoid such health problems, they advise parents to teach their children backpack safety before classes start.

"If a backpack is used properly and with some sense, it's the way to go," said Dr. Jay Cook, a professor of neurology at the University of Texas Southwestern Medical Center at Dallas. "But often kids don't use the abdominal strap, they carry their backpack on one shoulder, which means twice the pressure on that shoulder, and they overload the backpack."

Heavy backpacks are a common occurrence among schoolchildren. A 2002 survey of students in grades 5 through 8 found that 55 percent of the children carried backpack loads heavier than the maximum weight recommended for children by most experts.

This overload, combined with improper use, can create strain on the child's shoulders and arms, causing not only neck and back pain, but also fatigue and nerve injuries. The end result, especially if left unattended, could be muscle weakness, sensory loss and even permanent damage, said Cook, who has seen an increase in these injuries in his practice over the years.

"It's far more frequent now than it used to be. I think this is primarily because more people are using backpacks," he said. "I don't know when backpacks became the en vogue thing to do, probably in the last 15 years. Before this, I didn't see many of these problems."

Still, compared to satchels or briefcases, backpacks are usually safer for kids since they help distribute the weight evenly across the body and use the back and abdominal muscles for support, helping to prevent strain and pinched nerves. The trick to preventing these injuries, though, is finding the right backpack for your body type.

"Look for the features of a backpack, not the brand or model, though lower-end models are often cheaply made," said Dr. Avrom Gart, medical director of the Cedars-Sinai Institute for Spinal Disorders in Los Angeles.

Gart recommended buying backpacks with multiple compartments to help evenly distribute the weight, two padded shoulder straps (both of which should be used) to stop them from cutting into the shoulders, a waist band to help take the weight off the shoulders, and reflectors to prevent accidents, especially in the winter when it gets dark early. He also suggested limiting the weight in the backpack, by keeping books at home or at school, for example, or finding alternative ways to get information from textbooks.

Cook agreed, adding that children should also learn how to use the straps on their backpack properly and to adjust the straps before loading up the pack. Rolling backpacks are also a good choice, both experts said, as long as the handle is long enough that the child can stand straight when pulling the bag. Sports bags, on the other hand, should be avoided, since they load all the weight onto one shoulder.

Though there's no real consensus on how much weight should go into the bag, most experts agree that a backpack is too heavy if it's more than 15 percent of a child's body weight. This means, for example, that a 100-pound child shouldn't carry more than 15 pounds on his or her back. However, Cook added there are other warning signs.

"If a child is leaning forward or straining, no matter what the weight, the bag is too heavy for them," he said. "Also, if they are complaining of pain, numbness or tingling, something isn't right. Stop using the backpack, and go see a doctor. And be sure to take your backpack to the doctor with you."

By Juhie Bhatia HealthDay Reporter

More information

For more on backpack safety, visit the Nemours Foundation ( ).

 SOURCES: Jay Cook, M.D., professor, neurology, University of Texas Southwestern Medical Center at Dallas; Avrom Gart, M.D., medical director, Cedars-Sinai Institute for Spinal Disorders, Los Angeles; Fall 2002 Pediatric Physical Therapy

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