Backpack Safety

By Diana Brooks, PT, DPT
Tidewater Physical Therapy, Inc.
Ironbridge Clinic

Cute Brothers and Sister Wearing Backpacks Ready for School.

Why is it important?

It is estimated that 80% of people will experience back pain at some point in their lives.  Having a history of back pain in youth is the strongest predictor of back pain in adulthood.

Is your child carrying too much weight?

A recent study published in the journal of Pediatric Physical Therapy examined 62 children ranging in age from 8-11 years old.  They had the children wear backpacks loaded with 10-20% of their body weight.  The children walked with the backpacks for 6 minutes.  They reported increased neck and back pain for all weights both initially and after walking.  There is a large body of research that supports a maximum backpack weight of 15% of a child’s body weight.

What happens when the spine is placed under too much load?

To counter the weight of the backpack, the trunk and head shift forward.  In the neck, this increases the compressive force to the spine, and tension of the neck musculature.  This causes increased fatigue of the neck extensors and can cause tension headaches.  In the back, the natural curvature of the spine (lordosis) is increased.  This increases disc pressure and sheer force to the lumbar spine.  This is all assuming the backpack is worn on one shoulder.  Wearing a bag on just one shoulder causes compensations in more than one plane, meaning you not only get flexion of the spine, but side-bending and rotation.  These compensations increase as the load and wear time increase.

What do I look for when purchasing a backpack?

Purchase a lightweight pack with wide, padded shoulder straps.  Multiple compartments can help distribute weight more evenly.  Backpacks are a better choice than messenger bags or briefcases.  When it’s not possible to decrease loads, consider a backpack with wheels.

Kistner F et al. Postural Compensations and Complaints from Backpack Users. Pediatr Phys Ther 2013; 25:15-24.


Diana Brooks, PT, DPT earned her Bachelor of Science with a concentration in Sports Medicine from the University of Virginia, and her Doctorate of Physical Therapy from the Medical College of Virginia.
Make an appointment with Diana at the Iron Bridge Location.

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