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Orthopedic Surgeon: Parents Should Calm Down About Backpacks

A muscle and skeleton expert on how to make sure both can bear the weight of the bag your kid carries.

A backpack is one of the first school items a parent purchases for their kid. And, for the next 12 years, the backpack they carry becomes sort of hybrid tumor, cross, and library. As most parents know — or think they know — the consistent pressure of the backpack can warp and reshape a child’s anatomy, pressuring the spine to do things that spines aren’t supposed to do. But pediatric orthopedic specialist Dr. Pablo Castaneda believes there’s no need for panic. Backpacks are heavy, sure, but he suggests there is little reason to believe that children can’t carry that weight a long time.

“Backpacks don’t cause deformity,” explains Castaneda. “You can neither cause nor help, for example, scoliosis, through use of a backpack. That’s a myth.”

Even a very heavy backpack, worn unevenly, would not be likely to cause permanent damage to a kid’s spine, Castaneda says. However, he warns this peace of mind should not overshadow the fact that the wrong backpack, worn the wrong way, could cause muscular strain or pain for a kid loaded down with learning materials.

The biggest cause of discomfort is most obviously weight. But there are very simple guidelines to follow on this front. “The way backpacks work is that they basically distribute the weight of load amongst the child’s shoulder and back muscles,” Castaneda says. “And the rule of thumb is that it should not weigh more than about 20 percent of the child’s body weight at most. Between 10 and 15 percent of the child’s body weight is good.”

Of course, this means that a parent needs to know both their child’s weight and the weight of their backpack. Ultimately a scale is the most helpful on this front, as is the motivation to weigh child and backpack. But unless a parent has a scale beside the front door, a weighing ritual is unlikely to occur amid the morning rush. Luckily, there is a way to not weigh and still detect if a child is overburdened.

“Your child should be able to lift the bag comfortably without having to make any strain to pick it up,” Castaneda says. “It should be the same for you, you should be able to pick up their backpack fairly comfortably with one hand without having to put too much effort into it.”

Another possible cause of backpack-related pain is the actual design of the backpack, starting with the straps. These should be broad and padded to keep from cutting into the shoulders. This could lead to restricted blood flow or even cause a kid to lose feeling in their arm. This rules out the drawstring backpacks currently en vogue among school kids. “We have seen problems with these,” Castaneda comments. “We haven’t seen major issues, but we have seen bruising and skin chaffing that can be avoided with a larger padded strap.”

Beyond the shoulder straps, there are also issues related to the pack portion of the backpack. Castaneda points out that ergonomic studies have shown that a backpack is best worn when the weight can be evenly distributed across the back rather than on one point in the spine. This would suggest that the optimal backpack design is one that allows for this kind of distribution. This is another strike against drawstring backpacks, which tend to sag, causing all the weight to be carried at a point low on the back.

And while a child is unlikely to be injured by carrying a backpack, it’s important for parents to be watchful for changes that might require a visit to the orthopedist. These include pain, uneven shoulders (one higher than the other) or bruising and persistent discomfort.

There are also preventative measures.

“Being physically fit and active has all sorts of muscle benefits,” Castaneda says. “So by stretching and having an active lifestyle, we encourage children to have healthier muscles and be able to carry backpacks in a much more efficient way.”