Overweight School Backpacks : How to Reduce Back Pain, Injury Risks

A recent study has confirmed what many parents suspected that school children's backpacks are overloaded and cause back pain and injuries. ( See A recent study of Spanish school children published in the journal 'Archives of Disease in Childhood' )

The study found that almost the-thirds were carrying backpacks exceeding 10% of their body weight. The group of students carrying the of heaviest backpacks showed a 50% higher risk of back injury and back pain. Girls showed higher risk of back pain than boys. A total of 1,403 school children aged 12–17 were involved in the study.

In the UK the average backpack weight is 15-20% of their body weight, and some children carry backpacks as heavy as 30% to 40% of their body weight. Many children carrying bags over just one shoulder or very low on their backs. This greatly increases the risk of pain and injury. Local authorities have asked schools to check that backpacks are not overweight and are worn properly and over both shoulders.

Backpack must not be too heavy so the person cannot stand upright
Backpack must not be too heavy so the person cannot stand upright. Source: Public Domain
Source: Public Domain
OK: CORRECT POSITION! Source: Public Domain
WRONG: TOO LOW Source: Public Domain

Recent research studies have highlighted the risks of heavier backpacks, especially when weights exceed 20% of the child's body weight. Several researchers and organisations have recommended that backpack weight should not exceed 10% of body weight. It seems that time carrying the backpack is as important as weight.

The design of the backpack and the way it is loaded and worn are also claimed to be important for reducing the risk of injury and back pain.

Backpacks can cause pain in the head, neck or face, as well as the hands, the wrists, the elbows, the shoulders, the feet and the ankles. Back pain and injury is generally regarded as in the top-five most widespread injury and reported ailment. It is not commonly known that the real 'weakest point' is the shoulder rather than the back itself. A badly worn backpack can change posture and gait when walking and this compounds the problems.

Carrying the backpack with both shoulder straps has much less effect on posture and gait than carrying the backpack on one shoulder. There are more change to the posture of the spine with heavier backpacks.

However the link between the weight of the backpack and the common back injuries of scoliosis or kyphosis (curvature of the spine), has yet to be proven in controlled studies.

But, it has been shown that adolescents diagnosed with back pain are much more likely have chronic back pain and injuries as adults. A study of 10,000 Danish twins discovered that the flow on risk was up to four times higher.

However, there is no definitive evidence that illustrates a connection between the development of spinal deviations and the weight of backpacks worn by children.

Statistics on the incidence of back pain in adolescents show a huge variation ranging from 8% to 74%. This is partially due to how 'back pain' is defined with studies including neck and shoulder pain, others not.

While research does show an association between back pain and heavy school bags it does not prove that heavy bags actually cause the back pain.

There may be a lot of other factors involved. Back pain is caused by a variety of things such as sedentary lifestyles and slumping for hours and hours in front of the TV, and weaker back muscles through lack of exercise and fitness.

Carrying a heavy bag has been shown to change how children walk (e.g. inducing a forward lean, making the shoulders asymmetrical, changing the head-neck angle and increasing how much the hips and knees move).

However, so far there is no conclusive research that these changes causes any lasting deformity such curvature of the spine.

There are differences in the research outcomes with at least one study finding no direct link between the weight of the school bag and how likely an adolescent is to complain of back pain. The researchers suggested that emotional factors might influence whether an adolescent complains of pain. 

What School Bags are Best?

When selecting a backpack choose lightweight design that won't add a lot of weight. Look for bags that have two wide and well-padded straps.

If the strips are too narrow they will dig into shoulders and be uncomfortable.

Padding in the back of the backpack is also recommended as it adds to the comfort and also protects the child from sharp objects or edges that may poke into the back.

Backpacks should have two shoulder straps and both be slung over. The need to be well designed so that they can be packed so that the heaviest items are low down, against the back, but evenly distributed and not-lopsided.

The bag should have a light and sturdy design with padding for the back and be fitted with wide, padded and adjustable straps.

Hip straps are an excellent idea,as they provide additional support and ensure the back is orientated properly.

Students should be encouraged to use school lockers for items they don't all the time and to only carry books and other heavy things that they need for than particular day.

Summary of What to Look for:

Tip to Reduce the Injuries from Backpacks