How to Avoid the Aches and Pains from Backpacks

Heading back to the classroom means school shopping for supplies, clothes, and more than likely, a new backpack. More than 79 million
students in the United States carry school backpacks.
Not only are our children carrying books and supplies, there has been a rise in recent years in carrying a tablet or laptop. Add these all up and a backpack can be very heavy! “A child wearing a backpack
incorrectly or that is too heavy can be contributing risk factors for discomfort, fatigue, muscle soreness, and musculoskeletal pain especially in the lower back,” says Karen Jacobs, EdD, OTR/L, CPE, clinical professor of occupational therapy atBoston University, and an expert on school ergonomics and healthy growth and development of school-age children.

Heavy backpacks and the way they are worn can lead to pain and strain in the back, neck, and shoulders. Has your child ever complained about aching shoulders after a long day at school?
Have you noticed a change in their posture as the school year progresses?
Parents can help alleviate these aches and pains resulting from improper backpack use by helping children load and showing them the correct way to wear the pack.

First, let’s look at what is in the pack.

A child’s backpack should weigh no more that about 10% of his or her body weight. If your child weighs 100 pounds, his or her backpack should not weigh more than 10 pounds.

Be sure the pack is being loaded with the heaviest items first and closest to the child’s back.
This will keep the backpack from pulling away from your child’s body and causing strain in the shoulders, back, and neck.

Check to see if there are items sliding around. Movement in the backpack will again cause the center of weight to shift and pull on your child.

Do they really need to carry everything in their backpack every day? Only pack what
is necessary for that day. Or carry an item in their arms.

How is your child wearing his or her pack?

Before you purchase, have your child try the backpacks on. Just like their school wardrobe, you want to be sure the pack fits properly. Do not buy an adult size backpack. Be sure the pack is balanced for your child’s height.

Adjust the shoulder straps while your child is wearing it. The straps should be adjusted so that the pack fits snugly on the child’s back. A pack that hangs loosely from the back can pull the child backwards and strain muscles. A good rule of thumb is to see where the bottom of the pack falls on your child’s back. The bottom of the pack should rest in the curve of the lower back. It should never rest more than four inches below the child’s waistline.

Always use both straps. Wearing a pack slung over one shoulder can cause a child to lean to
one side, curving the spine and causing pain or discomfort.

Look for straps that are well- padded for added comfort. Pain and tingling in the neck, arms, and hands can happen when too much pressure is applied.

School backpacks come in different sizes for different ages. Choose the right size pack for your child as well as one with enough room for necessary school items. Perhaps a rolling pack would be best if your school allows backpacks with wheels.

With watching the load and making sure the pack fits properly on your child, you can help to alleviate some of those aches and pains that are oftentimes caused by backpacks.

For additional tips and information on celebrating National School Backpack Awareness Day, visit

Seeking Expert Assistance

As pediatric clinicians, we know that healthy students are happier and more productive. If your child
starts to show signs of pains or strains because of wearing a backpack,
he or she may benefit from a physician’s referral for a pediatric therapy evaluation. A pediatric therapist working in an outpatient center can determine if your child could benefit from skilled services and home exercise programs.

Provided by FMH Rehabilitation Liberty Pediatric Team—Physical, Occupational, and Speech Therapy.