Lewis Gale Physicians
December 05, 2017

Backpacks used to be for carrying a few books and a lunch box. When you add in portable video games, gym clothes, water bottles, and designer school supplies, though, they are simply too heavy for most kids. Many backpacks that appeal to children are not well designed for the task at hand—carrying a day's worth of school books, supplies, gym clothes, and kid treasures. They may have fun patterns on them, but they often do not have the proper padding and support to keep children from developing chronic back problems.

Having Chronic Back Pain

According to the American Academy of Orthopaedic Surgeons (AAOS), the extra weight in backpacks can lead to back, neck, shoulder, and posture issues in children. Improperly using a backpack, such as slinging it over one shoulder, or using one that is too heavy, strains young muscles and joints. A backpack and its contents should not add up to more than 15% of a child’s body weight. In a study of children in middle school, researchers found that 37% reported back pain. A third of the students said that the pain limited them from doing some activities. Researchers also found that having school lockers available and using a lighter backpack were associated with less back pain.

Lightening the Load

Researchers at Spine-health.com make the following recommendations to help lighten a backpack’s load:


  • Use both of the backpack's straps. Make sure the straps are firmly tightened.
  • Tighten the straps so that the top is just below the base of the head and two inches above the waist. When packs are carried low on the back, near the buttocks, it weighs down the spine.
  • Use correct lifting techniques. Bend with both knees when picking up a heavy backpack.
  • Place the heaviest items close to your back.
  • Neatly pack your backpack, and try to keep items in place.
  • Try to make frequent trips to your locker between classes to replace books.


  • Make sure that the weight of the backpack is not be more than 15% of a child’s body weight, and even less for a very young child.
  • Look for backpack design features that help reduce the chance of back pain:
    • Lightweight material (canvas as opposed to leather).
    • Two padded, wide (2-inches), adjustable shoulder straps.
    • Padded back.
    • Individualized compartments.
    • Hip strap, waist belt, or frame to redistribute the weight of the backpack from the shoulders and back to the pelvis.
    • Wheels so that the backpack can be pulled rather than carried. Not all schools allow wheeled backpacks, so be sure to check before purchasing one.
    • Consider using a separate bag for the child's laptop or other heavier electronic items.
  • Buy the smallest backpack possible.
  • Clean out your young child's backpack once a week.
  • Talk to your child's teacher about sending home only what is absolutely necessary.

American Academy of Orthopaedic Surgeons (AAOS): www.orthoinfo.aaos.org
Pediatric Orthopaedic Society of North America (POSNA): www.orthokids.org
Spine-health: www.spine-health.com

Never ignore back, neck, or shoulder pain in children. If you need suggestions on good backpacks or for your child to see someone about pain, Dr. Michael Simpson is available. To schedule an appointment, call the practice at (540) 674-4560 or book an appointment online below.

Book An Appointment Online with Dr. Michael Simpson