Secret Backpack Pains

By Allison Kolk, Assistant Writer

It is back to school time. Again, the familiar yellow school busses patrol the streets, and parents everywhere rejoice at the peace and quiet that fills their houses. However, another less pleasant image appears as well: backpacks. Not the cute cartoon ones but the big, overstuffed and extremely heavy backpacks. The type of backpacks that injure.

It is estimated that 13,260 children were treated for backpack-related injuries in 2000, reports the U.S. Consumer Product Safety Commission. Staggering numbers like this leave many questions. What happened? When did backpacks become such a problem? Is it just one factor or many contributing ones?

Anna Jugan, PT, a pediatric physical therapist with the University of Tennessee Medical Center was able to offer some insight. According to Jugan, the problem with backpacks starts much earlier than people think. She explains that children are spending less and less time on their stomachs than they did in years past. Instead, children are being put into walkers and other pieces of equipment that force them to sit up, and that’s not good.

“The children haven’t developed the strength in the lower back, “Jugan says. “They’re really having to arch their backs just to stay upright in the walkers and by doing so that’s actually compressing the vertebral body and causing a wedging.”

Jugan says that it is better for children to spend a lot of time on the ground learning how to move around because it helps to strengthen postural muscles. Children need to learn to prop themselves up through their arms, pull themselves up and strengthen their core muscles. The time they spend moving around on the floor is time that they’re strengthening and developing good curves in their spine.

Another contributing factor to backpack problems is the lack of physical activity. “Part of it is that we’ve become more sedentary and so the children aren’t as strong in their core muscles as they should be,” Jugan says. Kids spend a majority of their time sitting. Sitting in class. Sitting in the car. Sitting in front of the TV or the computer. Jugan advises to “try and stay as active as possible to relieve that stress instead of coming home from school and sitting.”

Regardless, there are a few things that parents and children can do to help alleviate some of the problems caused by backpacks. Jugan makes the following recommendations.

  1. Use both straps
  2. Visit the locker often
  3. Carry only 15 to 20 percent of the child’s body weight
  4. Educate children on the proper way to wear a backpack
  5. Pack heavier books closer to the back
  6. Chose a backpack that is light weight with a padded back and padded straps


One question still remains, won’t the years of not wearing a backpack make up for the years of wearing one? Not necessarily. When there is a heavy load placed on the back, people compensate by rounding their shoulders, which throws the head back and increases the curve in the C-spine.

“Your muscles stretch and are shortened improperly and all of the supporting tissues respond the same way,” Jugan concludes. “Unless you’re doing things to counter act that, it becomes your way of moving. You’ve reset the way that your body feels to be normal.”
Jugan explains that it’s the everyday activities of life that also reinforce this poor posture and it becomes hard to change.

Thankfully children are very resilient, and if they use their backpacks properly and get lots of physical exercise they should be okay. However, Jugan advises that if your child complains of persistent pain for more than two weeks, then it’s time to seek the advice of your physician. The physician will be able to determine if the pain is caused by the heavy backpack or something more long-term such as scoliosis.

For more information, visit the Brain and Spine Institute or the Center for Women & Children’s Health.

Jugan, Anna, PT, Aug. 16, 2007.
National Institute of Neurological Disorders and Stroke, Aug. 8, 2007,