Take a load off

Items recently emptied from my first grader's backpack: lunch box (with leftovers), water bottle, homework folder, two Encyclopedia Brown books, Star Wars Lego guys, a pair of dice, rubber bands, spy notebook, a green Ugly Doll, pencils, pens, lanyard string, rocks, sticks, a petrified cupcake and a yellow marble. No wonder he prefers to drag his pack along behind him or simply kick it down the hallway. 

Jingling with charms and decorated with buttons, patches and paint, backpacks are as much cool art pieces as they are necessities. But as the school year gets rolling and packs get heavier, students begin to resemble Mac -- the overburdened turtle at the very bottom of Yertle's pile. According to the American Occupational Therapy Association, over 50 percent of all students between the ages of 9 and 20 suffer from chronic shoulder, neck and back pain related to lugging around heavy packs and wearing them incorrectly. Backpack related strains, pulls, circulation problems and even falls account for more than 21,000 injuries in the US each year, according to the National Safety Council. Heavy packs carried on slumped shoulders can also lead to chronic poor posture, which can be difficult to reverse. 

The spine's spongy intervertebral discs are designed to absorb the compressive loads we carry. But when too much weight, improperly distributed, causes the body to strain in the wrong direction, the spine may be compressed unnaturally, leading to injury.

 "It's about safely distributing weight, and managing it effectively so that it is less likely to injury one specific part of the back," advises American Academy of Pediatrics fellow Dr. Benjamin Hoffman. He suggests the following guidelines to keep kids comfortably upright:

• Look for a pack with wide shoulder straps, which better distribute force. Advise kids to wear both straps (though they may not listen!), and make sure they are reasonably snug, but not so tight as to pull or pinch.
• Buy a pack that is the right weight and size for your child. A pack should not weigh more than 10-20 percent of a child's total body weight (so for a 50 pound kid, that's 5-10 pounds, max.). A heavy-duty pack, however well constructed, could be the wrong thing for your first grader.
• Advise your child to pack lightly and distribute their stuff evenly through the pack, with the heaviest stuff closest to their back. When the weight is farther away from the back, it torques the muscles.
• Adjust the pack so it sits a couple of inches above the waist, to avoid pulling the child backward.
• Fit the pack snugly against the curve of the lower back. If it is too low, it creates pressure on the upper back muscles.
• Wear the waist strap to transfer the load to hips and a shoulder strap to prevent slouching.
• Encourage your child to tell you if he is uncomfortable. Muscular-skeletal pain will always worsen if not addressed.
• Consider a rolling backpack, but keep in mind that these too must be kept light in order to be pulled comfortably up stairs or along uneven surfaces.

Be a good PTA parent and healthy back advocate: ask schools to let students frequent their lockers throughout the day so that they carry only what they need throughout the day, and encourage schools to provide CDs or home internet access to course materials so students don't have to lug 5-10 pound textbooks back and forth to school. 

And if you are the parent of a teenager, take heart – flat and empty is apparently the new cool. According to teenbackpacks.org, "teens are wearing trendy backpacks in bright patterns and colors -- even when they have nothing to put inside."