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The Backpack Dilemma

By Claudia Anrig, DC

Chiropractors, pediatricians and or thopedic surgeons alike agree that backpacks are a problem for your child’s spine. While they may not cause major problems, overloading and improper carrying of a backpack can lead to neck and shoulder pain as well as lower back pain.1

How heavy is too heavy?

While healthcare professionals do not all agree on the exact weight, the consensus is that more than 10% of your child’s body weight can lead to back and neck pain; and the majority of healthcare professionals agree that 15% or more of their body weight can lead to severe back, neck and shoulder pain as well as headaches and other spinal discomfort; not to mention aggravating pre-existing spinal conditions such as scoliosis.2So, how do we lighten the load?

It’s important to weigh your child’s backpack once a week. If it weighs too much then take just a moment to lighten the load. Maybe they’re carrying a book that they can do without that day, or maybe they’ve got some sports equipment in there that they won’t need until after school. Be willing to bring whatever items they won’t need until the end of the day to the school for them. If taking ten pounds out of their backpack will avoid pain and discomfort then it’s worth ten minutes out of a busy day.

Proper Loading

Surprisingly enough it’s also important how they load their backpack. It’s vital that the heaviest items rest against the back, which means loading them first. It’s also important to have the weight distributed evenly. If they must carry a rock collection for show-and-tell then it needs to be in the center with other items on the left and the right to evenly balance the weight.3

Proper Carrying

While your teenager may think it looks cool to carry their backpack slung over one shoulder, the truth is that this fashion statement is damaging to their developing spine; one shoulder is being required to carry a burden that both shoulders and the back should be sharing. The only proper way to carry a backpack is with both straps over the shoulders and the backpack resting against the lower back.4

Available Options

Your first option, as a concerned parent, is to make sure that your child’s backpack is functional more than aesthetic.2 Every child has a desire to have the “coolest” backpack, but if it’s not functional then it’s damaging to the spine. Find a backpack that fits properly (not too long or too short) and make sure that it has wide, padded, adjustable straps (for proper positioning on the back). A second option is to look for a backpack with a hip strap or lumbar pillow.4 The hip strap, when used, can distribute a portion of the weight to the hips easing the load on the spine and shoulders. On the other hand, the lumbar pillow helps the back support the greater portion of the weight with the least amount of damage. Remember, just because the backpack is sturdier does not mean it can carry more. A backpack should never weigh more than 15% of the child carrying it.

The Roller Bag

Despite the hype this is not the answer to a parent’s dream. Yes, the roller bag takes the weight off the child’s spine and shoulders; however, an empty roller bag weighs up to 80% more than an empty backpack. Yes, the roller bag uses wheels and levers and thus requires less energy to transport. However, being bigger they hold more so the tendency is to overload it; parent beware, your child’s backpack can end up weighing 50 pounds or more. Of course, the most important and undeniable fact is that eventually your child will need to lift that bag. Just because it’s on rollers doesn’t make it any less damaging to your child’s spine, especially if overloaded or used improperly.2

In Summary

For your child’s spinal health it’s important to realize no function on a backpack is going to alleviate your responsibility to teach your child to properly load, carry and lift a heavy backpack. Take a moment today to go over the major points of proper backpack usage.


  1. The American Academy of Orthopedic Surgeons. Bulletin Volume 47, No 6. December 1999
  2. Arnsdorff, M. Mounting Research on Backpack Use. Originally published in INPA Newsletter May/June 2002
  3. Widome, M. Weighing in on Backpack Safety: Tips for toting school gear without physical injuries. 2000
  4. Pistolese, R. Book Bags: What Every Parent Should Know. Originally printed in ICPA Newsletter November/December 2000