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A pain in the backpack: Experts’ advice about your child’s load: Lighten up!

News Tribune photo illustration

For some kids, back to school can mean back pain.

Often, the reason is as plain as the pack on their backs.

“It’s unusual to have a child under the age of 12, a preadolescent, to have back pain,” said Dr. Timothy Zager, an Essentia Health pediatrician. “So when you hear about back pain as a chief complaint, you need to ask some questions. It’s rather common to find that they wear a backpack when they’re going off to school.”

By the time your child fits textbooks, a library book, a snack, a cellphone, an iPad and homework assignments into a backpack, it can take a toll on a young back, experts say.

“Backpacks are much too heavy,” said Dr. Scott Bautch, a chiropractor from Wausau, Wis., who has written extensively on the backpack-back pain connection.

Bautch, a chiropractor for 30 years and past president of the American Chiropractic Association’s Council on Occupational Health, said he thinks the problem has worsened.

“It’s a passion of mine,” he said. Over time, he added, “I saw young kids with more and more back pain.”

Bautch cited research reporting that 7 percent of 14-year-olds experience enough back pain to affect their daily living. But the relationship of backpacks to back pain is difficult to quantify scientifically, partially because so many kids wear backpacks to school.

A 2006 study led by Dr. D.L. Skaggs of the Children’s Orthopaedic Center, Children’s Hospital Los Angeles, looked at more than 1,500 children ages 11-14 in a large metropolitan area. On the basis of a questionnaire, the researchers found 37 percent of the children reported back pain.

But were backpacks a factor? They couldn’t say for sure, the authors wrote, because 97 percent of the children used them. The remaining kids comprised too small of a sample size for a clinically valid comparison. (However, 82 percent of the children who reported back pain said they believed their backpacks were part of the problem, the authors noted.)

What’s well-established, though, is that damage occurs when loads are too heavy. The rule of thumb is that a child should carry no more than 10-15 percent of her body weight in a backpack, Zager and Bautch said. (Bautch advocates for 10 percent before puberty, and 15 percent after.)

“If you think about that, if you’ve got a 50-pound first- or second-grader, that’s a backpack that weighs, at most, 5-7 pounds,” said Zager, a practicing pediatrician since 1982. “If you think of a textbook as weighing 3 pounds, that’s only two textbooks in there.”

Bautch described going to a school to conduct a simple experiment: weighing the backpacks of fourth-graders. The average weight was 32 pounds, he said — just right for a fourth-grader weighing 320 pounds. A lot of the backpacks were in the 70-pound range, Bautch added.

That might surprise a lot of parents.

“The parents often don’t know exactly what’s in the backpack and how much they weigh,” Zager said.

But neither Zager nor Bautch is anti-backpack, per se.

“I think there’s so many options to manage backpacks, so that they’re a reasonable load,” Zager said. “There’s real value to having a backpack. … It can help kids be organized. It can be hard to carry all that stuff around loose.”

So what should parents do?

Here’s some tips from the experts:

Pick the right backpack

Two straps are better than one, Zager said; a backpack with a waist strap is better than one without; multiple compartments are better than a single compartment.

“With single compartments, it’s very easy for things to shift around,” he said.

Parents may have to veto a brightly colored and decorated backpack if it’s not well-designed for utility, Zager said.

“It’s important to really consider the backpack as more than just a vehicle to distribute Spider-Man graphics,” he said.

Straps should be wide and supportive, he added. The waist band should be padded.

Smaller is better.

“Buy a backpack that truly fits your child,” Bautch said. “We want to get the smallest functional backpack possible for a child.”

Kids and backpacks are like men and their garages, Bautch suggested — the bigger they are, the more they get filled.

Wear it correctly

Not only should your child’s backpack have two straps — he should use them both.

But starting at age 10 or 11, it’s common to see kids — and boys, especially — with the one strap, over-the-shoulder look, Zager said.

“If you’ve got to carry a backpack … you’re probably trying to figure out how to look the most casual and the most cool,” he explained.

But no serious backpacker — the sort who backpacks from campsite to campsite on the Superior Hiking Trail, for example — would consider using just one shoulder strap, Zager said.

Nor would a serious backpacker fail to fasten the strap about the waist.

But that might be a hard sell, too.

“I’m sure a waist strap isn’t very fashionable at all,” Zager said.

It matters how the backpack is loaded, Bautch said. The heaviest items should be closest to the person’s back. If the child carries a computer tablet, it should be housed in the compartment designed for it.

A chiropractor can show you and your child how to properly fit, pack and wear a backpack, Bautch said.

Backpack Safety Checklist

Empty it

With the same group of fourth-graders, Bautch had them empty their backpacks on their desks. Lost items were found.

“And all you heard was: I haven’t seen that in two months,” he recalled.

Don’t let that happen, Zager said.

“One of those things that is probably worthwhile is to go through the contents and start pruning things once in a while,” he said. “You don’t need to carry the papers that should have been handed in a month ago.”

Parents should help their children get in the routine of cleaning out their backpacks every day, Bautch suggested.

If your child’s school has lockers, encourage your child to use hers, Zager said. She should just carry what she needs for the next class.

“Sometimes the temptation is to load everything in the backpack that they use for the whole day,” Zager said.

Wheels

Wheeled backpacks can be a good thing in theory, Zager said.

But they are bulkier, and other kids might trip over a wheeled backpack next to someone’s desk. Also, kids with wheeled packs are likely to pack more in them, he said. If the school has stairs, your child will have to carry the pack some of the time.

Besides, wheels just don’t seem to be happening.

“I haven’t seen it catch on in the literature or catch on with schools,” Bautch said.

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