Back-to-School Safety: Unpacking the Pain of Backpacks

August 7, 2009

Wearing a backpack incorrectly or carrying too much weight can cause injuries to muscles and joints and lead to neck pain, back pain, shoulder pain and posture problems in children.  The following guidelines are recommended when selecting and wearing a backpack.


  • Wide, padded shoulder straps — Narrow straps can dig into shoulders, which can cause pain and restrict circulation.
  • Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles. Wearing a backpack on one shoulder may increase curvature of the spine.
  • Two shoulder straps — One shoulder strap cannot distribute weight evenly.
  • Padded back — Protects against sharp edges on objects inside the pack and increases comfort.
  • Waist strap — A waist strap can distribute the weight of a heavy load more evenly.
  • Lightweight backpack — The backpack itself should not add much weight to the load.
  • Rolling backpack — A good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried up stairs and may be difficult to roll in snow.
  • Fit-Pack should rest on back, not extending above shoulders when resting about 2 inches above waist.


  • Tighten the straps so that the pack is close to the body. The straps should hold the pack two inches above the waist while allowing arms to move freely.
  • Pack light. The backpack should never weigh more than 15 percent of the child’s total body weight.
  • Organize the backpack to use all of its compartments. Pack heavier items closest to the back.
  • Stop often at school lockers, if possible. Do not carry all of the books needed for the day.
  • Bend using both knees, when you bend down. Do not bend over at the waist when wearing or lifting a heavy backpack.
  • Learn back-strengthening exercises to build up the muscles used to carry a backpack.

Parents also can help in the following ways:

  • Encourage your child or teenager to tell you about pain or discomfort that may be caused by a heavy backpack. Do not ignore any back pain in a child or teenager. Ask your pediatrician for advice.
  • Talk to the school about lightening the load.
  • Consider buying a second set of textbooks for your student to keep at home.

These guidelines were developed from recommendations from the American Academy of Pediatrics and the American Physical Therapy Association.