By Kelsie McGladrey, DPT

With summer dwindling down and school just around the corner, it’s time to start thinking about school supplies. One of the key supplies that your child uses is a backpack! While your child may find it most important to get the sparkly one or the one with a superhero pattern, it is most important that you find one that properly fits your child.

Proper backpack fit is essential to allow your child to carry their supplies without negative effects on their musculoskeletal system (their muscles and bones). Young people are constantly growing and developing their muscles and a poor-fitting backpack can have adverse effects on proper orthopedic and musculoskeletal development and alignment, ultimately causing pain and dysfunction. A proper fitting backpack includes:

• Matching the child’s size. It should not extend past the child’s low back with the bottom resting in the contour of the low back.
• Two straps for even weight distribution and prevent of trunk side bending or shoulder elevation.
• Ability to put it on and take it off without difficulty- a backpack that is too tight can restrict lung function
• Free movement of the arms

Along with fitting the backpack, it is important to monitor the load your child is carrying. The American Physical Therapy Association (APTA) recommends limiting your child to 10-15% of their body weight. This means if your child weighs 75 pounds, they should be carrying no more than 7.5—11.25 pounds in their backpack. Higher loads than this can cause an increase in a forward trunk lean with added stress to your child’s joints and muscles, especially in the spine. In 2009, the an APTA published a study by Goodgold which reported 55% of the children carried above the 15% recommended load, resulting in 1/3 of the children from the study experiencing back pain causing a doctor visit, missed school, or abstaining from physical activity. The APTA recommends only carrying materials needed for that day and placing the heaviest items closest to the back. In some cases, families have used two sets of book (at school and at home) to prevent overloading the backpack. When determining the weight allotted the distance your child is walking should also be considered. If the child has a significant walk to and from school the load should be lowered.

Some families like to consider wheeled backpacks. These backpacks eliminate the major loading component of carrying a backpack but still need to be properly fitted. If considering a wheeled backpack please consider the following:

• Does your child have to navigate stairs? Will he or she be able to get up and down the stairs with backpack?
• Will the backpack fit in your child’s his locker or storage cubby?
• How heavy is the backpack when empty? Will they be able to pull it once filled? Can they lift it over curbs, steps, in/out of cubby, up/down stairs, etc.?

If your family decides to purchase a wheeled backpack it is recommended:

• Fitting the backpack with large wheels to prevent shaking or toppling over
• Fitting the arm extension to avoid twisting or bending of your child’s trunk while pulling it

If you are unsure of the fit of your child’s backpack monitor them for complaints of back pain or tingling in their arms. Also check their shoulders for red marks. In addition, your physical therapist can assist in fitting a backpack to your child.

If your child experiences back pain, your physical therapist can work with you and your child to address the pain by improving their posture and muscle imbalances and working to prevent further injury.

Resources-
Is your Child’s Backpack Making the Grade; APTA- consumer interest, Alexandria, VA March 2011