Heavy backpacks go hand-in-hand with the return of the school year, and parents need to know how to help their children avoid the pain. While there are no studies showing that carrying a heavy backpack causes structural deformity to the back, kids with chronic back pain are predisposed to becoming adults with chronic back pain.

Warning signs that a backpack is too heavy

The National Safety Council, founded in 1913 by Congress to build awareness, training and share best practices on safety issues, has developed the following warning signs that a backpack is too heavy:

  • Change in posture when wearing a backpack.
  • Struggling when putting on or taking off the backpack.
  • Tingling or numbness.
  • Red marks.

A child’s backpack should not weigh more than 10 to 20 percent of the child’s body weight, according to a 2016 report by the American Academy of Pediatrics (AAP). Younger children and girls seem more susceptible to backpack-related pain, so parents may want lean more towards 10 percent.

Children should also use lockers, if that option is available. Parents can also talk to their child’s teacher and ask how they can help lighten the workload.

Preventing back pain

The AAP provides the following tips to prevent back pain and injury from backpacks:

  • 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.
  • Tighten the straps so that the pack is close to the body. The straps should hold the pack two inches above the waist.
  • Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back.
  • 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.

Back pain among children and adolescents is very common, but if lightening the load and back exercises are not working, it may be time to see an orthopaedic specialist.


Matthew Oetgen Matthew Oetgen, MD, is the Division Chief of Orthopaedic Surgery and Sports Medicine at Children’s National. He primarily works at the main hospital along with the Laurel and Montgomery County Outpatient Centers and specializes in many topics, including achondroplasia, bowlegs and broken bones.

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