Beth Israsel Deaconess Hospital - Plymouth


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Web Q&A: Lightening the Backpack Load

A Forward Lean Means Put Less in the Back Pack

Ian Paskowski, DC, Medical Director
Beth Israel Deaconess - Plymouth Spine Care Program

With children trudging off to school soon, leaders in the spine care field have a few pointers for a child’s posture that boil down to this: take a load off your back. The heavy hitters in the field, The American Physical Therapy Association, American Academy of Orthopedic Surgeons, and the American Chiropractic Association, all recommend reducing the weight students pack with the goal of reducing and preventing back pain.

Beth Israel Deaconess - Plymouth Spine Care Program Medical Director Dr. Ian Paskowski provides some advice on why we should lighten students’ daily loads.

Q: This can’t be that serious an issue for our youth, can it?

People tend to think that young people are strong and flexible and able to carry heavy weights. Yet a recent article in the Journal of Pediatric Orthopedics noted that 41% of adolescent students identified back pain or neck pain specifically associated with the use of their back packs. The further they carry these packs, the more back pain was present.

Q: How can I tell if this is an issue for my child?

It’s  really pretty simple. A basic indicator is the forward lean. Does your child lean forward when carrying a pack? This stature compensates for too much weight. Even without the lean, take a moment to ask your child if he/she feels back or neck pain when wearing the pack. Ask how often and far your child carries the pack. Is it just to and from school or during the school day between classes as well?

A child’s pack should weigh no more than 10-15% of his/her body weight. So a 100 lb. child should have a pack of 10 to15 lbs. Consider also, how far your child carries the weight and his/her physical fitness.

Q: Any tips for reducing the weight of a pack?

The pack itself should be light and have two, wide padded shoulder straps. Avoid sling packs with just one strap. And a padded back provides more support. Separate compartments inside help distribute weight. If you limit the overall size of the pack it is less likely to get overloaded. A large pack seems to beg for more stuff to be put inside. For smaller children, consider having them pull a pack with wheels. It is a good idea to clean out the pack once a week to reduce unnecessary items.

Talk to your child and your child’s teacher about this issue if you see too much weight being required. Share that research shows back pain can start at a very young age and become progressively worse if unaddressed. If back pain continues for your child, talk to your pediatrician.

The most common indicators for adult back pain are also true for adolescents: smoking, obesity, sedentary life style – such as extended periods of TV watching, video game and computer use – and poor general health. Remaining active and building flexibility and strength are important for all of us and especially critical for children as they grow. Taking healthy steps will help prevent back pain from developing.

For help evaluating and treating back pain, contact Beth Israel Deaconess - Plymouth’s Spine Care Program by calling (508) 830-6991 or visit



Q: What steps can I take to improve the situation?

275 Sandwich Street
Plymouth, MA 02360
(508) 746-2000

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