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BACK TO SCHOOL: Backpack Safety

Updated: Mar 16, 2023

Many times when we think about persistent back pain, we usually think of a middle aged or older adult. We overlook the fact that our young children are also suffering from back pain. Due to today’s demands with devices and longer days in school, our youth are experiencing this same back pain much earlier than previous generations. One common cause is the use of overweight backpacks. According to the American Chiropractic Association (ACA) overweight backpacks are leading to early back pain. This information is based on a peer-reviewed journal listed at the end.

Small child in yellow raincoat walking with a blue back pack
Photo credit: Daiga Ellaby

Based on previous experiences, I have noticed an increase in the number of young children who are complaining about back, neck and shoulder pain. In the initial evaluation I ask what type of backpack does your child have? Then I ask these patients is, “Do you carry a backpack to school?’ Almost always the answer is ‘Yes’”.

This back pain trend among young people is not surprising when considering the disproportionate amounts of weight kids are carrying in their backpacks. Surveys show children today carry everything from books, laptops and school supplies to sports/gym uniforms, shoes and water bottles in their backpacks at any given time. To make matters worse children often sling the backpacks over just one shoulder, creating an imbalance.

Multiple studies examining the impact of backpacks on children found that over 70% of children surveyed had a backpack that exceeded the recommended 10% of their body weight (10-20%). Of these children, 32% complained of back pain.

Other studies have shown that the weight of the backpack and school children’s posture showed that head and spinal posture were affected by backpack weight, with heavier backpacks causing a child’s head and spine to bend farther forward. When the head is flexed forward it puts a heavy load on the neck, shoulders, and upper back.

In summary it is recommended that your backpack should adhere to the following:

  • Padded shoulder straps

  • Have adjustable shoulder straps

  • Use both straps

  • Have compartments to keep supplies intact

  • Have a padded back

  • When full it should weigh less than 10% of your child's weight. (Ideally between 10 and 20%)

What Can You Do?

It is recommended using an ergonomically designed backpack. Parents follow the following steps on choosing the proper backpack for your child and wearing it properly:

  • Check the weight of the Backpack: Be sure your child’s backpack is less than 10-20% of their body weight. This prevents pressure on the shoulders and the keeps the head and neck from bending forward.

  • The backpack should never hang more than a fist length or four inches below the belt. Again this prevents leaning forward.

  • Make sure the backpack has adequate pockets to keep supplies.

  • Try to pick an average sized backpack, if oversized there is a tendency to try to overfill it.

  • The backpack should have padded shoulder straps this alleviates pressure on the shoulder complex. Encourage your child to use both straps this keeps them balanced.

  • Make sure the shoulder straps should be adjustable so the backpack can fit to your child’s body. Avoid excessive movement, which could cause improper balancing.

  • At the end of each day empty the contents make sure excessive papers are placed in their folders, and the books that are not needed are not taking up extra weight.

  • Only those students who are not physically able to carry a backpack should use roller packs or backpacks on wheels. This should be done cautiously and on a limited basis. They present their own risks including cluttering hallways, potentially resulting in a trip hazard.

Chiropractic Care Can Help

If you or your child experiences any pain or discomfort resulting from backpack use, it is best to get evaluated immediately. As a doctor of chiropractic, we are trained and licensed to diagnose and treat patients of all ages. In addition, exercises can be designed to help children develop strong muscles, along with instruction in good nutrition and posture.

At IVY Integrative, you can work with one practitioner or build your own team of holistic practitioners! Reach your optimum health in-person or online. Check out our Get Started page to learn how to work with us!


  1. Chen Y-L, Mu Y-C. Effects of backpack load and position on body strains in male schoolchildren while walking. PLoS ONE. 2018;13(3): e0193648.


This information is generalized and intended for educational purposes only. Due to potential individual contraindications, please see your primary care provider before implementing any strategies in these posts.



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