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Guidelines may help prevent backpack injury in children

April 21, 2003

Concerned with the destructive impact the improper use of backpacks has on the spinal health of the state's children, Maryland Gov. Robert L. Ehrlich Jr. has proclaimed April Backpack Safety Awareness Month.

Back pain is pervasive among American adults, but chiropractors with the Maryland Chiropractic Association have become increasingly concerned with a trend emerging among the state's youth. Young children are suffering from back pain much earlier than previous generations, and chiropractors say the use of overweight backpacks is a contributing factor.

The problem is becoming an epidemic with 55 percent of U.S. students carrying more than the recommended national guidelines of 10 percent to 15 percent of body weight. A child weighing 80 pounds should carry no more than 12 pounds.

The American Academy of Orthopedics states that backpack injury is a significant problem for children, with 58 percent of its members having seen patients complaining of back pain related to backpack use.

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The Maryland Chiropractic Association provides the following recommendations to prevent backpack injury:

  • Wear a backpack properly.

  • Distribute the weight properly. Put the heavier items on the bottom and against the back to keep the weight off of your shoulders and maintain a better posture.

  • Wear both shoulder straps unless the pack is designed for use on one shoulder. Carrying a heavy backpack using one strap can shift the weight to one side, which can lead to neck and muscles spasms, low back pain and walking improperly.

  • Choose a backpack with a lumbar support. The lumbar cushion will redistribute weight to the lower extremities, creating a fulcrum that facilitates an upright standing position and good posture that is essential for proper spinal health.

  • Use an ergonomic backpack. Shift the weight off the shoulders, neck and upper back to the lower back. That will prevent injury and is more comfortable.


Lift a backpack correctly.

  • Face the backpack before you lift it.

  • Bend at the knees and lift your legs, not with your back.

  • Keep the pack close to the body.

  • Carry only what you need. Every extra item adds weight.



Founded in 1928, the Maryland Chiropractic Association is a nonprofit professional association dedicated to the advancement of chiropractic health care.

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