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Guest column: Lightening the load
by Dr. L. Anita Cone-Sullivan
Guest Columnist
August 29, 2013 02:42 PM | 5757 views | 0 0 comments | 104 104 recommendations | email to a friend | print
Dr. L. Anita Cone-Sullivan
Dr. L. Anita Cone-Sullivan
For many, back pain is an unavoidable part of everyday life. Given the generally sedentary lifestyles of adults in society today, this is no surprise.

Many things can contribute to aches and pains in the back, including spending the day sitting at a desk and general lack of exercise. But could this problem be starting earlier than we realize? In recent years, more and more doctors are seeing back problems starting at a young age. Possible contributing factors are backpacks and the way they are used. They seem to be getting larger every year.

When a backpack is properly worn and of a reasonable weight, it is not a problem. All too often, though, these are not the bags we see children wearing every day to and from school. What we do see are bags spilling over with textbooks and binders — often with the straps too loose — leaving the heavy weight dangling down past the lower back. Given that an estimated 40 million children carry their school materials in backpacks, the habit of overloading and improperly using backpacks is a real problem. In fact, of those 40 million children who use backpacks, about 23 percent of elementary school children and about 33 percent of middle school children were found to already exhibit back problems.

So how do you protect your children from becoming part of these percentages? The first thing to keep in mind is weight. One of the main issues with carrying heavy loads on the shoulders and back is the effect it has on the lumbar spine. Studies have found that increased backpack loads significantly compress lumbar discs and increase disk asymmetry. In other words, the heavy loads are changing the shape and curvature of the lumbar disk.

The same study found that this change was highly linked to an increase in back pain. With that in mind, a healthy backpack weight for all individuals, including children, is between 10 and 15 percent of that individual’s body weight. If your child is already experiencing back pain, you should consider keeping their load lower than the recommended weight.

One of the best ways to cut down on backpack weight is to encourage children to leave books at school. Most of those in middle and high school will have access to lockers, which can be a huge help in lightening the daily load to and from school. While overweight backpacks are less of a problem for elementary school children, parents should still be aware of their younger children’s backpack load and any possible signs of injury.

Another important factor in backpack safety is proper use. Most children, especially as they get older, do not wear their backpacks properly. When combined with an overweight load inside the backpack, this can lead to serious problems. Some of the most common misuses of the backpack structure involve the straps. Wearing the straps extremely loose puts more pressure on the lower back and causes an over-arching posture, which usually comes with an unnatural hunch to overcompensate and balance the load.

Using only one strap is also not recommended. This prevents the even distribution of the load’s weight across the back. Not only can this lead to overuse of the joints, tendons and muscles in the one shoulder, but when done regularly, it can lead to unhealthy posture and more serious back problems long-term.

Finally, one of the easiest ways to lower your child’s risk of sustaining these back injuries is by making sure their backpack has an abdominal support strap (the band which fastens around the waist right above the hips in the abdominal region) and that it gets used regularly. Studies have found that utilizing this strap can significantly decrease the forward-leaning postural changes which often accompany a heavy backpack load.

Dr. L. Anita Cone-Sullivan, is a board-certified physician with Resurgens Orthopaedics and has been practicing medicine for 18 years. She practices at Resurgens’ offices in Sandy Springs and Midtown. Reach her at

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