September 08, 2008|By Holly Selby | Holly Selby,Special to The Baltimore Sun
Have you ever wondered what your child is carrying in his or her backpack? Textbooks, notebooks, pens. Perhaps gym clothes. A library book or two. Oh, and don't forget lunch. With all this - and who knows what else? - in their backpacks, is it any wonder that youths may be at risk for back pain?
Indeed, overstuffed backpacks can cause aching muscles and strained backs, long the province of the over-the-hill set, in youths, says Chris Wood, a physical therapist with Good Samaritan Hospital's Back School. But there are some simple steps that, if taken, can help prevent injury.
What kinds of injuries may be caused by overly heavy backpacks?
As the school year goes on, we do see an increase in adolescents with low or middle back pain, or neck pain - sometimes with tingling in the arms or neck. And, more often than not, these symptoms go untreated, which can allow [the injury] to get worse and possibly to become chronic.
When do doctors and physical therapists typically get consulted about these kinds of injuries?
This type of injury is not immediate. The children start back to school at the end of August, and the change in activities coupled with a poorly fitting backpack with too much in it slowly start to strain the back. In a few months, we start to see the increased symptoms.
Backpacks are certainly more fashionable than they were a decade ago; are you seeing a commensurate rise in injuries?
Yes, and there are several reasons for this. Many children are underconditioned these days. They have less time [during the school day] to go to their lockers and so they carry all the books they need all day long. And then, fashion plays a role: I often see kids going to school with double-strapped backpacks slung over one shoulder because they don't want to look uncool.
It used to be a high school issue, and now we see it in elementary and middle and high school.
What do you recommend to avoid these injuries?
The [filled] backpack should weigh no more than 15 percent of the student's body weight - so if the child weighs 100 pounds, the backpack should weigh no more than 15 pounds. Frequently we see backpacks that weigh in excess of twice that much.
How should it fit?
If it is a double-strapped backpack, it should be placed evenly over both shoulders. If the child doesn't like that style, use a sling-back backpack, which has one strap that you place over the top of your head.
And the shoulder straps should be snug but not really tight. Excessively tight straps can actually cut into the shoulders and interfere with circulation and nerves that pass from the neck and arms, which can cause these symptoms.
Also, the lighter the fabric, the more you can tolerate additional weight in the backpack.
If your child complains of back pain, how should you treat it?
Anytime you have an injury or pain, you should ice it for approximately 15 minutes several times a day for the first 24 or 48 hours.
After that, you can start applying heat, using the same time frames to relax the area. But the most important thing is to correct the source of the symptoms in the first place. Otherwise, the injury will just come back.
When should a youth with aches and pains consult a doctor?
If [the aches and pains] are acute or don't resolve with short-term rest, they should see their pediatrician.
Can these symptoms lead to other injuries?
Yes, they can become chronic problems especially in developing children. They can create chronic spine and shoulder issues.
When a patient comes to you with these symptoms, what do you recommend?
If [the pain] doesn't fade out in a day or two, it is a good idea to call your pediatrician because he or she will evaluate the condition and decide whether they should refer you to a physical therapist. We get involved in the exercise component as well as posture and body mechanics training (helping the youth to learn to lift, turn, carry, push and pull correctly).
What muscles are involved in these injuries?
These injuries spring from [lack of] abdominal strength and trunk stability. ... So in addition to the backpack, it is a fitness issue: The stronger and better condition [the children] are in, the less likely it is to be a problem.
