Backpacks and good posture making the right choices

Backpacks and good posture –

making the right choices

By Erryn Green, Motheo Moroane & Dr Jonathan Davy

As your child goes to school every day, it is crucial to ensure they remain safe and healthy, and that includes ensuring that they have the right schoolbag and that they use them correctly. It is this interaction, between children and their schoolbags, that parents, caregivers, and teachers need to be mindful of to ensure the safety of the children.

During childhood and adolescence, the musculoskeletal system is growing and developing rapidly and is therefore more susceptible to musculoskeletal imbalances, poor posture, or injury. A common contributing factor of

poor posture and musculoskeletal strain in children is their schoolbags, specifically how these are worn and what they are used to carry. A mismatch between children and their schoolbag can contribute to a multitude of health issues (such as back, shoulder and neck pain) as it puts extra stress on joints and muscles.

Over and above this, bags worn inappropriately or that are too heavy will result in postures that may also affect the position and function of abdominal organs, negatively affect breathing and oxygen intake which may cause headaches and may affect mood. Carrying a heavy load distributed unevenly or improperly can over time also cause strain to the spinal column and the supporting musculature of a growing child, which presents potential risks for developing a musculoskeletal injury.

These injuries are associated with pain and disruptions to every-day school life and activities. Many students experience back pain quite early in life, partially due to the heavy load in, or the misuse of schoolbags. Girls, shorter and younger children, particularly for fifth and sixth grade, may be especially at risk of injury because they carry loads that are heavier in proportion to their body weight. These risks can be minimised by making the right choices regarding the type of schoolbag, what it is used to carry and most importantly, how it is used.

Best schoolbag is a backpack with two straps

The best style of a schoolbag to use is a backpack with two straps. A backpack with two straps will ensure that the load is distributed and carried evenly. The equal weight distribution will ensure that learners do not experience arm or shoulder muscle strain from the backpack digging into the shoulder, provided that the mass of the bag is not excessive. Two-strap backpacks will ensure that the backpacks are carried and supported by the strongest muscles in the body which are the back and core muscles.

Other important features include:

• wide shoulder straps to limit pressure points on the shoulders; • adjustable straps to ensure that the load is as close to the back as possible; • hip straps to assist in the distribution of weight; • padding on the shoulder straps and back area for added comfort; and • compartments that can be used to distribute the mass as evenly as possible.

It is important to use both shoulder straps, instead of ‘lugging’ the backpack over one shoulder because of how this can cause postural imbalances (known as “drop shoulder”), misalignment of the spine and the rest of the musculoskeletal system. The backpack should not sway from side to side during walking. If it does, the straps are too loose. The heaviest items should be placed closest to the back to reduce pressure on the shoulders and none of the contents should move around excessively while walking.

Position of the backpack is important

The best positioning of the backpack is driven by personal preferences, so users should choose the best position of the backpack for themselves, according to what is comfortable and what causes the least amount of discomfort. However, researchers do suggest that carrying a backpack in a higher position on the back may be more advantageous than carrying it in a lower position for many reasons, including:

1. Backpacks placed higher up on the back are less demanding on the physiological systems. 2. The perceived effort of load carriage is lower with this higher positioning. . High positioning of the backpack places less pressure on the shoulders, which helps to relieve shoulder pain. Lastly, this higher position is also associated with greater stability as compared with a pack positioned lower.

Consider the weight of the backpack

With regard to the mass recommendations for the backpack, the general consensus is that the mass of any bag should not exceed 10% (but some students may carry up to 15%) of the child's body mass to prevent muscle fatigue and poor posture.

However, this recommended mass is dependent on other factors too, including the design, backpack mass, how it is worn, and the children’s age and physical fitness.

Consider how long the backpack is carried

The duration spent carrying the load is also important to consider. Carrying a backpack for long durations creates compression forces acting on the spine which may cause discomfort. It is recommended that children take breaks as often as possible. If heavy loads need to be carried, parents could consider using double pack bags (wearing a load on the back and front of the body) instead of traditional backpacks because of how it benefits many aspects such as postural stability, metabolic cost, and muscle activity.

However, if children are required to carry excessive loads to school daily, it is important to have a conversation with the schoolteachers to find a way to limit this (such as leaving sports equipment at school for example).

Consider what needs to go in the backpack

Parents and teachers both have a role to play in how children wear their backpacks and the weight within. Teachers can influence the children when it comes to what material needs to be brought home daily. They should be sensitised to the changes of posture created by poor backpack use, so they understand the importance of proper use.

When they are planning their weekly curriculum, they could do so according to the textbooks that the children will need on a specific day and be mindful of what goes in the children’s backpack. Parents and learners need to also learn how to make good choices when packing their backpacks, including choosing to carry only things that are necessary and not everything they might want to take to school.

Backpacks are a popular and practical way for children and teenagers to carry schoolbooks and supplies. They are designed to distribute the weight of the load among some of the body's strongest muscles. When used correctly, backpacks can be an excellent way to carry the necessities of the school day. However, it is evident that backpacks have an influence on pain and injury in children, which is caused by many interacting factors such as design, time worn, and physical fitness of the child. It is very important that the individual needs of each child determine the approach that is taken. 

References Backpack Safety - Preventing Injury - OrthoInfo - AAOS. https://orthoinfo.aaos.org/en/ staying-healthy/backpack-safety. Harvard Health Publishing. Posture and Back Health. Retrieved October 2022 from https:// www.health.harvard.edu/pain/posture-and-back-health Hossain, F.M.A., & Tonima, M.A. (2017). A study on the effects of heavy backpacks and the development of a preventative prototype. Journal of Sensors, 2017. https://doi. org/10.1155/2017/9419373. Janakiraman, B., Ravichandran, H., Demeke, S., & Fasika, S. (2017). Reported influences of backpack loads on postural deviation among school children: A systematic review. J Educ Health Promot, 6:41. doi: 10.4103/jehp.jehp_26_15. PMID: 28584840; PMCID: PMC5441201. Lavigne, V. (2014). Weight limit recommendation in backpack use for school-aged children. Journal of Clinical Chiropractic Pediatrics, 14(2). Lee, J.C.N., Li, S.S.W., & Chow, D.H.K. (2021). School backpack design: A systematic review and a summary of design items. International Journal of Industrial Ergonomics, 84. ISSN 0169-8141.