Be Well: Schoolkids, backpacks and pain

Cleveland Clinic Andrew Bang, a chiropractor at the Clinic's wellness institute
Cleveland Clinic Andrew Bang, a chiropractor at the Clinic's wellness institute

RICK: Over the years, we've heard concerns about kids carrying around these backpacks laden with books and other things, and the toll carrying all that weight day after day takes on kids' backs.

SARAH: Right, and I think for parents, it's not a passing concern. It bothers us day in and out. So, my first question was: Has there been any research actually showing that heavy backpacks hurt kids?

RICK: What did you find?

Sarah: Surprisingly, there's not a lot of research on this. As one Cleveland Clinic chiropractor told me, who wants to run experiments on kids, right?

RICK: That makes sense.

SARAH: But, I did find a few studies confirming that heavy backpacks can cause back pain and that I should be a concerned. There was one back in 2006 that surveyed about 1,500 children ages 11 to 14 years old, who for the most part, wore back packs. The study was done in southern California and researchers found that nearly 40 percent of the children in the study reported back pain.

But the study I found to be most interesting was done by Fran Kistner and released this year. The cool thing about this study is it has before-and-after pictures of the kids.

RICK: Like a makeover show?

SARAH: Yes. So, I called so I called the study's lead author Fran Kistner, who is an assistant professor of MCPHS University, formerly known as Massachusetts College of Pharmacy and Health Services. Not surprisingly, she's a parent.

"So this all started in 2003, watching my own second grader go off to school and coming home with this back pack that was just, it blew me out of the water how heavy it was," Kistner says.

SARAH: That sight of seeing her son lugging around a heavy load was enough to send Kistner on a decade-long mission. She was in graduate school at the time and began asking other parents in her neighborhood, at the playground and eventually handing out flyers to recruit kids to a study.

And she says she did this because, like me, she was surprised at the lack of enough objective information to satisfy her worries. When she talks, she sounds like any frustrated parent…

"There's nothing out there to protect children… Your pediatrician will say well that's too heavy. Your chiropractor will say that's too heavy, you really should lighten it up. Until there is enough objective data, nobody is going to respond to it and say, yeah, we really do need to set limits," Kistner says.

SARAH: Eventually, she recruited 62 grade-school children - 41 girls and 21 boys. And she took pictures to measure trunk and pelvic tilt angles after the kids walked for six minutes in a backpack that weighed 10 -15-OR 20 percent of their body weight.

RICK: Why six minutes?

SARAH: That was the amount of time she found it took most kids to walk from their bus to their lockers or school rooms each day. And the pictures are striking. A boy is standing there straight and tall with nothing on.

Then, there's the initial load backpack picture taken before the walk and the boy's head juts out a bit and he's tilting forward. Finally, after the walk, the boy is hunched over with his head sticking forward even more and shoulders slumped.

Kistner said that these are scary findings.

"The amount that these children move their head forward at 10-15-20 percent of their body weight in backpacks is similar and comparable to what they've seen in adults with chronic headache issues and problems with that," Kistner says.

RICK: So, the use of heavy backpacks on daily basis can lead to not just lifelong back pain but other problems?

SARAH: Kistner believes so and she's not alone. As I mentioned, I also spoke with Cleveland Clinic chiropractor Andrew Bang. He says he's very worried about repetitive stress syndrome.

"When a child wears his backpack for five minutes running from the bus back into the house, that's really not going to do any damage to their low back or their neck and that's same thing with a factory worker, the first time they are doing their specific line job, that's not where the injury happens. It's where they continue to do that day after day or year after year," Bang says.

RICK: So what is a parent to do? They have to have backpacks for school, right?

SARAH: Bang and Kistner both said that kids should not wear a backpack that weighs more than 10 or 20 percent of their body weight. And that recommendation matches one put out by the American Academy of Pediatrics.

RICK: So, wait, a parent is supposed to weigh the kids backpack every day?

SARAH: Well, that's what Kistner said she did with her kids. Now, I'm not sure I can do that. The mornings so far this school year have been a bit rushed. But Kistner did make another suggestion that might be more reasonable for those who can afford it. She said to buy two sets of books - one for home and one to leave at school.

And Bang suggested those backpacks on wheels.

RICK: And what about you? What are you going to do?

SARAH: I'm ordering a padded backpack, like the one recommended by the American Academy of Pediatrics and I might have to reconsider the stainless steel lunch containers that I have.

RICK: Thanks, Sarah.

Support Provided By