By Drs. Sally Robinson and Keith Bly

Backpacks are great to help kids to carry items back and forth from school to home, but you should know that backpacks weighing more than 15 percent of your child's weight may cause health problems. Neck, shoulder and back pain may develop from carrying a heavy backpack every day.

The spine is made of 33 bones called vertebrae that have disks in between them that act as natural shock absorbers. A child carrying an unusually heavy backpack leans his head and chest forward to compensate for the weight on her back, which puts stress on the back and neck. If your child uses only one strap to carry her backpack, the spine's natural shock absorption ability is reduced because only one side is carrying the weight, and she will end up leaning to one side to make up for the imbalance.

Backpacks, if used properly, can be very useful for children. When choosing a backpack check to make sure that it has two wide, padded straps that fit over your child's shoulders; a padded waist or chest belt that will distribute weight more evenly across the body and multiple compartments to distribute weight. Also ensure that the backpack is no wider than your child's chest.

Backpacks that have metal frames, such as those used by hikers, are better for your child's back, but may not fit into lockers at school. Backpacks on wheels are also better for your child's back, but many schools do not allow them, as other children may trip over them in hallways. Check with your child's school to see what their policy is for these types of packs.

Here are some tips to help prevent backpack-related injuries:


· Make sure that the backpack is the appropriate size.

· Teach your child to pick up and put on the backpack correctly. Your child should face the backpack, bend at the knees, grab the pack with both hands to lift it and put one strap on at a time.

· Encourage your child to use his locker frequently during the day instead of carrying all of his books at once.

· Tell your child to avoid carrying unnecessary items in her backpack. If your child must carry heavy items, such as sporting equipment, the heavier items should be placed in the back of the pack, closer to the body.

· Help your child with homework planning. If you notice that he is putting off assignments until the weekend, help him manage homework time during the week to avoid having a heavier pack on Fridays and Mondays.

• Put sharp objects, such as scissors, that can poke through the backpack in protective containers. 

If your child experiences back, shoulder or neck pain, struggles to get her backpack on or off, leans forward when carrying her pack, or has numbness or weakness in her arms or legs, contact your pediatrician.
Dr. Sally Robinson is a pediatrician in the division of children's special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email