Is your child at risk of backpack pain? Prevention is easy as 1, 2, 3 when you follow these guidelines.

by Elizabeth Bonorden, OTR/L | Virginia Gay Hospital Therapy Services

It’s that time of year again. The school tours have been done, home rooms have been assigned, meet the teacher night is around the corner, and the school supply lists will soon be sent. One of the most important hot ticket items, along with pastel and glitter gel pens and colorful trapper keepers is the backpack that will carry it all. As practical (and as fashionable) as backpacks are, they often become too heavy and used incorrectly, an unfortunate result of the mad dash that is the school year.

Fast Facts:

In one study with student’s ranging in age from 11 to 15 years, 64% reported back pain related to heavy backpacks and twenty one percent reported the pain lasting more than 6 months1. What is worse is that more than 2,000 backpack-related injuries were treated at hospital emergency rooms, doctor’s offices, and clinics in 20072, most of which could have been prevented with education on proper backpack wear and use.

Easy as 1, 2, 3!

The first step to prevention of backpack pain is choosing the backpack that is the best fit for your child. When selecting the backpack, make sure the height of the backpack extends from approximately 2 inches below the shoulder blades to waist level or slightly above the waist. Shoulder straps should be well padded and adjusted to ensure the proper fit for your child. Always wear both shoulder straps to avoid unnecessary strain to one side of the body.

The next step is proper loading of the backpack. The key is to distribute weight evenly with the heaviest items closest to the child’s back and lighter items placed further away from the child’s back. Loose light items such as pens, pencils, water bottles should be placed in pockets and distributed evenly.

Once the backpack is packed, it should weigh no more than 10% of your child’s body weight. If the backpack is too heavy, lighten the load and determine if certain supplies can stay at home. If it is still too heavy, consider use of a wheeled book bag.

For more information on backpack awareness, including a demonstration of proper pack loading and selection of backpack, be sure to check out the VGH facebook page where we will be posting videos soon as part of our back to school video series! You can find additional information on Virginia Gay Hospital and the Therapy Services department at



  1. UC Newsroom, University of California. (2004, August 26). Back to school; heavy packs endanger kids’ health, study shows [Press Release]. Retrieved May 14, 2009 from
  2. S. Consumer Product Safety Commission National Electronic Inquiry Surveillance System (NEISS) Database (2007).