Tuesday, September 17, 2002

Kids can cope with backpack attack

By Peggy O'Farrell pofarrell@enquirer.com
The Cincinnati Enquirer

        Here's a news flash: Yes, backpacks do cause injuries. But 41 percent of those injuries occur when someone either falls over a backpack or gets hit by it, says a Cincinnati expert.

        Dr. Eric Wall, a pediatric orthopedic surgeon and director of the sports medicine program at Cincinnati Children's Hospital Medical Center, analyzed data from the U.S. Consumer Product Safety Commission to find out just how dangerous backpacks really are.

  Place heaviest items first. The closer they are to the back, the less they will pull on those muscles.
  •Put smaller, lighter objects at the outside.
  • Put pens and pencils in interior pouches.
  • Lunch always on the top, please.
  • Packed, the weight should not exceed 15-20 percent of the user's total body weight.
  • Unpack and clean out at least once a week. OK, once a month.
- Enquirer news services
        Parents - used to reminding kids to stop leaving the backpacks in the middle of the floor - won't be surprised to find out that 28 percent of the more than 12,000 backpack-related injuries reported in 1999 and 2000 occurred when someone tripped over a backpack. Another 13 percent occurred when someone was hit by a backpack.

        The actual percent of injuries caused by carrying or lifting a backpack was also 13 percent.

        Statistically, Dr. Wall says, the moral of the story is: “The floor is no place to put a backpack.”

        But carrying a heavy backpack can make your child's back hurt, experts say. Carrying a load that's too heavy can strain muscles and nerves in the back, neck and shoulders. No studies have shown carrying a backpack can cause permanent damage to the back or spine.

        “We don't see a lot of serious injuries from carrying backpacks,” Dr. Wall says.

        Treating kids

        Dr. Mark Goddard, who chairs the physical medicine and rehabilitation department at the University of Cincinnati, says children and teens sometimes need physical therapy and medication - usually anti-inflammatory medications such as ibuprofen - because of back and shoulder strains caused by backpacks. Sometimes patients need to be educated on the right way to lift and carry a backpack to prevent further injuries.

    Concern is growing that heavy backpacks are causing back injuries and developmental difficulties in children:
  • The American Occupational Therapy Association considers it enough of a problem that members are conducting backpack weigh-ins and teaching backpack safety in public schools across the country on Sept. 25.
  • In 1999, there were 6,174 backpack-related injuries, according to the most recent data available from the U.S. Consumer Product Safety Commission. More than half of those injuries 56 percent were in children 5 to 14 years old; 2,057 were strains or sprains.
  • The American Academy of Pediatrics says a backpack should never weigh more than 10 percent to 20 percent of a student's body weight.
  - USA Today
        His suggestions:

        • Check the backpack's weight. Most experts recommend the backpack weigh from 10 to 20 percent of the youngster's total body weight. So if your eighth-grader weighs 100 pounds, his backpack shouldn't weigh more than 20 pounds. This is especially important with younger children.

        • Check the backpack's position. The backpack should be worn on both shoulders, not slung over one. Putting all the weight on one shoulder throws off posture and can strain muscles and nerves.

        • Check the straps. They should be pulled tight enough to keep the load close to the student's body, not hanging loosely so the load is carried by the lower back.

        • Buy the right kind of backpack. Look for one with several compartments so weight can be distributed evenly and choose a backpack with padded or cushioned straps to cut down on pressure to muscles and nerves in the shoulders.

        • Lift the pack correctly when putting it on: Use both arms and bend from the knees to avoid straining the arms, shoulders and back.

        • Check the contents. If the backpack is too heavy, get rid of unnecessary objects. (We'll let you and your kids decide what's “unnecessary.” We suggest you start by tossing all the uneaten lunches and negotiate from there.)

        “Parents don't realize how much stuff can accumulate in a backpack. It adds up, too,” says Dr. Goddard.

        Dr. Goddard and Dr. Wall each pointed out that studies conducted by the military show that backpacks are the most efficient way for humans to carry heavier loads, provided the backpack is properly loaded and worn.

        Two-shoulder approach

        Emily Berger, an eighth-grader at St. James School in White Oak, is ahead of the game when it comes to following doctors' orders for backpacks. The 13-year-old carries her backpack on both shoulders, instead of letting it hang on just one.

        “It's too heavy for one shoulder,” she says.

        And the Bergers have a firm backpack storage policy in place at their White Oak home: Backpacks get tucked away under a desk in the kitchen, not in stairways or in the middle of the living room floor, says Emily's mom, Ann Berger.

        “I don't like them on the floor. If I see them on the floor, I put them up on a chair or under the desk,” Mrs. Berger says.

        Emily's not perfect, though: She lifts her backpack with only one arm, which can put too much strain on the arm and shoulder, experts say. Using two arms to lift a backpack is less likely to cause injury.

        Victor Moore, a freshman at Princeton High School, gets slightly higher marks in Backpacks 101: Not only does the 14-year-old wear the backpack on both shoulders, he lifts it with both arms. But he doesn't bend his knees when he picks up his backpack.

        Victor usually stows his backpack in the living room, but he tries to make sure it's out of the way, says his mother, Gina Moore.

        The weight of their backpacks varies from day to day, depending on class schedule and homework. Emily's backpack weighed 26 pounds when she was interviewed. Victor's weighed in at 20 pounds.

        Research reports

        There's some disagreement over just how painful those heavy backpacks can be.

        Researchers in Italy followed 237 sixth-graders whose backpacks weighed, on average, from 19 to 21 pounds. Forty-six percent of the children felt carrying their backpacks caused back pain, and 66 percent felt fatigued by carrying them. Children who felt more fatigued by carrying them and who carried them for longer periods of time were more likely to report back pain.

        A study completed in July in Delaware followed 1,126 teens 12 to 18, and 75 percent of the students reported feeling varying levels of back pain. Factors that made pain worse included carrying a backpack that exceeded 15 percent of the student's weight, using a backpack between classes and climbing stairs while wearing the backpack.

        But Dr. Wall just completed a survey of 350 students who came to Cincinnati Children's complaining of back pain. In that survey, one student said the backpack caused his back pain, and two said their backpacks made their pain worse.

        “They listed more things like sports, standing, sitting, as causing pain way ahead of backpacks,” he says.“Parents don't realize how much stuff can accumulate in a backpack. It adds up, too.”

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