As children return to school to complete the academic year, parents should consider the backpack guidelines established by the American Academy of Orthopedic Surgeons and the American Physical Therapy Association. Although the use of backpacks has not yet been directly linked to particular back issues, excessive stress placed on the back can lead to chronic issues over time, especially when that stress occurs during a child’s formative years. The following guidelines may help parents to ensure that his or her backpack is safe:

• If a child’s posture changes (for example – leaning forward, backward, or to the side) after putting on his or her backpack, the backpack is likely too heavy or not properly fitted.
• Choose a backpack with padded shoulder straps and back.
• Choose a backpack with a waist belt in order to distribute the weight more evenly.
• Choose a backpack with two straps, and wear both straps at all times. Do not wear a one-shouldered backpack.
• Adjust the shoulder straps so that the bulk of the backpack sits in the center of the back. Backpacks worn too high or too low can cause additional stress.
• Encourage children to carry only what they need. Decide which items may be left at home or at school. Suggest that the child make multiple trips to his or her locker during the day rather than carrying all of the day’s materials at once.
• Children and adolescents should not carry more than 15 percent of their body weight on their back. Weigh the child’s backpack to determine whether some items may be left at home or at school.
• If carrying multiple books or other heavy materials cannot be avoided, suggest that the child carry several in his or her arms in order to distribute the weight more evenly.