Backpacks and back health: What parents and students should know this school year

As students of all ages return to school, making sure they stay safe in all aspects is a common concern. You’ve probably thought about topics like food allergies, mental health and teen driving, but have you considered backpacks?

According to a 2024 study published by Cureus, the average weight carried by children of all ages was averaging 13.53% of their body weight. This could elevate pressure on neck and back muscles, leading to fatigue and potential damage to the skeletal system.

Research even suggests that the heavy load of backpacks can lead to back, shoulder and neck pain, as well as long-term posture issues if not addressed early. With students carrying books, laptops, water bottles and sports gear, the strain can add up pretty quickly. Aki S. Puryear, MD, professor of clinical orthopaedic surgery at the Indiana University School of Medicine, shares key takeaways parents and students can use to protect against backpack-related injuries this school year.

Question: Why is backpack safety such an important issue for students as they return to school?

Aki S. Puryear: When backpacks are heavy or worn incorrectly, the wearer can develop repetitive injury, strain or acute injury, which over time may cause pain and discomfort in the neck, back and/or shoulder region.

Q: What’s the rule of thumb for how heavy someone’s backpack should be compared to their body weight? What features should parents look for in a safe backpack?

Puryear: The ideal backpack weight is less than 20% of the wearer's body weight. The backpack should be lightly weighted, have wide padded shoulder straps and include a padded back. For a heavy load, backpack should have a waist strap and preferably be a rolling backpack.

Q: What’s the correct way for students to wear and pack their backpacks to avoid back, shoulder or posture problems?

Puryear: Optimal backpack wear involves using both straps to help distribute the weight and tightening the straps to keep the pack close to the body. The organization of the backpack itself should have heavier items lower in the backpack.

Q: What are some warning signs that a child’s backpack may be too heavy or causing health issues?

Puryear: Warning signs could include complaints of back or neck pain or an increase in use of over-the-counter pain medication or the request for them.