Your daughter rolls out of bed to the sound of a blaring alarm and heads for the shower. She brushes her teeth, washes her face, dresses herself with the outfit you left out the night before, and heads downstairs for a piping hot bowl of oatmeal that her father just prepared for her. After breakfast, she grabs her backpack and jams her science and math textbooks inside, followed by her spelling workbook, lunch bag, and the makeup she is hiding from you. She slings the bag loosely over one shoulder, and off to school she goes. She has become accustomed to filling her bag with all the books she needs for the entire school day so as to avoid making several trips back to her locker. At the end of the day, she makes the trek back home with her backpack loosely slung over the same shoulder as it was for the morning commute.

Let’s look at the above scenario in terms of this fictitious young girl’s spine and nervous system. The straps pull down on her shoulders, placing a downward compression force on the spinal column. Depending on how heavy the bag is and how many straps are used, the bag will cause a slumped posture, a head that is jutting forward, and shoulder muscles that are working overtime to maintain some semblance of proper biomechanics. In our scenario, a bag worn on one shoulder consistently can cause a head tilt or rotation, unbalanced shoulders and hips, a winging of the shoulder blades, and/or rucksack palsy, which, in the most severe cases, can lead to permanent nerve damage. Early-onset spinal degeneration, disc herniations, vertebral subluxations or misalignments, abnormal curvatures of the spine, muscle imbalances, fatigue, and a decrease in health potential are more than a possibility. What can complicate this even further is if this child has an underlying neurologic or orthopedic condition such as a scoliosis, or the student is an athlete playing full-contact sports. I challenge you to look at your children, how heavy their backpacks are, their posture, and how these factors are affecting their performance in school and, more importantly, their health.

Current research points to the health of your spine and nervous system leading to long-term wellness. Let’s examine how we can avoid any problems from improperly worn backpacks.
Backpack safety can be broken down into a few easy steps, with many of these ideas and recommendations coming from Dr. Marvin Arnsdorff, cofounder of Backpack Safety America/International. First and foremost, your child needs to choose the proper size bag. The proper size is approximately the space between your child’s shoulder blades and waist. A disproportionately large bag will result in carrying too many unnecessary books, toys, and so on, while a too small bag will result in your son or daughter carrying too many objects in his or her hands, thus causing even greater balance and postural problems. Remember, nature abhors a vacuum, and it is likely that your student will fill his or her bag to capacity, whatever the size, so it is critical to have the right-sized bag.

Packing the bag is also very important and has two distinct areas of concern. First, a loaded backpack should not exceed 15 percent of your child’s body weight. To accomplish this, your son or daughter may find it necessary to make a list of what is needed throughout each day to limit the amount of unnecessary cargo. If a backpack is too heavy, the wearer often has to lean forward to carry the bag or balance himself. Below is a 15 percent chart.
User’s weight (lbs.)Backpack weight (lbs.)507.57511.251001512518.75

In addition, your child needs to be taught how to pack his or her bag, rather than simply shove belongings inside without any regard for safety. You should always pack the heaviest books nearest your back and the lightest books farthest away from your back. This will help avoid an excessive lean backward and help prevent tipping over. Also of concern are sharp objects such as scissors. These items should be kept in a special place, such as a small box or bag, designed to avoid harming the wearer or any passersby.

If parents and educators model proper lifting habits and teach children backpack safety at an early age, many childhood injuries and spinal conditions can be avoided. The first lesson students should be taught is to gently check the weight of their bags. The weight can certainly be deceiving simply by observing the bag, so your child should pick up the backpack slowly and cautiously, as he or she may be surprised with the weight of the contents. Your son or daughter should be facing the bag and use both hands to lift the bag up using his or her leg muscles. It is important to have your children realize that their leg muscles are infinitely stronger and less prone to injury than the lower back muscles, which most people erroneously use to lift objects. Any quick turning or twisting should also always be avoided when lifting anything.

The last step to proper backpack safety is wearing the bag in a manner that distributes its weight equally. Primarily, this means always using well-cushioned arm straps—all the time and without exception. While it may be more fashionable for your daughter to wear her bag hanging off one shoulder, this practice should always be avoided. I also suggest that parents look for bags that include a waist strap to provide the wearer with even more support. If your child has a bag with only one strap, make sure it is worn fully across the chest to evenly distribute the weight of the bag as much as possible. I typically do not recommend suitcase-style backpacks that are on rollers. These bags become very cumbersome when anyone has to carry them up flights of stairs, and a child is made to twist and torque the spine to pull the bag along. The only benefit of this type of bag is that on flat surfaces, the wheels cause the weight of the bag to become almost negligent.

Simple education and demonstrating the proper way to use and wear backpacks can have a huge impact on the health and vitality of your school-aged children. Not only is it important to teach our children the content in the books they carry, but also how to safely transport their materials between school and home each day.

If you suspect that your son or daughter may have some underlying condition, such as a scoliosis, or his or her posture has been getting progressively worse, first look to your child’s backpack-wearing habits. The next step should be a visit to your chiropractor for a full evaluation. He or she will be able to determine whether conservative chiropractic care with some lifestyle changes will be able to correct the problems uncovered or if more aggressive steps need to be taken. Chiropractically maintained scoliosis or postural problems can save a young child a lifetime of pain, discomfort, lack of self-esteem, and ill health.

** This article is one of 101 great articles that were published in 101 Great Ways to Improve Your Health. To get complete details on “101 Great Ways to Improve Your Health”, visit

Author's Bio: 

Dr. Noah De Koyer graduated magna cum laude from Montclair State University in 1997 with a BS in biology and summa cum laude from Life University Chiropractic College in 2000, obtaining his DC degree. Dr. Noah has been practicing passionately in Bayonne, New Jersey, for the past six years. He is a certified Toastmaster and a member of the Association of New Jersey Chiropractors. Dr. Noah can be reached at (201) 437-0033 or at for speaking engagements, consultations, or patient care.