It’s back to school again, and many students are getting loaded up with homework. Unfortunately, this can also mean loading up a school backpack with too many heavy books.

The Consumer Product Safety Commission (CPSC) reported in 2018 that emergency departments, doctors’ offices and clinics treated 50,635 people for backpack-related injuries.

I weighed my own daughter’s book bag the other day, and it was 40 pounds. I couldn’t believe that’s what she lugs around every day. The general rule of thumb is the backpack shouldn’t weigh more than one-third of their body weight. So if your child weighs 60 pounds, their backpack should be about 20 pounds.

The problem is the extra weight puts a lot of stress on the back. Children are not grown people yet. Their spines are still growing. In order to accommodate the extra weight, they have to be in a bad body position – leaning over and hunching their back. This can permanently change posture and cause bones to grow incorrectly. If you were in the Army and lugging around 50-pound ruck sacks, that’s different because you were a fully developed adult.

Besides the weight, how you carry the backpack is another big problem. Today you see many kids like to carry it very low on their back. This is bad, because it puts a real detrimental force onto the back.

Make sure to always use both straps, as opposed to just one, when carrying it. Just using one strap distributes the weight very awkwardly.

I suggest carrying the backpack up higher on your back, not low down near your waist. A chest strap makes it even better to spread the weight.

When you head to school for the day and load up your backpack, put the heaviest items in first, closest to your body.

There are some things to consider when buying a new backpack, too. We can learn a lot from the hikers and backpacking equipment that outdoor enthusiasts use. Some very important structures are built into these backpacks. Stiffer shoulder straps mean the backpack won’t slide down the back as easily. A waist strap, extra padding on the back and chest straps are also usually a given with any outdoor-style pack.

When you shop for a backpack, the more similarities it shares with the hiker or backpacker designs the better. Look for something built more sturdily to handle the load.

It’s a good investment to spend a few extra dollars to get a better backpack. You can’t expect them to last forever. A more expensive backpack with the support structures built in will last longer, because they’re meant to carry the weight and won’t break down as easily. Several companies offer lifetime guarantees and will replace their products free-of-charge, so do your research ahead of time.

As parents, there are some things you can be aware of, even when they’re not wearing a heavy backpack. Keep an eye on your child’s posture when they’re not wearing it. Are they hunched over? Are their shoulders rolled over?

Bad posture leads to pain! If you can maintain better posture while you’re wearing a backpack, you’re less likely to run into trouble. This is where an appropriate fitting backpack helps tremendously. If you have to hunch over, it’s too heavy, or ill-fitting, or you don’t have the strength to carry it.

Dr. Greg Palutsis is an orthopaedic surgeon at MUSC Health-Orthopaedics on the campus of MUSC Health-Florence Medical Center. He is accepting new patients. For more information, call 843-413-6835 or go to

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