Kids' Backpacks 101

Just about the time your child enters middle school, his or her backpack burden starts to grow. Laden with everything from textbooks to sports gear to cell phones and laptops, kids' backpacks get weighed down with some of their most prized possessions.

But do overloaded backpacks carry serious health risks? Experts give WebMD a lesson in kids' backpacks, covering their effect on your child's muscles and bones, the right backpack to look for when the new school year is about to begin, and how to pack and wear it to reduce pain and maximize comfort.

Kids' Backpacks: A Real Risk?

School backpacks are a staple, holding all the essentials kids need to make it through the day. But when the backpack starts to weigh your child down, could it be causing long-term damage?

"A lot of parents come in to my office thinking that their child might have scoliosis because of a heavy backpack," says Lori Karol, MD, a spokesperson for the American Academy of Orthopaedic Surgeons (AAOS).

In reality, explains Karol, scoliosis is not a danger. But kids' backpacks can cause back, shoulder, and neck pain when they're too heavy and worn for the better part of eight hours a day.

"Yes, your child might have pain related to a heavy backpack," says Karol, who is a pediatric orthopaedic surgeon at the Texas Scottish Rite Hospital for Children. "But parents don't need to worry that their child is going to end up with a back deformity, nor are backpacks going to create a problem that is going to need surgery."

While kids' backpacks aren't likely to cause long-term damage to muscle or bone as a result of constant wear, they do pose a more obvious risk.

"The issue I have seen is that kids fall and have an injury because their backpack is so heavy," says William Hennrikus, MD, chairman of the orthopaedic section of the American Academy of Pediatrics. "If kids are carrying a 40-pound backpack and they weigh 80 pounds, they can fall right over or not have enough stability to balance themselves throughout the day, risking wrist, arm, or leg injury, or worse."

Risk of falling aside, the right backpack -- packed and worn properly -- can be a valuable tool from elementary school all the way through college.

Buy a Better Backpack

There are dozens of kids' backpack brands available to choose from, starting at about $10 and running upwards of $25 or more. When you're shopping for the new school year, here are some backpack basics to follow:

• Two is better than one. While your child might beg for this because it's what all the "cool kids" are carrying, avoid the sling-style backpack, which has one strap that crosses the chest. "Using a backpack with one strap, not two, puts all the pressure on one shoulder," says Hennrikus, who is a pediatric orthopaedic surgeon at Children's Hospital in California. "It pulls the shoulder down and can cause back, neck, and shoulder pain." Look for a backpack with two straps instead, which splits the weight of the backpack across the shoulders.
• The thicker the shoulder pads, the better. "Padded shoulder straps help prevent the straps from digging into your child's shoulders, back, and neck," says Hennrikus.
• Wheels optional. "Backpacks with wheels definitely ease the burden of your child having to carry a lot of weight around all day," says Karol. "But many schools have stairs, which can be difficult for wheeled bags, and they might not fit in a locker." And they're pretty tough to roll in the snow. Weather permitting, check with your child's school before you buy a backpack with wheels.

The next trick is to pack the backpack properly.