School Kids Carrying the Weight of the World on Their Shoulders

From the WebMD Archives

Dec. 3, 1999 (Atlanta) -- More and more often, schoolchildren are carrying too much weight, and it may be causing undue back pain. But stress is not the culprit, backpacks are -- heavy, book-laden backpacks.

A team of Italian researchers did a study of students in Milan and found heavy backpacks there may be contributing to "increasing back pain in children." According to the research, published in the Dec. 4 issue of the British journal The Lancet, nearly 35% of Italian schoolchildren carry more than 30% of their body weight at least once a week, which exceeds the limits proposed for adults.

The researchers followed over 230 students in Milan for three weeks. The group's average age was about 11 and included as many girls as boys. A subgroup of 115 students was assessed after the three-week trial by a specialist in pediatric orthopedic rehabilitation.

The average load carried by the students in their backpacks weighed more than 20 pounds, with the maximum load tipping the scales at 36 pounds. The researchers found, on average, the backpacks accounted for 22% of the kids' bodyweight, and often it was far higher.

To put that into perspective, that's the equivalent of a 180-pound man lugging around a minimum of 40 pounds for a large part of the day, or a 120-pound woman carrying about 26 pounds. The National Institute for Safety and Health in the U.S. recommend adults lift no more than 51 pounds during the course of a workday. That's lift, not carry for extended periods of time.

Arnold J. Weil, MD, an Atlanta physician certified with the American Academy of Physical Medicine and Rehabilitation, tells WebMD the problem is real, and not just in Italy. "I see that all the time in the office; school-age kids carrying heavy backpacks, developing back pain a lot of times. ... In addition to sporting activities, it seems to really present a problem," he says

"We've seen it intermittently in the past, but we're seeing it more now," Weil adds. He also mentions the "issue with lockers." Many schools around the country, because of concerns about security, space, or both, are abolishing lockers. That means kids have to carry their books with them at all times. Add to that a trend towards larger and heavier backpacks by the multibillion-dollar school supply industry, and you get back pain.


Weil recommends exercises to strengthen the back when students come to him complaining of pain. He suggests wearing the backpack over both shoulders, because carrying it on one shoulder "contorts the spine."

And, Weil says, limit the weight in the backpack. The Italian researchers write that backpacks in their country should generally weigh no more than 10-15% of bodyweight. That mirrors the general attitudes in the U.S., too, although some experts suggest the range should be even lower, around 5-10% of bodyweight.

The researchers say that, although "the economic importance of the problem is small at this age, the lack of certified limits for backpack carrying is shortsighted." They write, "the time has come to propose some limitations."

The study was supported by the Italian Health Ministry

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