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A real pain in the neck 

Identifying and alleviating backpack strain

click to enlarge kids-backpacks.jpg

Picking up a backpack seems like a no-brainer: lift and go. It's actually a complex operation: arm muscles, upper and lower back muscles, trapezius (traps) and other shoulder muscles, abdominals and thigh muscles all synchronize to raise, place and carry a backpack. The heavier the weight, the harder those muscles work. Now is the time to make kids aware of possible damage from overburdened or improperly carried backpacks. Beth Winkler, licensed physical therapist and co-owner of Magnolia Physical Therapy (citywide; www.magnoliatherapyla.com) discusses back-to-school back pain and prevention.

What are some signs that back or spinal injury may be occurring?

Pain is the No. 1 sign. One other symptom is tingling in the back and arms due to [the backpack's] compression of arteries and nerves. If pain or tingling persists, a parent should take the child to see a physical therapist or doctor.

What areas are most commonly affected by backpack strain?

We definitely see neck and shoulder pain, even if the student is wearing both [backpack] straps. A backpack engages upper traps and hikes the muscles up, and they can get very tight. If the backpack is too heavy, it causes the child to lean forward to counterbalance the weight, putting a lot of pressure on the lower back as well.

Is a particular age group at risk?

We see [injury] in high school students, because that's when the workload dramatically increases. But more and more we are seeing it in younger kids. Parents should start educating their kids [about backpack safety] once they start school — sooner rather than later. Middle school is when the injuries can really start.

How can a parent educate his or her child?

Parents should definitely tell kids to wear their backpack straps on both shoulders and make sure that the backpack is zipped up all the way. If it's open, the weight shifts backward, and the student will lean further forward to counterbalance that weight. If the backpack is too full and can't be zipped, the student should take one or two of the heaviest books and carry them in front to distribute the weight more evenly. Also, leave the extra stuff at home. That extra load over time will cause problems later in life. A student's backpack should not be more than 15 percent of his or her body weight. Get weights, put them in a bag, and let them see what it feels like so they know how heavy the backpack should feel.

If a child is already experiencing pain, what steps should a parent take?

The biggest thing is to educate the child, especially if [the pain] is limiting the child from engaging in a sport or other activities. Lighten the load. Neck and lower back stretches may help.

What type of backpack do you suggest parents purchase?

I recommend something with pads on the shoulders and straps. A backpack with straps around the waist counterbalances and evenly distributes the weight of the bag. Another good choice is a rolling backpack, but if [there isn't elevator access and] a student has to take the stairs, this may not be practical.

If the pain doesn't go away, what should a parent do?

You can see a physical thera-pist without seeing a doctor first. A physical therapist is trained to look for signs that the injury is musculoskeletal and to treat it. You may not need several sessions of physical therapy. You may only need one evaluation and a home program to follow. If [the issue] is more neurological — losing strength in the extremities or if there is persistent numbness — the therapist will send the client to a doctor for further evaluation.

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