child holding backpack on stairs

Preventing Backpack and Sports Injuries

School supplies? Check. First day of school? Check. Back-to-school night? Check. Now that kids are back in the swing of things at school, it is a good time to evaluate their risk for injuries and ways to prevent them. Two courses of action you can take today include assessing your child’s backpack usage to prevent low back pain and preparing for fall sports.

Backpacks and low back pain

Low back pain has increased over the years among adolescents and young adults. Some of the contributing factors include poor posture, muscle imbalance, decreased muscle endurance and overuse.1 Adolescents these days spend more time sitting: sitting in school, sitting in front of the computer, sitting while watching television, sitting and playing video games. Prolonged sitting increases pressure on discs of the spine, stiffness of the lumbar spine (lower back), reduces strength of the lower back muscles and decreases metabolic exchange (the breakdown of food into energy) leading to excessive body weight.4 The majority of the population sits with a curved back posture, which will often decrease muscle activity and weaken lower back muslces.5

Carrying heavy backpacks can lead to low back pain, neck pain, headaches and spinal deformities. The load of a heavy backpack can cause the body to lean forward in order to balance the center of gravity, which will reduce lumbar lordosis (swayback) and increase thoracic kyphosis (rounding of the upper back).2

Tips for backpack safety:

  1. Wear both straps; not just one on one shoulder.
  2. Wear the backpack over the strongest mid-back muscles (be sure the straps are tightened appropriately so the backpack isn’t hanging too low).
  3. Lighten the load—the American Physical Therapy Association (APTA) advises that a backpack load should be 10–15% or less than the child’s bodyweight.3

Sports injuries

Want to stay ahead of the game when it comes to sports injuries? Preventing injury is a winning strategy for active, school-aged children.

Kids tend to get more traumatic injuries like fractures and sprains, partly because their bones are weaker and they play more contact sports. They’re also more prone to overuse injuries than adults. That’s why it’s good when kids play multiple sports and don’t start specializing too early. Also, children are significantly more vulnerable to concussions than adults. Parents should know risks of secondary concussions, which happen when you suffer another concussion before you’ve recovered from the first. To avoid an even more serious reinjury, rest and “therapeutic boredom”—minimizing stimulation—is essential after a concussion.

For prevention’s sake, kids should use proper equipment that fits well. Also, kids should be supervised by qualified adults and be prepared to play—with proper training and warm-ups and cool-downs. In general, not enough attention is given to proper stretching. It can add range of motion, make kids more limber and help prevent strains and sprains.

Overlake offers sports physicals at our urgent care locations to prepare for team sports, as well as physical therapy for adolescents (middle school through college) with orthopedic and sports-related injuries.

  1. O’Sullivan P, Smith A, Beales D, Straker L. Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management. Journal of Orthopaedic & Sports Physical Therapy. 2017;48:741-751.
  2. Walicka-Cuprys K, Skalska-Izdebska R, Rachwal M, Truszczynska A. Influence of the Weight of a School Backpack on Spinal Curvature in the Sagittal Plane of Seven-Year-Old Child. BioMed Research International. 2015;1-6.
  3. American Physical Therapy Association. 3 Tips for Backpack Safety. American Physical Therapy Association. Accessed Sept 4, 2019.
  4. Gupta N, Christianen C, Hallman D, Korshoj M, Carneiro I, Holtermann A. Is Objectively Measured Sitting Time Associated with Low Back Pain? A Cross-Sectional Investigation in the NOMAD study. PLOS ONE. 2015; 1-18.
  5. Chatchawan U, Jupamatangb U, Chanchitc S,Puntumetakul R, Donpunha W, Yamauchi J. Immediate effects of dynamic sitting exercise on the lower back mobility of sedentary young adults. J phys Ther Sci. 2015(27):3359-3363.