The Back-to-School Item Most Likely to Cause Pain?
Their Backpack
As parents, we spend August hunting down school supplies, new clothes, and the perfect lunch box—but rarely do we think about the one item our kids carry every single day that could actually hurt them: their backpack.
Heavy or poorly fitted backpacks are linked to back, shoulder, and neck pain in thousands of school-age children each year. (EPH.org) While not every ache sends a child to the ER, repeated daily strain on growing muscles and spines can affect posture, cause discomfort, and even set the stage for future injuries.
As physical therapists, we see this far too often—pain that could have been prevented with a few simple changes. The good news? With the right backpack, smart packing habits, and a few quick adjustments, you can set your child up for a pain-free school year.
Why Backpack Safety Shouldn’t Be Ignored
Kids’ bodies are still developing. Unlike adults, their bones, muscles, and joints are more vulnerable to stress and repetitive strain. A backpack that’s too heavy or worn incorrectly can lead to:
- Muscle soreness or tightness in the back, neck, or shoulders
- Nerve irritation from strap pressure
- Postural changes (like leaning forward or slouching)
- Increased risk of injuries during sports and play
Think of it this way: your child wears their backpack five days a week, nine months a year. Over time, those extra pounds and poor habits add up.
Four Steps to Protect Your Child’s Back This School Year
1. Watch the Weight
A child’s backpack should weigh no more than 10-15% of their body weight.
- A good rule of thumb is if your child struggles to put the pack on or leans forward while walking, it’s too heavy.
- Encourage kids to only bring what they need each day.
- Have a weekly “backpack clean-out” to ditch the clutter that adds unnecessary weight.
2. Choose a Supportive Backpack
Not all backpacks are created equal. Look for:
- Wide, padded shoulder straps to evenly distribute weight.
- A padded back panel for comfort and to prevent poking from supplies.
- Multiple compartments to balance heavy and light items.
- Optional waist or chest straps to shift some weight to the hips (not all kids use them, but they can help).
3. Wear It the Right Way
Even the best backpack won’t help if it’s worn incorrectly:
- Always use both straps. Wearing one strap may look cool, but it strains one side of the body.
- Tighten straps so the backpack sits high on the back, above the hips—not sagging down toward the waist.
- Keep it close to the body to avoid leaning forward and stressing the neck and shoulders.
4. Pack Smart
- Place heavier items closest to the spine, lighter items toward the outside.
- Use every compartment to keep the load balanced.
- Store frequently used items in easy-to-reach sections to avoid awkward twisting or lifting.
Signs It’s Time to See a Physical Therapist
If your child experiences:
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Frequent back, neck, or shoulder pain
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Red marks under straps after wearing their pack
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Changes in posture, like leaning forward or rounded shoulders
…it’s time to adjust their backpack setup or check in with a physical therapist.
At Axes Physical Therapy, we work with kids every day to improve posture, strengthen growing muscles, and prevent small problems from turning into lifelong ones. A quick assessment with one of our movement experts can help your child start the school year feeling strong, comfortable, and ready to learn.
Set Your Child Up for a Healthy, Happy School Year
A backpack should be a tool for learning—not a cause of daily pain. Small changes today can make a big difference in your child’s comfort and posture for years to come.
At Axes Physical Therapy, our team works with school-aged children across the Greater St. Louis area to prevent and treat back pain, posture problems, and sports injuries. If you’re unsure whether your child’s backpack is safe, schedule a visit—we’re here to help your family move, feel, and live better every day.
(Note: This article is inspired by the original blog from orthoinfo.aaos.org and has been redrafted on axespt.com for 2023-24 school year guidance)