Now that back to school is in full swing, you’ve definitely made sure your kids have everything they need throughout the day, including their books, supplies, lunch boxes, and other essentials. If you’ve ever picked up their school bag and thought, “Sh*t, why is this thing so heavy?” it seems that shrugging it off might not be the best move. In fact, a too-heavy backpack can actually be a serious health hazard, as a spine and neck surgeon tells Scary Mommy.

You might not give too much thought to your child’s backpack, but there’s a definite possibility it’s a potential safety concern. According to stats released by the U.S. Consumer Product Safety Commission in 2021, an estimated annual average of 7,500 kids under 19 were treated in emergency rooms for backpack-related injuries between 2017 and 2019. Here’s the scoop on how to keep your kid’s spine, neck, and shoulders safe this school year and beyond.

Backpack-Related Issues

“A backpack that fits poorly, is too heavy, worn too often or incorrectly can lead to our children having problems with posture, pain in their necks, arms, and back,” explains Dr. Rahul Shah, a board-certified spine and neck surgeon. “With a too-heavy backpack, the back will begin to compensate for the extra weight and create stress on their spinal column, which can lead to a cascade of effects for the back from temporary backache to a more serious injury.”

As for why so many kids end up in the ER with backpack-related injuries, Shah says it’s due to their unique physiological changes thanks to the extended period of growth during the school-age years. “As children grow, their center of gravity can change within their bodies, and that’s without backpacks,” says Shah, who notes that the added weight of a backpack then “amplifies where the pivot points in the body are when sitting, standing, or moving.”

And if you’ve got kids in high school or college, you know how heavy those books and binders are, which leads to more issues, says Shah. “As all of these loads and pivot points change, children are forced to use their backs to counterbalance these loads. Therefore, the hinges (the areas where the bones move in the back) are placed at further risk for injury with so much extra load.”

How to Keep Your Kid Safe

Thankfully, you can protect your child’s spinal health simply by choosing a backpack that is supportive and not too heavy, as well as ensuring that they’re wearing it properly to evenly distribute the weight any chance you can. As Karen Jacobs, national spokesperson for the American Occupational Therapy Association, previously told Scary Mommy, backpacks should be no more than 10% of their body weight. Jacobs recommended that parents bring their kids in person to shop so that you can get a feel for the size and structure of the bag on your kid, ensuring it’s not too flimsy or that the straps aren’t too thin.

Shah says that the fit and load are equally important, explaining, “The size of the backpack can play a significant role — strive to fit the backpack within a few inches of the waistline and within the confines of the shoulders.” Jacobs noted that a well-fitting backpack should form a rectangle from the shoulders to the waist, featuring a well-padded back (the part that rests against your child’s back). Both experts note that straps should also be well-padded and should be worn on both shoulders at all times.

Jacobs noted that crossbody bags aren’t the best option, and rolling bags eliminate the added weight (provided your child alternates the hand they use to carry it), but some schools don’t allow them.

A few ways your child can avoid back pain while wearing their backpack is to make sure they’re wearing it properly. One strappin’ may look cool, but using both evenly disperses the weight in the bag. Packing the heaviest objects first will also help your child feel less weighed down. Doing it this way will allow them to carry it lower and closer to their bodies.

Subtle Signs Something’s Awry

An ill-fitting backpack could cause several physical ailments, per Jacobs, including pain, fatigue, redness, swelling, and discomfort. Of course, if your child complains of pain, that’s a clear sign something’s not right.

Shah recommends keeping an eye on your kid when they’ve got it on, as balance issues can usually be spotted — especially if you notice they take it off quickly and often. “Children will also tend to find other ways to ‘offload’ the weight of the backpack by not walking as far with the backpack or other subtle maneuvers,” he says. “Also, many children may significantly alter their posture and lean far forward to accommodate the backpack as compared to being able to stand upright as they normally would.” He recommends paying close attention at the start of the school year as they begin carrying their new load each day.

Jacobs suggested regular backpack cleanout sessions to eliminate any excess clutter — nightly is ideal. “With regards to the weight of the backpack, begin by removing all non-essential items and items that can be potentially kept in a locker at school,” adds Shah. “If they significantly stoop forward — particularly at the pelvis — lighten the load and see if their posture improves. Improvements in posture by removing weight, especially after walking for a few minutes, will give you an idea of the best load that a child can handle in their backpack.”

When to See a Doctor

If you’re ever unsure about the safety of your little one’s school bag, Shah recommends checking in with their pediatrician. Musculoskeletal experts like an orthopaedist or sports medicine physician can also be helpful in preventing and treating advanced problems. Your child should never be in pain due to their backpack, but thankfully, it’s easy and simple to nip potential issues in the bud.