1. Rodts, Mary Faut

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FIGURE. Mary Faut Ro... - Click to enlarge in new windowFIGURE.

How often have you seen small children and adolescents struggling to carry heavy backpacks and athletic gear? Being an orthopaedic nurse with a specific interest in the spine, I think about it often, but I am not the only one. Increasing numbers of healthcare providers and parents are becoming concerned with what our children are carrying back and forth to school everyday. The American Academy of Orthopaedic Surgeons and the American Academy of Pediatrics have developed statements for what is appropriate backpack use for our children.


Rateau, in her article entitled, "Use of Backpacks in Children and Adolescents: A Potential Contributor of Back Pain," reviews the current literature on appropriate backpack use. She shows the correct way to use a backpack and discusses tips for packing a backpack correctly.


Educating our children about this issue is also important. Just like packing that suitcase for a trip, all too often children worsen the situation by adding the "extra things" they "might" need. If it fits in the backpack, then it is good to go. Children must be taught how to protect their backs when carrying and lifting backpacks and just because it fits inside does not mean it is all right to lift.


Healthcare providers must have this dialogue with their patients and their families and educators. Ways to identify and manage those who are at greater risk should also be developed. As children age, the amount of what they "need" to carry in their backpacks increases. By the time a child reaches 5th or 6th grade, it is not uncommon for schoolbooks to weigh in excess of 25 lb. By high school, that weight is even greater. Petite or small children are at increasing risk of injury because their backpack:body-weight ratio is too high. One alternative to aid these children is to purchase second sets of books for home use. However, this is not always a possibility, because it may place an additional financial burden on families. What is the role of the school district in protecting our children's backs?


By bringing this topic to the attention of the people who make curriculum decisions, choose textbooks, and develop teaching plans, an awareness and solution of the problem may be achieved. Can our educators develop a system in which Mondays and Wednesdays are textbook home night for math and science and Tuesdays and Thursdays for other subjects? Not to say that homework in every subject cannot be given each night, but maybe an alternative, such as the use of worksheets, could be instituted. Can we ask that teachers work together to protect our children's backs? I would venture to guess, that if approached, many educators would work to help their students. On the other hand, educators are under increasing scrutiny regarding the success of their students in the classroom. We must find a balance where these concerns can be managed as well.


Preventing back pain and strains among our children is important. Speak to your schools about the importance of watching what our children lift. Teaching children how much they should lift and how to lift is a job for all of us.