Choosing a backpack can be fun. It feels great when your child finds one that they are excited to wear for school. Maybe it has a favorite cartoon character on it. Maybe it’s her favorite color, or maybe he thinks he looks cool wearing it.

But when it comes down to it, choosing one that fits right and won’t hurt their backs is really the most important reason to buy it.

“Just remember, bags can be easily customizable,” said Casey Jo Hill, a physical therapist in Outpatient Rehabilitation for Lehigh Valley Health Network. “It may not be the color they want but it can be easily customizable with key chains, zipper pulls, patches, anything that you can think of. A backpack is an investment in a child’s health.”

Hill said back pain caused from the wrong backpack can lay the foundation for problems later on if not addressed early.

“Pain isn’t just musculoskeletal,” she said. It can cause pain in other areas of the body, which could cause the child to alter how he moves or uses the backpack.

Picking a backpack

Hill said the top of the bag should be positioned just below the shoulders, while the bottom remains above the waist when adjusted. This should be maintained when the backpack it fully loaded.

For that reason, try on the backpack with the school supplies in it. It is only after it is loaded that the child may change his posture to compensate for the extra weight, arch his back a little bit, or lean back due to the weight.

“When carrying heavy items in it, there is a certain percentage of your body weight that you want to try to adhere to,” she said.

A loaded backpack should not weigh more than 10% to 15% of the child’s body weight.

“So if your child weighs a 100 pounds, it shouldn’t be more than 10 to 15 pounds,” Hill said.

The ideal backpack should be one with two straps and a belt on the waist and the chest.

“One strap may feel or look cool, but using both of them will maintain an equal weight distribution when tightened,” she said. “One strap backpacks can lead to an imbalance of the weight and an excessive curvature to the one side.”

The backpack also should be reinforced in order to help maintain the shape of the bag.

A backpack that is too small will not be long enough to reach the child’s waist as it sits on her shoulders, and probably won’t be large enough to carry the needed supplies.

A backpack that is too big will come up too high, past the shoulders and up the neck, or it might be down too low and drop past the waist to the pants.

“The Goldilocks of it all is one that fits right between my shoulder blades,” she said, and right around the hips.

The backpack should also have padding, pockets and multiple storage areas, Hill said. Using pockets can help to distribute the weight of the items over the entire area and not centralized it in the middle of the back.

In addition to backpacks, Hill had some additional guidelines for good health to prevent back pain: keeping active, maintaining good posture, and setting up the student’s workplace.

Activity guidelines

Preschool children ages 3 to 5 should be active all day to enhance their growth and development. Of course, most children this age are naturally very active, so a parent’s role is to facilitate and encourage that activity, Hill said.

Children ages 6 through 17 should do an hour or more of physical activity each day, and participate in vigorous activity at least three days a week. Encourage them to do activities that they enjoy and are appropriate for their age.

They should also do muscle and bone strengthening activities at least three days a week, which could include body weight resistance training under supervision, and proper training and education.

“Lifting does not stunt growth and is shown to improve neurological pathways to the muscles,” she said. “It can also help reduce pain overall.”

Posture tips

Posture isn’t just standing upright. It’s a range of movements.

“Our bodies are meant to move,” Hill said.

Physical therapists generally assess alignment by looking at the plumb line from the head and shoulders down to the knees and ankles. This gives them an indication as to how the muscles are holding the body aligned.

Scoliosis, which is an abnormal curvature of the spine, is not caused by the improper wearing of backpacks.

Workspace setup

Posture is also important when sitting at a workspace. Hill said parents should encourage the natural S-curve of spine, which occurs in the neck, shoulders and lower back.

In order to get the right posture, she suggested this drill. Slouch over while sitting, then sit up as tall as possible. Next, relax about 10%.

“That’s about where you should be if you’re questioning whether or not you’re slouching too much or you’re extending too much. Do that drill and that can help you find a more natural position,” she said.

Avoid a slouched posture for prolonged periods of time, as well as overcorrecting a slouched posture.

Parents should also encourage their children to take frequent rest breaks and change positions.

“Sometimes staying rigid in that one position is a little too much on the bones and joints,” she said.

Hill also suggests placing materials in the workplace at eye level at about arm’s-length away. This prevents the need to lean to one side.

Final tip

Young children, especially, look up to their parents as role models, so stay active and find family activities that family can enjoy together.

“Be an example for your child. Establish and model good habits,” she said.