BY SUE MacDONALD
The Cincinnati Enquirer
Noah Gentry displays the contents of his backpack.
(Michael Snyder photo)
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Anna Young heaves her backpack onto the old-but-functional Toledo scale in school nurse Patty Elliott's clinic.
The pack lands with a thud.
"It usually weighs more," the Reading Junior - Senior High seventh-grader says, watching as the scale's needle wavers back and forth before it settles on a reading: 22 pounds.
That's how much this 12-year-old lugs on her 81-pound frame on a typical day at school.
Like many of her peers, Miss Young is carrying a hefty percentage of her own body weight -- probably more than she should -- on her back and shoulders in a backpack brimming with textbooks, binders, workbooks, folders, homework papers and school supplies.
No medical group has issued an official recommendation about how much weight is too much for children to carry, but there tends to be an agreement that 10 percent of a child's body weight is plenty, 15 percent the maximum.
For most kids, that's a 10-15-pound limit, although many carry at least that much or more.
The Reading kids know the results of heavy book bags:
"My back hurts most of the time," says James Conner, 13, an eighth-grader.
"It hurts right here," says seventh-grader Brenna Travis, 12, as she rubs her shoulders and neck, "and then it hurts my lower back when I lie down at home."
"It hurts on my shoulders where the straps have to go," adds Markeisha Chatman, 14, an eighth-grader.
To be sure, the homework load at Reading isn't to blame.
School officials and 28 at-random Reading parents were gracious enough to allow The Enquirer to weigh students and their backpacks in a not-very-official but eye-opening assessment of what kids are hauling on their backs.
And it's a LOT.
Of the 28 students in grades 5-8 who participated in the weigh-in, the lightest pack was 8.5 pounds, the heaviest 27 pounds. Miss Young had the dubious distinction of carrying the largest percent of her body weight in her pack -- 27 percent, more than one-fourth of her total weight.
The average: 15.5-pound backpacks on 108-pound bodies, or 14.3 percent of body weight.
"Ten to 15 percent of your body weight slung over one arm is more than enough," says Dr. Tim Flenner, physiatrist and medical director of TriHealth Rehabilitation Services in Cincinnati. (Last year, his 90-pound daughter, a high school senior, carried a 32-pound backpack all day because there was too little time to store books in her locker between classes).
"If you take these little kids carrying 20-pound backpacks, that's sometimes 20 percent or more of their weight, and that's just wrong," he says.
Lisa Houser, parent of Reading Hilltop Elementary fifth-grader Katie, says the weight of her daughter's backpack began to grow considerably in fourth grade.
"I wouldn't want to have to walk every day with that weight on my back," she says, noting that Katie also carries her trumpet and a water bottle to school at least one day a week (19 pounds on her 108-pound frame, or 17.5 percent of her body weight).
"As a mother and a worrywart, I never noticed her being in any pain. But I think we're setting these kids up for injury."
Where it can hurt
The injuries already are occuring, whether children know it or not.
"Parents and teachers need to be more aware of what the potential is for students lugging home all these heavy books," says Leslie Jackson, practice associate with the American Occupational Therapy Association, based in Virginia.
Heavy backpacks (and musical instruments, gym bags, binders, laptops) can cause a variety of problems, Ms. Jackson says, including:
Back pain (lower and upper).
Shoulder pain.
Neck pain.
Hip, knee and ankle pain.
Poor posture, which shows up as either an ostrich-like walk, with the head and body leaning forward to counterbalance the heavy weight on the back ("the reverse equivalent of being pregnant," Dr. Flenner says), or a slouching, sloping posture that tilts backward because of the pack's pull.
Vision problems, especially if poor posture or neck pain forces a student to sit, tilt or lift the head unnaturally to see.
"The trunk tends to be the part of the body that provides stability to the rest of the body," Ms. Jackson says.
If one place begins to hurt, the rest of the body compensates. Children carrying heavy weight across their shoulders are subject to the same complaints Dr. Flenner hears from adults who sling briefcases, laptop computers and heavy pursues on their shoulders -- namely, shoulder and neck pain, tingly arms and arm pain.
"There are a whole bunch of nerves that run through the space made by your rib cage and collar bone" below the shoulder, he says. "They run down into your arm and make your muscles work. Slinging a backpack across that space squishes the nerves and the blood vessels that have to travel in that space."
That compression can produce many of the aches and pains reported by children and adults, he says, because "the work you're asking the muscles to do is horrendous."
Nurse: Use both shoulders
Ms. Elliott, school nurse for all three Reading schools, says she tries to encourage students to carry backpacks properly -- slung over both shoulders and midway between the lower back and shoulders, not draped on just one shoulder or hanging low on the back.
The issue has international overtones. Several years ago, parents in France began complaining to school officials about heavy packs their children were toting to and from school, and parents in Israel picked up on the campaign as well.
A physical therapist at the University of South Australia is overseeing a four-year study of the effects of backpacks on children. According to preliminary results from that study, launched in 1997, students who have access to lockers between classes have fewer complaints than those who lug all their books with them.
Shifting the load
A properly fitted pack hangs just below the shoulders, the bottom resting on the hips. Shoulder straps should be snug without cutting into the armpits or shoulders. (Many children and teens today carry the packs extremely low and dangling off the back - buttocks; straps should not be that loose).
Buy backpacks with padding in the back and in the shoulder straps for comfort and cushioning.
If possible, find a pack with a separate strap - hook that buckles around the waist to distribute weight more evenly. Side straps that help collapse the pack when it's not full also are helpful. Each night (or once a week), clean out the backpack and remove needless items.
Urge children to carry packs on both shoulders, not slung on one side.
Remind children who carry extra things to school -- gym bags, musical instruments, purses, binders -- to switch arms frequently. If children complain constantly of a load that's too heavy, approach teachers about alternatives: workbooks instead of textbooks, rotating no-textbook homework days and regular access to lockers between classes.
Source: American Occupational Therapy Association Inc.; JanSport.
