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Backpack Shopping 101: Tips to Avoid a Pain in the Neck

Heavy backpacks can cause long-term health problems when worn incorrectly.

By American Occupational Therapy Association July 26, 2016
Now that the Fourth of July cookout gear and decorations have cleared the shelves in most stores across the country, school supplies have started to appear. One of the most important items: the backpack. And while students of all ages will search for that perfect look for the first day of school, experts say that the backpack’s fit is the most important consideration when back-to-school shopping.


“Heavy loads carried by more than 79 million students across the U.S. can cause low back pain that often lasts through adulthood,” says Karen Jacobs, EdD, OTR/L, CPE, clinical professor of occupational therapy at Boston University, and an expert on school ergonomics and healthy growth and development of school-age children. “A child wearing a backpack incorrectly or that is too heavy can be contributing risk factors for discomfort, fatigue, muscle soreness, and musculoskeletal pain especially in the lower back."


The American Occupational Therapy Association (AOTA) urges parents and caregivers to consider the following when selecting a backpack this school year:

  • Appropriate size - Make sure the height of the backpack extends from approximately 2 inches below the shoulder blades to waist level, or slightly above the waist.
  • Shoulders - Backpacks should have well-padded shoulder straps that can be worn on both shoulders so when packed with books, the weight can be evenly balanced by the student.
  • Hip belt - Backpacks with a hip or chest belt take some strain off sensitive neck and shoulder muscles and improve the student’s balance.
  • Fit - Just as your child will try on clothes and shoes when back-to-school shopping, experts say it is important to try on backpacks, too. “The right fit should be your top criteria when selecting your child’s backpack,” says Jacobs. “If you order online, be sure that the seller has a return policy just in case the backpack is not quite the best fit for your child and needs to be exchanged.”

When school is back in session, check that the child’s backpack weighs no more than 10% of his or her body weight. If it weighs more, determine what supplies can stay at home or at school each day to lessen the load. If the backpack is still too heavy for the child, consider a book bag on wheels.


The American Occupational Therapy Association feels so strongly about backpack safety that the organization offers tips for wearing and packing backpacks: 1, 2, 3’s of Basic Backpack Wearing, and marks National School Backpack Awareness Day on Sept. 21, 2016. On this day, thousands of students, educators, parents, and health professionals will increase awareness of the aches and pains that backpacks can cause by holding backpack weigh-ins, backpack check-ups, activities, and special events. To learn more about National School Backpack Awareness Day, visit www.aota.org/backpack.


Founded in 1917, the American Occupational Therapy Association (AOTA) represents the professional interests and concerns of more than 213,000 occupational therapists, assistants, and students nationwide. The Association educates the public and advances the profession of occupational therapy by providing resources, setting standards including accreditations, and serving as an advocate to improve health care. Based in Bethesda, Md., AOTA’s major programs and activities are directed toward promoting the professional development of its members and assuring consumer access to quality services so patients can maximize their individual potential. For more information, go to www.aota.org.