When you think of someone with back pain, you likely think of an adult, but it’s becoming more pervasive among children and teenagers due to overweight backpacks, according to the American Chiropractic Association (ACA).

“Backpack safety is something parents should take seriously,” adds Dr. Flatt. “Children are not as strong, and their bodies are very flexible, which can lead to a host of injuries and imbalances.”

Backpack injuries may include:

• Neck, back and shoulder pain
• Numbness or tingling in the extremities
• Stress fractures
• Postural concerns like swayback, especially if a heavy backpack is pulling a child’s weight backwards
• Uneven shoulders
• Leg length inequality

“The human body is pretty good at dealing with small misalignments,” says Dr. Flatt. “However, repetitive, asymmetrical movement can add up over time.”

Wearing the backpack all day is a problem for many children. “We see a lot of cases of children taking their backpacks to school, lugging them around all day, and then taking them to practice or extracurricular activities after school,” says Dr. Flatt. “They carry them for most of the day during the school year.”

Other behaviors and routines that can exacerbate injuries from a heavy backpack:

• Constantly picking it up and putting it down
• Wearing only one shoulder strap
• Wearing an improperly fitted backpack

Here are tips for ensuring your child’s backpack safety:

• Make sure that your child’s backpack weighs no more than 10 percent of their total weight when full.
• Make sure your child’s backpack is in the proper ergonomic position on their back: The base should never be more than 4 inches below their waistline, and the straps should be tightened so that the load is close to their back.
• Encourage your child to wear both straps.
• Encourage your child to stop and drop books off at their locker during the day.
• If purchasing a backpack, opt for a version with wide, padded shoulder straps, if possible.
• If your child’s school permits and your child is willing, consider a backpack on wheels.
• If your child’s load becomes too much to manage, talk to their teacher or school administration about other solutions such as having two sets of books (one for school and one for home) or digital versions of textbooks.

“It may be tough to convince your child of this, but at the end of the day, function is better than fashion,” concludes Dr. Flatt.