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Kids and Posture

By: Madison Harpenau

Backpacks and Posture

School, homework, electronics, and sports seem to be the major categories that consume our younger generations lives. School, homework, and gaming on electronics seem to be the least physically straining for children to engage in, but we could be wrong. Backpacks and sitting posture can lead to pain, injury, and postural deformities in children. Neck, shoulder, and back pain are the top three forms of pain linked to heavy backpacks (Azabagic, Spahic, Pranjic, & Mulic, 2016). These forms of pain are more likely to increase dependent upon your child’s sitting posture and duration they are sitting. Additionally, children who used the computer for 14 hours a week or more expressed that their neck, back, head and eyes were painful (Hakala, et al., 2012).

In many schools, children utilize their backpacks to bring their books to and from home but also use them to transport books from class to class. The average weight of a textbook is nearly 5 pounds (4.8lbs). According to The American Occupational Therapy Association (AOTA), a child’s backpack is to be no more than 10% of their body weight. For a 100 pound child, their backpack should weigh no more than 10 pounds (or 2 average sized textbooks!). Thankfully, many elementary students do not have to tote around large textbooks like older students, yet elementary backpacks can become weighed down too. If your child has been complaining of neck, shoulder, or back pain, I encourage you to weigh their backpack . If their backpack is more than 10% of their body weight here are some steps you can follow to help reduce your child’s pain.

When packing their backpack, teach them to put the heaviest objects in the back or closest to their back when they are carrying it.

If the backpack becomes too heavy with books, encourage your child to carry extra books in their hands.

Discuss with your child what objects are necessary for them to have in their backpack, eliminate unneeded weight. Additionally educate your child on what things are okay to leave at school or at home depending upon their schedule and needs. When your child is wearing their backpack remind them to use both shoulder straps.

Adjust the shoulder straps to they fit tight against your child and their back. Waist belts on backpacks help to distribute weight more evenly. (AOTA, n.d.)

Sitting posture can increase the pain that the weight of a backpack has caused. When your child seated working on homework or other table top activity, remind them to keep both of their feet on the floor (AOTA, 2011). Encourage them to utilize their core to sit up straight and tall. Remind them to take a break to get up and stretch every 20 minutes, this will increase their concentration and decrease their fatigue (AOTA, 2011). When children are playing on electronic devices, remind them to bring the device closer to their face, opposed to them bending their neck to get closer to the device.

When children are playing on the computer, utilize similar concepts to encourage good posture as previously stated above. Educating your child on how to properly sit and wear a backpack will hopefully reduce any neck and back pain they are experiencing. To help your child get back to their healthy, pain free selves, remember to get routine chiropractic adjustments to improve their spinal function and overall health!

Madison Harpenau is a Doctor of Occupational Therapy student from St. Ambrose University in Davenport, Iowa. Madison is anticipated to graduate in August of 2019. She has completed two prior internships in the settings of outpatient pediatrics and inpatient rehabilitation hospital. Madison’s Doctoral Project is focused on Connecting Holistic Health Care Professionals; such as Chiropractic and Occupational Therapy. Her project is largely rooted in health and wellness promotion for all clients.

For additional information about finding the right backpack and wearing backpacks please see attached handouts.


The American Occupational Therapy Association. (n.d.). Backpack strategies for parents and students.Retrieved March 25, 2019, from /Files/Backpack/Backpack%20Strategies%20for%20Parents%20%20Students.pdf

The American Occupational Therapy Association. (2011). Is your child positioned for school success?[Leaflet]. The American Occupational Therapy Association.

Azabagic, S., Spahic, R., Pranjic, N., & Mulic, M. (2016). Epidemiology of musculoskeletal disorders in primary school children in bosnia and herzegovina. Mater Sociomed, 28(3), 164-167.

Hakala, P. T., Saarni, L. A., Punamaki, R.-L., Wallenius, M. A., Nygard, C.-H., & Rimpela, A. H. (2012). Musculoskeletal symptoms and computer use among finnish adolescents - pain intensity and inconvenience to everyday life: A cross-sectional study. BMC Musculoskeletal Disorders, 13, 2-7.

Citations for pictures

Arora, M. (2018, May 22). [Boy laying on floor with phone.]. Retrieved from

Mascarenhas, H. (2016, June 10). [Children sitting with glasses on playing on phones]. Retrieved from by-correcting-their-posture-1564354


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