Backpack Safety: How to Prevent Backpack Injuries

Does your student come home complaining about back or shoulder pain? With textbooks, new electronic devices, and other necessary school supplies, backpacks are getting heavier and heavier. According to the American Occupational Therapy Association, more than 79 million students in the US carry a backpack and roughly 55% of them are carrying a backpack that is too heavy. That is more than 43 million students who might be doing damage to their bodies.

Improper wear of backpacks and other bags by children or adults can additionally contribute to health problems including back, shoulder, and neck pain and can ultimately cause posture issues that can cause further damage later in life. Making sure backpacks are worn properly can eliminate the possibility of these problems. To ensure proper backpack use you must choose the best backpack for the wearer, pack it so that the load is evenly distributed, adjust the straps so it is comfortable and safe, and make sure to watch out for the warning signs of unsafe backpack use.


It is important to choose the right backpack to ensure there is little to no strain on the body. The right backpack sits two inches under the shoulder blades to slightly above the waist. Choose a backpack with wide straps with comfortable padding.   Wide, padded straps provide support and prevent the straps from being too tight. The back of the backpack should be padded as well. It is also recommended to choose a pack with additional adjustable straps such as sternum and waist straps. These straps help hold the contents closer to your back which can help with maintaining balance.

It is not recommended to use most one-shoulder bags unless worn properly with the pack at the same proper placement of a backpack and as close to the body as possible. It is more likely to have strain and a loss of balance with a one-shoulder bag. The best alternative to a backpack with both shoulder straps is to use a roller board backpack as it does not cause strain on the spine.


The total weight of the packed backpack must not weigh more than 10% – 15% of the wearer’s body weight. Heavy items should be kept closest to the back and centered while lighter items can be kept toward the front of the bag. It is encouraged to use different compartments of the bag and to go through the bag regularly to ensure there are no unnecessary items causing extra weight. It can be helpful to carry heavier items in your arms, rather than on your back to avoid hunching while carrying. Also, make sure any sharp items are kept in a side compartment, or a compartment away from the back.


Make sure to adjust the backpack while you have it on to ensure a comfortable fit. First, start with the shoulder straps, they should fit with the pack snugly on the back sitting two inches under the shoulder blades to slightly above the waist. Next, if there is a sternum strap or hip belt adjust to comfort, starting from the top strap down to the next. It is important to use extra straps as they are included for your safety and comfort.

Warning Signs

Always watch for warning signs to prevent backpack injuries. Warning signs that the backpack is too heavy include:

  • Difficulty when putting on or taking off the backpack
  • Pain when wearing the backpack
  • Tingling or numbness in the arms and legs
  • Red strap marks over the anterior part of the shoulders
  • Any change in side to side posture while wearing the backpack

If you or your student suffer from pain after following the guidance above, the experts at Coastal Orthopedics can help!  Call 941-792-1404 or request an appointment online by clicking here.


1,2,3’s of Backpack Wearing. (n.d.). Retrieved from

Backpack Strategies for Parents and Students. (n.d.). Retrieved from