Dear Mr. Dad: School just started this week and already, our 10-year old son’s backpack is so heavy he can hardly lift it.  I see a lot of other kids with wheely packs—should we get one for him?

A: Overloaded backpacks are responsible for an increasing amount of pain, injuries, and emergency room visits. National School Backpack Awareness Day is the third Wednesday in September. But I think the American Occupational Therapy Association (which created it) should move it a month earlier so parents can be aware of their kids’ backpacks before the school year starts.

The easiest solution to the problem is to try to get two copies of all textbooks, especially the really heavy ones—one to keep at school, the other at home. If the school won’t allow that, check into digital copies. Many publishers are making their books available for iPads and other tablets.

Let’s start with wheely backpacks. They may seem like a good solution to the problem, but before buying one, consider this:

  • A recent study compared the posture of kids with wheeled packs against those with regular ones. The wheely kids were actually more asymmetrical (meaning they were leaning to one side) and were putting more stress on their spine (by twisting) than kids with traditional packs.
  • They still have to be lifted to get them in and out of cars and up and down stairs. And because of the wheels, it’s tempting for kids to put even more stuff in them than they would with a regular pack.
  • Some schools have banned them. They scuff floors, chip concrete, and ding up walls. They also cause traffic jams in hallways and because they’re below eye level, are major tripping hazards.

Wheely or not, here are a few important guidelines:

  • The pack should not weigh any more than 10 percent of your child’s bodyweight. The recommendations used to be 10-15 percent, but a recent study found that even 10 percent compressed the discs in the back and caused the spine to curve unnaturally.
  • If the backpack makes your child lean forward to carry it, it’s too heavy, no matter how much it weighs. It’s also too heavy if your child struggles when putting it on or taking it off.
  • The pack itself should be made of a sturdy, lightweight material and have two thick straps. Thin straps can cut into the shoulder and cause pain or even pinch a nerve.
  • Load heavier objects so they’ll be closer to your child’s back. And leave personal items at home or in a school locker (assuming it has an actual lock on it).
  • Lift properly. That means bending the knees, being right in front of the pack when picking it up, and using both hands. Yanking a heavy object with one hand or from the side puts too much pressure on the spine.
  • Wear it properly. Wearing a pack over one shoulder may look cool, but it can cause short- and long-term neck and back problems.  If the pack has chest or waist straps, use them. They help distribute the weight of the pack more evenly.  The pack should also be worn so it sits between the shoulder blades and not on the low back.
  • Stow it properly. Some backpack-related injuries are the result of kids tripping over them.

Finally if your son complains of tingling, numbness, or pain before, during, or after wearing the pack, have him stop wearing the pack completely until his pediatrician can examine him.