Facing the burden of backpacks head on

Boston Globe
2/11/2001

Facing the burden of backpacks head on
By Lisa Capone, Globe Correspondent, 2/11/2001

Waiting in a neighbor's kitchen last Monday for his ride to school, Ramin Sabouri leaned at least a foot forward from the back of his chair, his bulging backpack taking up the space in between. The Melrose fifth grader said it felt like 50 pounds - an exaggeration, maybe, but, still, he said, his back often bothers him.

''My dad always says I'm going to break my back,'' the 11-year-old said.

A week before, a Saugus sixth-grader, Carolyn Thaggard, spent an afternoon researching her science fair project at the Marblehead Library. Thaggard, 12, was there because two Swampscott chiropractors were
holding a workshop on the topic for her project - medical problems associated with backpacks.

And, at Beverly High School last week, Northeastern University began soliciting student subjects for a study of back, shoulder, and neck pain associated with backpacks. The study will examine whether students can get relief from aches and pains by learning proper techniques for carrying backpacks or by using an ergonomic pack designed by a Beverly company.

Around the North Weekly region, complaints about the weight of backpacks abound among parents and children at public and private schools. The Massachusetts Chiropractic Society doesn't track the number
of youngsters treated for backpack-related pain, but anecdotal reports indicate that the number of young patients is increasing, according to Dr. Peter Hill, the society's vice president of public information and education. With the U.S. Consumer Product Safety Commission reporting that the nation's emergency rooms treated 840 10- to 18-year-olds in 1999 for neck, shoulder, and upper trunk injuries associated with book bags, some area doctors are taking action. Several, like Drs. David Shahar and Valerie
Radziminsky of Swampscott Family Chiropractic Center, have been contacting schools and offering to conduct workshops on the problem.

''It's similar to a worker that has an over-use type of injury,'' said a Wakefield chiropractor, Christopher Halligan, who addressed Melrose school nurses on the subject last month and will speak at a Melrose
elementary school assembly Friday. ''Children have to be educated, but their bodies also need to function for the rest of their lives.''

In Melrose, medical professionals have already alerted parents to the hazard backpacks can be. ''We hear of kids with back spasms,'' said Dr. Alan Woolf, a pediatrician for the Melrose middle and high schools. ''We sent information home to parents warning them about excessive weight and improper use'' of backpacks.

In addition to the December newsletter to Melrose parents, Woolf said, he and school nurses have discussed the possibility of an educational effort aimed at students themselves.

While young bodies can take a lot of stress, he said, it's important to break bad habits, such as slinging a pack over one shoulder, that can lead to problems later.

Just as reports of neck and shoulder strain are consistent from town to town, however, so is this message: In the age of MCAS and competitive academic standards, the nightly cargo of books isn't likely to diminish. Better learn how to pack and carry your knapsack correctly or maybe invest in a new one
that more evenly distributes the load.

While doctors say children shouldn't carry more than 15 percent of their body weight in a backpack, students these days commonly exceed that, lugging around thick textbooks, binders, athletic equipment, water bottles, lunches, even laptop computers.

''It seems to be a way of life. I'm not sure where it started, but kids switched from carrying books in their hands to backpacks,'' said Beverly High School, Principal Bill Foye, whose students are participating in the Northeastern study.

Subjects in the study by Northeastern's orthopedic physical therapy professor, Mary Hickey, will include 100 students each at Beverly High School and at St. Jeanne d'Arc School in Lowell, where the experiment is targeting middle-schoolers. Each school includes four groups. One will receive instruction in backpack use, such as proper lifting techniques and maximum weight guidelines. Another group will get new backpacks donated by AirPacks, Inc., of Beverly. A third group will receive both new packs and training, while a fourth control group will receive neither.

At the end of a month, Hickey and a graduate student will question students about pain and physical functioning. She plans to present her data at the St. Jeanne d'Arc science fair in March and at the National School Nurse Association annual meeting in Phoenix in June.

Hickey's current study follows one she conducted in the Boston public schools last year that found that fifth- through eighth-graders who carry more than 10 percent of their body weight in backpacks were four times more likely to experience back pain. ''I was weighing 60-pound kids carrying 30-pound packs,'' she said.

According to chiropractors, medical trouble linked to weighty backpacks goes beyond the occasional stiff neck. Over the long term, they say, improper backpack use may aggravate scoliosis (curvature of the spine), put pressure on nerves attached to the spinal column, and cause lifelong poor posture. And, since the spine is the body's control panel, unchecked strain can lead to maladies such as headaches, pain in the lower back, muscle spasm, and pain that radiates into arms and legs.

AirPacks announced this month that its recent survey of more than 200 New England school nurses found that 66 percent reported seeing high school students with pain or injuries related to carrying backpacks.

AirPacks donated 100 backpacks for Northeastern's study. The packs feature air cushions in the shoulder straps and lumbar (lower back) area, and a triangular shape, said company president Jill Ammerman, who launch the firm in 1998. She said her design research included consulting with orthopedic specialists and interviewing makers of ''technical'' knapsacks used by wilderness hikers.

''I don't know of anyone who hikes and carries 50 pounds and complains of back pain. There are some basic principles they look at when they are designing the bags,'' Ammerman said. After attending a backpacking trade show in Vermont, she said she wondered: ''Why aren't we doing the same
thing for the packs the kids are carrying?''

Ammerman, who has a third-grader and a fifth-grader at the Brookwood School in Manchester-by-the-Sea, said the company also researched ''the cool factor'' - what backpack features would appeal to kids and what would turn them off. ''We literally sat in front of schools during dismissal times and saw what kids were doing,'' she said.

Anyone who has done that knows that it's rare to see a student using a waist belt, even though that is among the guidelines espoused by Backpack Safety America, a national educational group organized by chiropractors. Ammerman said AirPack's unique design reduces back stress by 80 percent
without a waist belt, and even works if the pack is worn over just one shoulder.

Just as wearing waist belts hasn't caught on, neither has another solution: the rolling pack, which has a handle that enables students to pull it behind them. Students report that the wheeled packs don't fit in some lockers and are awkward on stairs.

As part of a language arts class project last fall, two students at Higgins Middle School in Peabody, Melanie Garber and Melissa Panniello, wrote letters to The Gap and Abercrombie & Fitch, asking the trendy retailers to design a wheeled pack that fits into lockers and ''would be cool enough for
eighth-graders,'' said their teacher, Julia Wistran. The students haven't received feedback from the companies yet, said Wistran, whose department purchased two sets of textbooks last year so that students can keep a book at home, another option being looked at by some school systems be considered too expensive by most. According to a Boston textbook publisher, the per-book cost of a typical middle school social studies text is roughly $50.

In the end, technology may hold the key. The textbook publishing and technology industries are ''merging,'' and, eventually, students will trade textbooks for CD-roms and content downloaded from the Internet, said Carolyn Mauer, president of the National Association of Textbook Administrators. Aware of the backpack issue, the group is holding a ''Summit on Textbook Size and Weight'' at its annual meeting next month.