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Prisma Health Children’s Hospital–Midlands offers book bag safety tips

Monday, July 29, 2019

Orthopedic surgeon recommends ways to avoid injuries

A new school year is just around the corner and parents are busy stocking up on school supplies. Many parents like to take advantage of the tax-free weekend, which is set for August 2-4. With backpacks topping most students' checklists, Prisma Health Children's Hospital–Midlands offers some tips to keep in mind when purchasing and using backpacks.

According to Mark Locke, MD, pediatric orthopedic surgeon with Palmetto Health-USC Orthopedic Center, "Back pain is not an uncommon complaint for children and adolescents, particularly those in middle school. It seems that every year the books get thicker and book bags get heavier."

Parents may have the concern that book bags contribute to spinal deformities such as scoliosis. "There is clear medical evidence that there is no link between heavy book bags and scoliosis," said Locke.

The Consumer Product Safety Commission estimates that nearly 5,000 emergency room visits each year are due to injuries related to book bags. Many students have no lockers, or limited access to lockers between classes because of security or disciplinary issues.

"Twenty years ago, it was rare for a child to complain of back pain. Now, this type of pain is seen daily," said Locke. "Book bag related pain seems to be most prevalent in middle school-aged children, who sometimes carry loads of up to 20 percent of their body weight."

Locke said heavy book bags and those carried on one shoulder can contribute to postural problems. Rolling book bags are an option, but not a solution. Although it is better to pull than to carry heavy books, rolling bag weight can lead to its own set of problems, such as arm and leg pain.

“If a child is having back pain, the newest recommendation from the American Academy of Pediatrics is to schedule an MRI because it has no radiation, as compared to a CT scan or an X-ray,” said Locke.

Book bag and backpack injuries are avoidable. Here are a few backpack safety tips to keep in mind before sending your child off to school:

  • Use both shoulder straps.
  • Lap belts or roller bags may be helpful.
  • Pack heavy items close to back.
  • Keep the weight of the bag less than 15 percent of body weight.

Locke urged parents to weigh their children's book bags and to notice if the child tends to lean forward while wearing the backpack. "That's a sign that it is too heavy," he said. Locke also recommended that children do core strengthening exercises, such as Zumba, Pilates or yoga plank poses.

"As technology advances in the classroom, children will likely carry electronics rather than books. Hopefully this issue eventually will become a problem of the past," said Locke.

For information about Palmetto Health-USC Orthopedic Center, visit

About Prisma Health Children’s Hospital–Midlands
Prisma Health Children’s Hospital–Midlands is South Carolina’s first children's hospital and has more than 150,000 children’s visits each year. It offers more than 30 subspecialties to meet the unique health care needs of children and has central South Carolina's only Children’s Emergency Center. With more than 350 professionals who work exclusively with children, Prisma Health Children’s Hospital–Midlands has a team of highly skilled and trained experts unmatched by any hospital in the Midlands. Prisma Health Children’s Hospital–Midlands is the place to go for children's medical care, because the best care matters.

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