Heavy backpacks can strain growing bones and joints: AAOS shares back-to-school safety tips

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Heavy backpacks can strain growing bones and joints: AAOS shares back-to-school safety tips

A simple three-step approach can help students carry school supplies more safely and comfortably

ROSEMONT, Ill. (August 24, 2026)-As students head back to school, the American Academy of Orthopaedic Surgeons (AAOS) is encouraging families to pay closer attention to an everyday item that can take a toll on growing bodies: the backpack.

When backpacks are too heavy or worn improperly, they can contribute to back, neck and shoulder pain, muscle strain, and changes in posture. For children and adolescents whose bones and muscles are still developing, establishing good backpack habits can help reduce unnecessary stress on the musculoskeletal system.

"A backpack may seem harmless, but when it is too heavy, poorly fitted or carried incorrectly day after day, it can put unnecessary strain on a child's back, neck and shoulders," said Sumeet Garg, MD, FAAOS, pediatric orthopaedic and spine surgeon at Children's Hospital Colorado. "Parents should watch for signs that the load may be too much, including struggling to put the backpack on, leaning forward while walking or complaining of pain or discomfort."

As a general guideline, a child's loaded backpack should weigh no more than 15% of their body weight. That means a 100-pound student should carry no more than 15 pounds[1]. With laptops, water bottles, textbooks, lunches, and activity gear all competing for space, backpacks can become heavier than families expect.

AAOS suggests a simple "Pack It, Check It, Adjust It" approach to help families make backpack safety part of their back-to-school routine.

Pack it: Start with what they actually need
Before the first day of school, have your child pack their backpack with everything they expect to carry on a typical day. Books and technology may be obvious sources of weight, but water bottles, lunches, sports equipment and supplies can quickly add to the load.

To keep the backpack manageable:

• Remove items that aren't needed that day and regularly clear out papers, books and other supplies that accumulate over time.
• Place heavier items low and toward the center of the backpack to help distribute weight more evenly.
• Take advantage of lockers or other school storage when available rather than carrying every item throughout the day.
• Consider carrying sports equipment or other bulky items separately when they can be stored at school.

Check it: Watch how your child carries the load
Once the backpack is packed, pay attention to more than what's inside. Watch your child put it on, walk with it and take it off.

A backpack that causes a child to struggle when lifting it, lean forward while walking or adjust their posture to compensate for the load may need to be lightened or adjusted.

Parents and caregivers should also ask about back, neck and shoulder pain or discomfort associated with carrying a backpack. Persistent pain, numbness or tingling should not be ignored.

Adjust it: Small changes can ease the burden
A well-fitted backpack can help distribute its contents across some of the body's strongest muscles. Choose a lightweight backpack that is appropriately sized for the child and has two wide, padded shoulder straps and a padded back.

Encourage students to:

• Use both shoulder straps rather than carrying the backpack over one shoulder.
• Adjust the straps so the backpack fits snugly and stays close to the body.
• Keep the backpack positioned appropriately rather than allowing it to hang well below the waist.
• Bend at the knees when lifting a heavy backpack from the floor.

"The contents of a student's backpack can vary throughout the school year as schedules, activities and supplies fluctuate," added Dr. Garg. "Parents can make backpack safety an ongoing habit by periodically checking what their child is carrying and asking whether they're experiencing any pain or discomfort."

Learn more about backpack safety and back pain in children at OrthoInfo Backpack Safety.

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About AAOS
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world's largest medical association of musculoskeletal specialists. AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients daily. AAOS is the source of information on bone and joint conditions, treatments, and related musculoskeletal healthcare issues; and it leads the healthcare discussion on advancing quality.

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[1] https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Backpack-Safety.aspx