THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 539.5 Guest: Dr. Amal Jabra, Pediatric Radiologist, Johns Hopkins Children's Center Topic: Backpacks and Kids Producer/Host: Steve Girard

NEMA: Back to school...and my 8 year old hustles off with a backpack half his size, loaded up with books, lunch, a jacket and usually some project or baseball cards. Wondering about the way he and all his friends shuffle and bounce along, I'm speaking with Dr. Amal Jabra, a pediatric radiologist at Johns Hopkins Children's Center. Doctor, can the weight and size of a backpack cause some problems for kids...especially the way mine carries it with one strap on, one strap off?

JABRA: If... basically you have to start in giving you child a backpack which is well made, and the feature to look for is the shoulder straps should be well padded. And try to convince your youngster to wear both straps at the same time, so that whatever load they're carrying would be equally distributed to both shoulders, and the bag...so they don't end up causing strain and fatigue to one shoulder, one side of the neck more than the other. And concerning like, how much weight they should carry, there are really no hard and set rules about that . One advice would be that the youngster should gradually increase the load that he's carrying, or she's carrying. If they have not carried things on their backs before, it's a good idea just to increase whatever you're putting in their bag gradually, so that they're used to it. As to whether they're having any problems, clinically, one thing you can keep an eye for is whether they start complaining about any tingling sensations in their hands. And the reason for that would be that perhaps they are carrying too much of a heavy load that it is compressing the nerves that supply the upper extremities, and that could cause some tingling sensations. And so, they are just sort of like common sense things...try to distribute the weight, carry the weight, increase it gradually, and buy well padded shoulder strap backpacks.

NEMA: My son's backpack is just sort of open...a zipper at the top, and empty space to fill from the bottom up...I guess that having a bag with compartments would allow the weight to be distributed more evenly?

JABRA: Yes, some people say try to buy something like a hiking backpack, which has compartments to distribute the weight, but you know, as long as it's equally distributed along the shoulders, not to one side versus the other, then they should be okay.

NEMA: And if they do feel some tingling in the hands, or soreness on one side of the shoulder or neck...?

JABRA: ...Then, you need to decrease the load...because even if you give them an analgesic or whatever, it still means that there is compression on the nerve...and the tingling sensation should go away once you remove the load, basically. If you feel they have some pain, or whatever, then you can give them a Tylenol, or some analgesic.

NEMA: Common sense, yes. But I know if my boy came in complaining about tingling hands, and a sore neck or shoulder...I would think of twenty things before I suspected a backpack problem. Just something to think about...I'm Steve Girard.