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Are backpacks getting heavier these days? by Leo Albano Physical Therapist, Outpatient Clinic When I began thinking about backpacks and musculoskeletal impairments caused by wearing them, I couldn’t decide whether I should address the backpack itself or the person wearing it. This brings up the debate of ergonomics (adapting the workplace to meet the abilities of the worker) vs. body mechanics (performing daily activities with the least amount of strain on the musculoskeletal system) and individual fitness. I don’t think these issues can be viewed separately. First of all, when you look at the backpacks themselves, you need to be able to recognize the “ergonomically correct” features. Wide shoulder straps are crucial to prevent compression of the muscles/nerves/vessels in the thoracic outlet region. Compression of these structures could lead to neck pain, shoulder pain, or upper extremity paresthesias that could cause eventual weakness and loss of coordination.  In addition to wide shoulder straps, you should look for backpacks with a waist belt in order to displace some force to the pelvic region. The musculature in the pelvic region is much stronger than the musculature in the upper quarters. Recreational Equipment Incorporated (R.E.I.) has a nice selection of backpacks with waist belts. Finally, you should try to actually wear your backpack around the store for a while to see if it is comfortable (today’s online shopper will have a problem doing this). In terms of body mechanics and fitness, you need to have a general idea of how many books or how much weight you can safely handle in your backpack.  Some of my patients tell me that it is necessary to carry around all of their textbooks every single day. If this is actually true, then the educational system has drastically changed during the past 5-10 years. I thought that the new technological advances in education and the workplace were supposed to be helpful and make things more efficient, but I digress.  The major muscle groups that need to be strengthened in order to stabilize the spine are the abdominals, paraspinals, and parascapular muscles. Just remember that having good-looking abdominals does not necessarily mean that they are functionally strong. In other words, you have to consciously contract your abdominals and parascapular muscles when carrying your backpack in order to maximize stability of your spine. Above all, common sense is the most important factor in injury prevention when wearing backpacks. Be sure to use both straps around the shoulders and the waist belt at all times (no matter how much of a dork you look like). If you choose to wear a single strap bag it is better to wear it across your chest than dangling from your side. Take frequent breaks throughout the day, try to avoid carrying all of your books at once, and call a physical therapist if you are experiencing any pain or discomfort before it becomes a serious problem.