David Siambanes DO. discusses the weight of heavy backpacks on children and back pain associated with it.
Learn more about BayCare’s children’s health services at BayCareKids.org
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The Weight of Heavy Backpacks on Children
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Dr. Siambanes served as Director of Education, Clinical Assistant Professor of Orthopedic Surgery and Vice Chair, Department of Orthopedics at Riverside California County Regional Medical Center. He was also co-chairman of the Medical Advisory Team for the Children’s Spine Foundation and President, Spine Section of the American Osteopathic Academy of Orthopedics. Dr. Siambanes served as the primary orthopedic pediatric surgeon for the Riverside County’s division for California Children’s Services. In this capacity he was involved in the orthopedic management of cerebral palsy and its effects on the walking child.
Dr. Siambanes is a member of The American Osteopathic Academy of Orthopedics, American Osteopathic Association, Scoliosis Research Society, and the Osteopathic Physicians and Surgeons of California. He has performed multiple presentations and published numerous articles in peer-reviewed journals. His article titled “The Influence of School Backpacks on Adolescent Low Back Pain” published in the Journal of Pediatric Orthopedics addresses a growing national concern among parents of schoolchildren.
Learn more about David Siambanes, DO
David Siambanes, DO
David Siambanes, DO is board certified in orthopedic surgery and is fellowship trained in pediatric orthopedics and reconstructive spine surgery with a focus on scoliosis and spinal deformities. He received his Bachelor of Science in biology from the University of Illinois. He received his Doctor of Osteopathic Medicine from the Chicago College of Osteopathic Medicine, Midwestern University. He completed fellowships in reconstructive spine surgery from the University of Southern California and in pediatric orthopedics from Alfred I. duPont Hospital for Children.Dr. Siambanes served as Director of Education, Clinical Assistant Professor of Orthopedic Surgery and Vice Chair, Department of Orthopedics at Riverside California County Regional Medical Center. He was also co-chairman of the Medical Advisory Team for the Children’s Spine Foundation and President, Spine Section of the American Osteopathic Academy of Orthopedics. Dr. Siambanes served as the primary orthopedic pediatric surgeon for the Riverside County’s division for California Children’s Services. In this capacity he was involved in the orthopedic management of cerebral palsy and its effects on the walking child.
Dr. Siambanes is a member of The American Osteopathic Academy of Orthopedics, American Osteopathic Association, Scoliosis Research Society, and the Osteopathic Physicians and Surgeons of California. He has performed multiple presentations and published numerous articles in peer-reviewed journals. His article titled “The Influence of School Backpacks on Adolescent Low Back Pain” published in the Journal of Pediatric Orthopedics addresses a growing national concern among parents of schoolchildren.
Learn more about David Siambanes, DO
Transcription:
The Weight of Heavy Backpacks on Children
Introduction: Here's another edition of the BayCare Health Systems podcast series BayCare Health Chat with Melanie Cole.
Melanie Cole: Welcome to BayCare Health Chat, I'm Melanie Cole, and I invite you to listen in, as we discuss the weight of heavy backpacks on our children. Joining me is Dr. David Siambanes. He's a Pediatric Orthopedic Surgeon with BayCare. Dr. Siambanes, I'm so glad to have you with us. As a parent, this is something I have seen all throughout my kids' school years. Tell us a little bit how your passion as an orthopedic surgeon for this particular topic came about.
Dr. Siambanes: Well, I was practicing in California and I had a lot of families and mothers very concerned about their middle age kids leaving for school with backpacks that looked like they outweighed the child and were concerned about that only is it causing the child pain or are there any detrimental effects in the future? So it alerted me to kind of look into it and actually investigate it.
Host: So then tell us about the incidents of back pain in school, children. What have you been seeing and how does it relate to backpacks? How do we know it relates to backpacks?
Dr. Siambanes: So, you know, listen, these were questions that came up to me and they were asking that they weren't very many answers for. So I did in fact, start a study where we actually evaluated a lot of children, over 3000 children. And we found that many of them, the majority of them did have back pain. And these are the middle aged kids. And they were given a questionnaire on what their backpacks were weighed and it was clearly determined, there were issues. There was back pain in nearly 64% of the kids reported some low back pain. And almost all of them noted. It was when they were carrying their backpack. And even 80 something percent of them, 87% of them reported the pain was bad or very severe. So this was significant for an age group that most doctors feel back pain is not a significant problem.
Host: That's so interesting cause I'm sure the chairs at schools are not exactly great for their backs as well, but those backpacks could literally pull those chairs backwards. You know? So tell us a little bit about why this is happening. Why do you think, and what are the kids stuffing into these backpacks? Because they're not even using books as much anymore, so what's making them so heavy.
Dr. Siambanes: Right. So one thing I found that 30% of the weight of the backpack didn't even include educational equipment. So, you know, a kid that age will typically put whatever they can in the backpack. There really doesn't have to be carried back and forth to school. And they don't think very much about which books or which binders they need for that day and which ones they don't need. They don't typically have lockers anymore. Those are kind of, most of them were removed because of vandalism. And if they have a locker, the schools are so big, they can really get to it between classes. So that kind of really instigated the issue that I remember as a child. I had a, I mean I could even get to my locker every after every class. That's no longer the case.
Host: That's a really good point that you just made because I know that with my own kids, like I don't go to my locker, it's on the other side of the school. So they do try and carry everything they need for the day. So do you have a weight limit? I mean, I guess it depends. My kids are tiny Dr. Siambanes, but do you have a weight limit? Is there some way for a parent to say, okay, that one's too heavy for you, that's going to start to affect your back your posture. I can see you leaning forward. Is there some way for a parent to judge this as their child puts their backpack on?
Dr. Siambanes: Yeah, I do think that a weight no greater than 50% of their body weight is effective. But you know, we did find that it really wasn't a strict number. You know, the more weight you had your backpack, the more likely, the more prevalent you would have back pain. So there was a clear correlation with the weight of the backpack to how many kids or how severe the pain was. So the lighter weight, lighter weight than anything is the best, but that's hard to achieve. So you want to try to at least shoot for 15% of the child's body weight. And hopefully that will diminish the issue. But that takes a lot of effort. You know what I mean? Like you said, the textbooks are gone most of the time, but there are still notebooks that become very heavy. They have to think about what they're going use and what they're not going to use that day. You know, they're going to have to keep everything that's non-educational out of the backpack. I've actually recommended certain times that kids use a rolling backpack, which is not favorable a lot of times in the school. And I will tell you most of the kids at a certain age, they do not feel the backpack early backpack is cool and that alone will just kill it.
Host: Oh, absolutely. And I heard that myself and I remember doctor, pulling big binders and saying to my daughter, you don't need to carry this one. And she's like, well, in free period, I might be needing it for studying or this. And yes, you're right. They do not want to be rolling around those rolling backpacks. So what's a parent to do, what do we do? How do we get our kids to not overfill them? Or, you know, do something that's more ergonomically correct for their backs.
Dr. Siambanes: Yeah. I had one, one thought it was so comical. I had one, a young girl tell me that if she used a rolling backpack, should we consider it social suicide? And I thought that was interesting. But the first thing to do is try to participate in what they have in the bag. None of those kids want you looking in their backpack. So if you remind them that I'm going to have to check your backpack before you go to school every day, we might even have to weigh it to determine what's in there. And what's the weight of it. They'll be more likely to self regulate themselves. Wearing it over both shoulders is probably better than carrying it on one arm. We found out that it also the length that you're wearing it. So if you're, if you walk back and forth to school, that was a tremendous increase in complaints of back pain because of that timeframe. So anytime you can get, you know, a carpooling or things of that nature, anything, they reduce the actual, not only the weights, but the length of time you're wearing it.
Host: That's a great idea is to discuss your child, well, I'm going to look through it. If you don't do it yourself, because as you say, they do not want us to look through it and the length of time, and you said the length, it should sit down. Is there a spot in the back doctor that you would prefer it go up above the lumbar spine? Where do you want it?
Dr. Siambanes: Yeah, the higher, higher above the lumbar spine is better. I mean, you want to try to get a closer and closer to your center of gravity. So it's kind of hugged to your back. If it's hanging too low, it's going to actually pull your upper back down. So, you know, there is a benefit of trying to keep it close to the back and up on the back. But that honestly is probably less important than the length of time you're wearing it and the weight that's on your back. But some things can't be changed completely.
Host: Do you have some advice for parents on how they can help their children to strengthen their core so that even if the backpacks a little over heavy and not completely, the kid is strong enough in their core is strong enough. Do you have some advice for us?
Dr. Siambanes: Yeah. Standard exercise and things can be discussed, but simple enough is posture. We have a lot of kids that come to us with back pain. It's really associated to bad posture. And some of it's habitual. I mean, if you're leaning forward, looking at your phone all day long, that's how you're going to walk. So keeping your shoulders back and your head over your pelvis, kind of concept is very important to avoiding back problems in the future or during school and sitting proper in a chair, like you said, those chairs in the school are horrible, but you need to do your best to, you know, have that lumbar support or be able to sit with your shoulders back. I tell them, when the child sits down to dinner, you have to remind them shoulders back because that's the first time you'll see them, you know, with that inappropriate posture.
Host: Well, absolutely. That's really all good advice. Do you have a wrap up for us doctor that you would like parents to know about? What you're seeing is an orthopedic surgeon and back issues that children of middle school, age and younger age in high school, and even college should not be having at this point, but they're loading up those backpacks and causing back problems. So wrap it up, give us your best advice.
Dr. Siambanes: Yeah. I think, you know, it is a problem. And it's going to be, we don't know what a problem that's going to cause when they're an adult. So yeah. Keep it light, you know, get involved is the biggest thing. Get involved in how they're getting to school, what they're bringing the school and what they can avoid. And that's the biggest thing is the more involved you are, the more intervention you can provide. And I think that's part of the thing. I think we ask sometimes too much just from the school when we need to intervene as families also. So there's so much the schools could provide, the lockers are not coming back. They're not going to be more frequent. It's somewhat on our shoulders to do it.
Host: Well, it certainly is. And we can always give the old suggestion of the rolling backpacks and say that we know an orthopedic surgeon that told us rolling backpacks are cool. And then maybe the kids would think about it, but you're right. And thank you so much. It's great advice. I think parents need to hear this and get, as you say, and communicate, and maybe the kids don't need everything in their backpack and we can help them protect their backs while they're young, because we know that when you get older, it's a little bit more difficult. So thank you so much. And to learn more about BayCare's Children's Health Services, please visit our website at baycarekids.org for more information. And that concludes this episode of BayCare Health Chat. Please remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. I'm Melanie Cole.
The Weight of Heavy Backpacks on Children
Introduction: Here's another edition of the BayCare Health Systems podcast series BayCare Health Chat with Melanie Cole.
Melanie Cole: Welcome to BayCare Health Chat, I'm Melanie Cole, and I invite you to listen in, as we discuss the weight of heavy backpacks on our children. Joining me is Dr. David Siambanes. He's a Pediatric Orthopedic Surgeon with BayCare. Dr. Siambanes, I'm so glad to have you with us. As a parent, this is something I have seen all throughout my kids' school years. Tell us a little bit how your passion as an orthopedic surgeon for this particular topic came about.
Dr. Siambanes: Well, I was practicing in California and I had a lot of families and mothers very concerned about their middle age kids leaving for school with backpacks that looked like they outweighed the child and were concerned about that only is it causing the child pain or are there any detrimental effects in the future? So it alerted me to kind of look into it and actually investigate it.
Host: So then tell us about the incidents of back pain in school, children. What have you been seeing and how does it relate to backpacks? How do we know it relates to backpacks?
Dr. Siambanes: So, you know, listen, these were questions that came up to me and they were asking that they weren't very many answers for. So I did in fact, start a study where we actually evaluated a lot of children, over 3000 children. And we found that many of them, the majority of them did have back pain. And these are the middle aged kids. And they were given a questionnaire on what their backpacks were weighed and it was clearly determined, there were issues. There was back pain in nearly 64% of the kids reported some low back pain. And almost all of them noted. It was when they were carrying their backpack. And even 80 something percent of them, 87% of them reported the pain was bad or very severe. So this was significant for an age group that most doctors feel back pain is not a significant problem.
Host: That's so interesting cause I'm sure the chairs at schools are not exactly great for their backs as well, but those backpacks could literally pull those chairs backwards. You know? So tell us a little bit about why this is happening. Why do you think, and what are the kids stuffing into these backpacks? Because they're not even using books as much anymore, so what's making them so heavy.
Dr. Siambanes: Right. So one thing I found that 30% of the weight of the backpack didn't even include educational equipment. So, you know, a kid that age will typically put whatever they can in the backpack. There really doesn't have to be carried back and forth to school. And they don't think very much about which books or which binders they need for that day and which ones they don't need. They don't typically have lockers anymore. Those are kind of, most of them were removed because of vandalism. And if they have a locker, the schools are so big, they can really get to it between classes. So that kind of really instigated the issue that I remember as a child. I had a, I mean I could even get to my locker every after every class. That's no longer the case.
Host: That's a really good point that you just made because I know that with my own kids, like I don't go to my locker, it's on the other side of the school. So they do try and carry everything they need for the day. So do you have a weight limit? I mean, I guess it depends. My kids are tiny Dr. Siambanes, but do you have a weight limit? Is there some way for a parent to say, okay, that one's too heavy for you, that's going to start to affect your back your posture. I can see you leaning forward. Is there some way for a parent to judge this as their child puts their backpack on?
Dr. Siambanes: Yeah, I do think that a weight no greater than 50% of their body weight is effective. But you know, we did find that it really wasn't a strict number. You know, the more weight you had your backpack, the more likely, the more prevalent you would have back pain. So there was a clear correlation with the weight of the backpack to how many kids or how severe the pain was. So the lighter weight, lighter weight than anything is the best, but that's hard to achieve. So you want to try to at least shoot for 15% of the child's body weight. And hopefully that will diminish the issue. But that takes a lot of effort. You know what I mean? Like you said, the textbooks are gone most of the time, but there are still notebooks that become very heavy. They have to think about what they're going use and what they're not going to use that day. You know, they're going to have to keep everything that's non-educational out of the backpack. I've actually recommended certain times that kids use a rolling backpack, which is not favorable a lot of times in the school. And I will tell you most of the kids at a certain age, they do not feel the backpack early backpack is cool and that alone will just kill it.
Host: Oh, absolutely. And I heard that myself and I remember doctor, pulling big binders and saying to my daughter, you don't need to carry this one. And she's like, well, in free period, I might be needing it for studying or this. And yes, you're right. They do not want to be rolling around those rolling backpacks. So what's a parent to do, what do we do? How do we get our kids to not overfill them? Or, you know, do something that's more ergonomically correct for their backs.
Dr. Siambanes: Yeah. I had one, one thought it was so comical. I had one, a young girl tell me that if she used a rolling backpack, should we consider it social suicide? And I thought that was interesting. But the first thing to do is try to participate in what they have in the bag. None of those kids want you looking in their backpack. So if you remind them that I'm going to have to check your backpack before you go to school every day, we might even have to weigh it to determine what's in there. And what's the weight of it. They'll be more likely to self regulate themselves. Wearing it over both shoulders is probably better than carrying it on one arm. We found out that it also the length that you're wearing it. So if you're, if you walk back and forth to school, that was a tremendous increase in complaints of back pain because of that timeframe. So anytime you can get, you know, a carpooling or things of that nature, anything, they reduce the actual, not only the weights, but the length of time you're wearing it.
Host: That's a great idea is to discuss your child, well, I'm going to look through it. If you don't do it yourself, because as you say, they do not want us to look through it and the length of time, and you said the length, it should sit down. Is there a spot in the back doctor that you would prefer it go up above the lumbar spine? Where do you want it?
Dr. Siambanes: Yeah, the higher, higher above the lumbar spine is better. I mean, you want to try to get a closer and closer to your center of gravity. So it's kind of hugged to your back. If it's hanging too low, it's going to actually pull your upper back down. So, you know, there is a benefit of trying to keep it close to the back and up on the back. But that honestly is probably less important than the length of time you're wearing it and the weight that's on your back. But some things can't be changed completely.
Host: Do you have some advice for parents on how they can help their children to strengthen their core so that even if the backpacks a little over heavy and not completely, the kid is strong enough in their core is strong enough. Do you have some advice for us?
Dr. Siambanes: Yeah. Standard exercise and things can be discussed, but simple enough is posture. We have a lot of kids that come to us with back pain. It's really associated to bad posture. And some of it's habitual. I mean, if you're leaning forward, looking at your phone all day long, that's how you're going to walk. So keeping your shoulders back and your head over your pelvis, kind of concept is very important to avoiding back problems in the future or during school and sitting proper in a chair, like you said, those chairs in the school are horrible, but you need to do your best to, you know, have that lumbar support or be able to sit with your shoulders back. I tell them, when the child sits down to dinner, you have to remind them shoulders back because that's the first time you'll see them, you know, with that inappropriate posture.
Host: Well, absolutely. That's really all good advice. Do you have a wrap up for us doctor that you would like parents to know about? What you're seeing is an orthopedic surgeon and back issues that children of middle school, age and younger age in high school, and even college should not be having at this point, but they're loading up those backpacks and causing back problems. So wrap it up, give us your best advice.
Dr. Siambanes: Yeah. I think, you know, it is a problem. And it's going to be, we don't know what a problem that's going to cause when they're an adult. So yeah. Keep it light, you know, get involved is the biggest thing. Get involved in how they're getting to school, what they're bringing the school and what they can avoid. And that's the biggest thing is the more involved you are, the more intervention you can provide. And I think that's part of the thing. I think we ask sometimes too much just from the school when we need to intervene as families also. So there's so much the schools could provide, the lockers are not coming back. They're not going to be more frequent. It's somewhat on our shoulders to do it.
Host: Well, it certainly is. And we can always give the old suggestion of the rolling backpacks and say that we know an orthopedic surgeon that told us rolling backpacks are cool. And then maybe the kids would think about it, but you're right. And thank you so much. It's great advice. I think parents need to hear this and get, as you say, and communicate, and maybe the kids don't need everything in their backpack and we can help them protect their backs while they're young, because we know that when you get older, it's a little bit more difficult. So thank you so much. And to learn more about BayCare's Children's Health Services, please visit our website at baycarekids.org for more information. And that concludes this episode of BayCare Health Chat. Please remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. I'm Melanie Cole.