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Back Pain and School Bags

Can you imagine the amount of discomfort, pain, and even damage that can happen to your back and neck when you carry a heavy bag on one side of your neck and shoulder?

Imagine if that happens for years and years.

And THAT is what our children, teenagers and even adults have been doing for years and years, not realizing that repeated action of carrying heavy bags on one side (or even with both shoulders) can damage their soft and hard tissues around their spine, shoulders, hips, knees and more.

Many of these children who develop back pain in their childhood, will likely to have their back pain evolve into long term chronic back and neck pains and problems in their adults years...as well as into late adulthood and life a whole, if situation doesn't change, of:

  • the situation of heavy school bags (one sided carry or both shoulder carry)
  • carrying repeatedly for years on end

Many of these children who develop back pain, develop into chronic back and neck problems in their adult years, and well into late adulthood and life, if left untreated or unmanaged.

Other health and postural issues that may arise from these repetitive strain injuries:

  • soft tissue tears
  • muscle strains
  • disruption to the natural "S" shape curve in the spine bones
  • chronic fatigue and tiredness
  • neck pains
  • rounded shoulders

As a parent (or if you have back/neck pains because of the same problems of heavy school bags), you can help reduce the risk by:

  • buying appropriate sized school bags that distribute load better (better still, school bags that have wheels)
  • ensuring that their school bags are not too heavy for them
  • where possible, get school lockers where they can leave heavy books/items in school to minimize distance/time to carry heavy school bags

Back Pain and School bags:
Risk Factors

  • The school bag must not weigh more than 10% of the child/student's weight. Eg a 50 KG student should carry at max 5 KG load in his/her school bag
  • Do not carry school bags only on one shoulder
  • Do not hold the bag in one hand (like carrying a briefcase)
  • Try to "centralize" the weight in the back pack (rather than having one side more heavy than the other)
  • Try to correctly fit the back pack to the person
  • Buy the correct size and shape back pack to the person

And example of back pack being slung too low (bottom of bag way below buttocks), poorly fitted bag and maybe even too heavy such that the child needs to lean forward to compensate

Back Pain and Schoolbags:
Buy the right kind of schoolbags

Any given time, school children always should have a back pack as compared to having a side sling bag, for better distribution of weight.

Some factors to consider:

  • Where possible, look for a school bag/backpack that has been endorsed by a health care organization, such as Physiotherapy Association of Allied Health Professions Council/Associations in your country
  • Please do not try to save money by buying the biggest back pack for your children/self, to stretch the use of the bag over time. Children and people need to have school bags and back packs that are just right for them. Anything too small or too big, they will have to compensate their posture and movements.
  • Choose a school bag backpack with a frame/adjustable hip strap, so that the weight of the back can and will be carried by your child's pelvis instead of their shoulders, back and neck.
  • The shoulder straps need to be wider for better support (the wider, the more support BUT the warmer it'd be) and padded for extra comfort and support. Straps need to be adjustible.
  • Ideally, the backpack should have a few separate compartments to separate out packing/storage
  • Canvas and plastic school bags are ALWAYS LIGHTER than leather ones
  • School bags can be quite personal, so please bring your children along when buying their bags (especially so if they're more conscious of their style and also minding peer pressure). If you choose a bag for them that YOU know is good but "not cool/hip" enough for them, they may end up carrying it in a less-than-ideal way to look cooler (such as carrying bags over one side of the shoulder).

Back Pain and Schoolbags:
Pack the backpack correctly

  • School bags/backpacks including all its content should not weight more than 10% of your child's body weight. Eg a 50 KG student should carry at max 5 KG load in his/her school bag.
  • Please pack the heaviest items as close as possible to the child's back - this will bring the center of gravity closer to the child and decrease the risk of muscle strains in the back and neck (and decrease "see-saw moves" (happens when there is a lighter load between a heavier load, there the child adopts a see-saw movement pattern)
  • Following to the point above, please show and teach your child how to ensure that items are securely fasted in the school bag as the child move - this will

    a. prevent their balance from being thrown off (decreasing risks of injuries and falls from loss of balance)
    b. prevent "see-saw movements"

Correct lifting and carrying techniques

  • The bottom of the school bag/backpack needs to be located ABOVE your child's waist. It shouldn't be located low eg at the buttocks
  • School bags that are fitted well to the child will follow the shape of the child's back and body, rather than "hang off their shoulders"
  • Please try to ensure the weight is adequate for them - your child needs to be able to lift the school bag with a straight bag using their thigh muscles, before slipping one arm through one strap and then the other arm through the other.
  • If you notice that your child has to leave one side to counterbalance the weight of the bag, then it's very likely that their back pack is too heavy for them, wrongly packed or doesn't fit well.
  • Please try to share and teach your child to understand that carrying backpacks or school bags over one shoulder will cause back pains, neck pains, hip pains and more.

Good back pack, fitted to child and even has roller wheels!

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(or check your pains / injuries)

Phoenix Rehab Physio Services

Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.


Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to

  1. manage and decrease hand pains
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  3. increase the function of their hand following injuries or post-operations

Commonly treated hand pain injuries includes


Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.

It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.

You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.


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Sports and deep tissue release massage helps to increase nutrient-rich blood flow to tired, tight and tense muscles to accelerate recovery and  shorten downtime / recovery period required.

It also prevents muscles from scar tissue micro-tears (and potential ruptures), and increases muscle performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.

Read the benefits of regular deep tissue release therapy here.


All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

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