August 1, 2023

Shoulder injuries and your child’s backpack

Pediatric Orthopedics | Shoulder | Urgent Care

Back-to-school shopping can be more exciting for kids than actually going back to school; but even more fun is picking out the backpack that will represent their style, has the perfect cell phone pocket and holds enough books.

The back-to-school rush is the time to really consider what type of backpack your child will be wearing and how that can affect their orthopedic health. Though it may seem silly or unnecessary, you may need to keep a close eye on your child’s search for a backpack; looking into the structure of the backpack and how much is going to be carried in it on a daily basis.

Did you know that a backpack can be a contributing factor for various overuse injuries of the shoulder and spine? Backpacks have potential to cause a lot of problems for kids if they are overloaded with books or are not properly fitted.

Shoulder injuries in children

Injuries affecting children’s shoulders can occur for various reasons. There can be an acute incident, congenital deformity or overuse injury. Dr. Chris Bales, an orthopedic surgeon at OrthoIndy specializing in knee and shoulder injuries, states that some of the common shoulder injuries affecting children and teens today are little league shoulder and shoulder subluxations. According to the American Academy of Orthopaedic Surgeons (AAOS), little league shoulder (not to be confused with little league elbow) is an overuse injury to the humerus at the shoulder joint where growth is still occurring. It can be caused by repeated overhead throwing combined with lack of proper mechanics, strength and endurance.

This injury is most common in boys ages 12 to 13 years old. A shoulder subluxation, seen more commonly in teens, occurs when falling on an outstretched arm. More commonly known as the “shoulder coming out of socket.” When this injury occurs the teen may feel a pop or experience a hanging feeling from the shoulder. Following the incident a person may notice the shoulder feels back in place; however, pain may still be present. Though these injuries occur during participation in sports and other extracurricular activities, poor shoulder mechanics can contribute to these injuries.

Furthermore, improperly fitted backpacks have potential to contribute to poor shoulder mechanics. The pediatric population is unique when assessing orthopedic injuries because they may still have open growth plates of the bones (little league shoulder). A physician will be able to see the open growth plates on an X-ray. “This information becomes important when I am assessing the severity of the shoulder injury and formulating a plan for healing,” says Dr. Bales.

Long term effects

There has not been enough research completed to thoroughly asses the long term affects of improper use of backpacks on shoulder health. What we do know is that how a backpack is fitted, carried and what is placed in it has potential to affect both shoulder and spine health of children today.

Backpack tips

According to AAOS, children’s backpacks should have two wide straps, a padded back, a waist strap, wide back and not be too heavy. suggests that the weight of the backpack should not exceed 10 to 15 percent of the child’s body weight. However, if your child must put a lot of books in their backpack for a short period of time, it is important that the heavier books be closer to the child’s body.

Dr. Bales believes that with the growing school systems and increased distances between classes, students have less time to get to their lockers, and are piling more in their backpacks and unloading less often. Ultimately, in order to help your child prevent injuries associated with improper backpack use, you need to look more at the backpack’s structure itself and what will go in it in stead of what color it is or who manufactured it.

Not just kids

Adults you are not off the hook either – worse than an overweight backpack are heavy purses and briefcases that pull on one shoulder. Whether your child is running off to school with a poorly fitted backpack or you are stepping out the door with a heavy purse or briefcase, we all must be aware of how our repetitive daily activities can negatively affect our shoulder health.


The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician.

Schedule an appointment

Your well-being is important to us. Click the button below or call us to schedule an appointment with one of our orthopedic specialists. If your injury or condition is recent, you can walk right into one of our OrthoIndy Urgent Care locations for immediate care. For rehabilitation and physical therapy, no referral is needed to see one of our physical therapists.

Schedule an Appointment Call OrthoIndy 317.802.2000

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