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Help your child avoid back pain with proper backpack fit and usage

August 22nd, 2011 · Article

It’s school time again, and many back-to-school shopping lists include a backpack.  Choosing a pack that’s appropriate for your child, and educating your child on correct usage of the pack can help reduce the chance of injury down the road.  Things to consider include proper fit, proper packing, putting the pack on safely, and wearing the pack correctly.

Proper fit

  • A common mistake is purchasing a pack too large for the child; for many children under 12, or for smaller framed children, a child-sized pack often provides a more comfortable fit.
  • The pack should fit between the top edge of the shoulders and the level of the top of the hip bones.  Have your child try the backpack on.  This allows you to assess how the pack fits, and allows your child to determine if the pack is comfortable.
  • Shoulder straps should be well padded, wider over the shoulder and narrower under the arms.  This helps to prevent obstruction of nerve and blood flow.
  • A hip belt helps to distribute the weight of the pack more evenly.  The belt allows some of the pack’s weight to be taken by the pelvis, taking weight off of the shoulders and neck.
  • For older students carrying heavier packs, look for a pack with padding down the center.
  • Choose a durable yet lightweight backpack.  This will help to keep the total weight of the loaded pack at or under the recommended limit (see below.)


Proper packing

  • Physicians and physical therapists recommend the loaded pack’s weight not exceed 10-15% of the child’s weight.  10% is the guideline for elementary aged children, 15% for junior and high school students.  This means a 70 pound fifth grader should not carry more than 7 pounds, including the weight of the pack.
  • When loading the pack, place heavier items along the back and up top.  This keeps the greater load closer to the body. 
  • Use all the compartments in the pack.  This helps to prevent shifting of items while the pack is being worn.
  • Teach your child to carry only what is necessary, and to periodically clean out the pack. 


Putting on the pack safely/wearing the pack correctly

  • Use this opportunity to teach your child how to lift properly.  Have your child bend at the knees using the stronger leg muscles to bring the pack up to the child’s center of gravity.
  • Loosen the shoulder straps, making it easier to get the pack onto both shoulders without straining, bending, or twisting.  Then retighten the straps once the pack is in place
  • All the above effort will be for not if the pack is then slung and worn over one shoulder.  Use both shoulder straps, and fasten the hip belt.


Signs of improper pack fit/weight/usage:

  • Complaints of pain or aching in the neck, shoulders, or back.
  • Creases or red marks across the shoulders.
  • Tingling in the arms, hands, or fingers.
  • Slumped forward posture.
  • Struggling with putting on/taking off the pack.
  • Signs of excessive exertion while wearing the pack.


If it appears the backpack fit, weight, and usage are correct, and your child continues to experience back pain, have him or her evaluated by your physician or physical therapist.  Other factors may be contributing to the pain including muscular imbalance and/or weakness as well as poor posture.  This is the time to be proactive to ensure your child’s future spinal health.

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Gear up for the cold and flu season

October 4th, 2008 · Article, Cold and flu prevention

The cold and flu season is back upon us.  Here are some tips to help you and your loved ones stay as healthy as possible this season: 

1)     Stay hydrated.  This is one of those tried and true pieces of advice we keep hearing, but there’s good reason behind it.  All of our body’s systems need proper hydration to function optimally, and the immune system is no different.  Staying hydrated also helps to keep mucous secretions thin, making them easier for our body to dispel.  It is recommended that the average adult consume eight 8 oz glasses of water/herbal tea per day.  Caffeinated beverages, soda, and juice are not adequate substitutes for good old water. 

2)     Wash hands frequently, keep your hands away from your face.  This is another one of those suggestions that involves common sense, yet many of us could still improve these habits. Because some viruses can stay alive on surfaces from hours to weeks, we are continually coming into contact with the germs that have been left behind by others.  If water and soap are unavailable, rubbing the hands together briskly for a minute also helps.  To avoid spreading your germs to others, cough or sneeze into a tissue or the bend of your elbow, rather than your hands.

3)     Get regular aerobic exercise.  Research has shown a direct correlation between regular aerobic exercise (exercise that raises your heart rate to your target range, 3-4 times per week) and the prevention of the flu and common cold.  Aerobic exercise improves our circulation, makes us more efficient at oxygenating our blood, and causes us to sweat.  All of these bodily responses in turn stimulate our immune system by improving the strength and circulation of the virus and bacteria fighting white blood cells.

4)     Eat for health.  The same dietary guidelines for general health apply when eating to enhance your immune system.  Foods high in antioxidants, such as dark green, yellow, and red fruits and vegetables give your immune system a boost.  Some research has linked consuming yogurt to a decreased incidence of contracting the common cold.  Garlic has also been shown to improve immune function.  Allicin, the compound contained in garlic which produces its odor, is a powerful agent against viral and bacterial invaders.  Also, limit those foods and beverages that hamper immune function such as those containing refined sugars, coffee, and alcohol.

5)     Don’t smoke.  Here’s one more reason to kick this habit.  Not only does smoking decrease immune function, but second hand smoke also inhibits the immune system by drying the nasal passages and paralyzing the cilia (the hair like projections lining the mucous membranes which keep respiratory passages clear of viruses and other pathogens.)

6)     Stay well rested.  We all have that occasional night of poor sleep or of getting to bed too late.  However, consistently getting inadequate sleep takes its toll on the immune system.  Research has shown that immune function drops by 60% after only three nights of poor sleep, so make sleep a priority!

7)     Manage your stress.  When the body is stressed, it releases the hormone cortisol.  Over a prolonged period of time, elevated levels of cortisol will wreak havoc on multiple body systems including the immune system.  In my mind, stress management is a two part process.  We can’t control the external stressors in our lives (deadlines, traffic, etc.), but we can learn to change our perspective on these factors.  The second part of the process involves regularly practicing some form of relaxation technique.  Guided imagery CDs, progressive muscular relaxation, and meditation are only a few of the many techniques available.

8)     Take you vitamins.  It’s always better to consume vitamins through healthy whole foods rather than rely on supplements.  However in order for the body to function optimally, the quantities needed of some nutrients make this unrealistic if not impossible.  Taking a high quality multivitamin makes good sense, particularly during the cold and flu season.  Above and beyond your multivitamin, here are some supplements you may want to consider because of their immune enhancing benefits.

Vitamin D (D3)  Vitamin D is unique in that the main source is not dietary, but through our exposure to the UVB rays of the sun.  Vitamin D helps the body to make antimicrobial peptides, which in turn attack and destroy viruses and bacteria.  Vitamin D levels in our bloodstream reach their lowest points during the cold and flu season.  Particularly at latitudes above 35 degrees (approximately everything north of L.A.), the sun is at a low enough angle during the winter that the ozone layer in the atmosphere blocks the UVB rays.  Vitamin D (in the form of D3) can be easily and inexpensively supplemented.  The RDA for Vitamin D is the amount sufficient to prevent rickets or osteomalacia; the optimal daily intake is much higher.  Many feel supplementing should be in the 1000-5000 IU/day range, with anything under 10,000 IU/day being safe.

Vitamin C   Numerous studies have shown Vitamin C to enhance immune function.  It does this through multiple mechanisms, including improving white blood cell activity, improving antibody responses and levels, and increasing interferon levels (the body’s own antiviral and anticancer compound.)  During times of stress, the body increases its secretion of Vitamin C through the urine; supplementing with Vitamin C helps to lessen this consequence of stress.  500-1000mg/day is an amount typically recommended to healthy individuals.  You are exceeding your optimal intake if you begin to experience diarrhea, in which case simply lessen your dosage.

Zinc  Zinc is a mineral involved in many immune system functions.  Like Vitamin C, it also has direct antiviral activity.  One study showed that supplementing with zinc through lozenges decreased the average duration of the common cold by 7 days. 

Selenium  Another mineral, Selenium, functions as an antioxidant and assists immune function by stimulating white blood cell and thymus function.  Even in individuals with normal levels of selenium in the blood, supplementing with 200 micrograms/day improved the ability of the “natural killer cell” to kill foreign microorganisms and cancer cells by over 80%.

9)     Acupuncture and herbal medicine  We’ve already discussed stress and its consequence of hampering immune function.  Acupuncture has been shown to alleviate stress, allowing our immune system to work properly.  Additionally, acupuncture improves blood circulation, helping to spread our microbe fighting cells.  It has also been shown to increase the numbers of several immune enhancing cells such as cytokines, interferon, and natural killer cells.  In studies, these cells have remained at an elevated level for approximately one month after only one acupuncture session.  Chinese herbal medicine used adjunctively with acupuncture, or on its own, also boosts our immune system.  Herbs such as astragalus (huang qi), ganoderma (ling zhi), and cordyceps (dong chong xia cao) have been shown to improve immune function via multiple mechanisms including increasing blood levels of immune enhancing cells.  Due to research design requirements, these herbs are studied individually.  Ideally, they should be prescribed as part of an herbal formula, where the herbs can work synergistically and amounts of individual herbs can be adjusted according to a specific person’s needs. 

This information is not intended to be a substitute for professional medical advice.  We recommend you seek the advice of your healthcare practitioner before applying the information provided in this article. 

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