December 1999 Bulletin

AAOS tells media backpacks can cause problems

Joseph A. Buckwalter, MD, discusses data published in new AAOS publication, Musculoskeletal Conditions in the United States (second edition).

An Academy survey of 101 physicians disclosed that 58 percent had seen school-age patients complaining of back and shoulder pain caused by heavy backpacks.

Carrying backpacks loaded with school books, athletic equipment and other items, could cause muscle fatigue or strain, said Charlotte B. Alexander, MD, at the Academy's Orthopaedics Update press briefing in New York City Oct. 13. The annual event featured orthopaedic surgeons presenting the latest information on musculoskeletal conditions, treatments, prevention and research.

"The survey findings do not suggest a link between backpack use and conditions such as scoliosis and spondylolysis," said Dr. Alexander. However, the survey indicated that a backpack could cause a clinical problem when the contents weigh 20 percent more than the child's body weight.

"If you have an 90-pound female carrying a 20-pound backpack, then the backpack weight becomes a medical issue," Dr. Alexander said. "Most of the students surveyed are carrying backpacks weighing more than 10 percent of their body weight," Dr. Alexander said. "We found one 10-year old female student with a backpack weighing 47 pounds."

In addition to the results of the survey of physicians at Children's Memorial Hospital, Chicago, Ill., and Alfred I. duPont Hospital for Children, Wilmington, Del., Dr. Alexander presented guidelines on the use of backpacks.

Others addressing the 32 writers and editors this year were Joseph A. Buckwalter, MD, who presented important statistics from the Academy's new publication, Musculoskeletal Conditions in the United States (second edition); Nicholas A. DiNubile, MD, baby boomers' sports injuries and prevention; Carol C. Frey, MD, women's work shoes and problems they can cause; Rosemarie M. Morwessel, MD, prevention and treatment of osteoporosis; Clarence L. Shields, Jr., MD, dietary supplements and their affect on athletic performance; and John R. Tongue, MD, sledding safety.

News releases on the presentations are in the Orthopaedics Update section of the Academy home page at

The media attending Orthopaedics Update included Julian Phillips, medical/health reporter of WPIX-TV, who interviewed Dr. DiNubile, Dr. Frey, Dr. Alexander and Dr. Tongue. The report aired Oct. 13. A CNN Cable network sent a camera crew to interview Dr. Alexander. The segment aired on more than 100 affiliate stations. Max Gomez, medical/ health reporter of WNBC-TV interviewed Dr. DiNubile. The story aired Nov. 2. and will be syndicated to other NBC stations.

Other media at the press conference represented the New York Post, Parenting magazine, Ladies Home Journal, Orthopedics Today, Town & Country magazine, Parents magazine, Remedy magazine, WCBS Radio, Reuters Health news service and Medscape.

Statistical information from the new AAOS publication, Musculoskeletal Conditions in the United States (second edition) was mentioned on the World News Tonight with Peter Jennings (ABC) broadcast and in a Wall Street Journal column.

Do you feel that backpacks are a clinical problem for children?

71Yes 30No

If so, define the problem:

63Muscular fatigue
2Causes scoliosis
14Contributes to the progression of scoliosis
0Causes spondylolisthesis
6Contributes to the progression of spondylolisthesis

Do you see patients complaining of back or shoulder pain related to backpacks?

58Yes 42No

Do you feel this is a significant clinical problem?

52Yes 27No

At what point do you think back packs become a clinical problem?

1510 % of body weight
3720% of body weight
1730% of body weight
240% of body weight
3>50% of body weight

At what weight do you think backpacks become a clinical problem?

1210 pounds
3720 pounds
1030 pounds
140 pounds
5>50 pounds

Source: AAOS survey of physicians at Children's Memorial Hospital, Chicago, Ill., and Alfred I. duPont Institute, Wilmington, Del.

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