It is back-to-school season here in the US.  One of the items on shopping lists is a new backpack.  But for kids with low muscle tone or hypermobility, backpacks can be more than a way to carry books and water bottles.  They can be a source of pain, headaches, even numbness in hands and fingers.  The important question isn’t how to lighten the load of a heavy backpack.  It is whether these kids should be using them at all.

The standard recommendations from occupational therapists and orthopedists regarding backpacks are simple:  lighten the load, use both straps (select one with wide straps), and make sure the heaviest items are placed close to the body.  All good suggestions.  But if a child already has pain or weakness around their spine and/or shoulder joints, reduced stability and endurance, and limited ability to judge posture and force, then the picture changes.  Using a backpack may be a significant physical risk, no matter how well designed or used.  And even when armed with good strategies, many kids will insist that it isn’t possible to go without one.

Here are some suggestions that further minimize the risk of injury but can still be acceptable to kids who may be sensitive about being perceived as different if they don’t have a backpack:

• Request a set of the heaviest books for home use.  This can be part of an IEP or a 504 plan, or the school may be willing to do so without anything formal on paper.
• Request a locker on every floor or every section of a large school.  They won’t have to drag every item to every class if they can store things in more than one place.  Again, a 504 plan or and IEP can include this, making it happen without a lot of fuss from your child.  Bonus round:  Set up your home in the same way, to get your child into the habit of energy and joint conservation strategies.  Make them think like an occupational therapist….!
• Select the smallest size backpack possible.  Stores like Land’s End and L.L. Bean  are great sources for a variety of backpack sizes.  Bigger backpacks encourage kids to load more stuff inside.
•  Have your child carry lighter and fewer items.  Pick the smallest water bottles and travel sizes of anything they really need.  Think “weekend in Paris on a shoestring” not “trekking the Himalayas“.  At least they have a backpack like the other kids.  Sources like The Container Store and even your local Walmart will have tiny containers for the things they need.  Offer to refill these containers or replace them right away.  A shelf of small water bottles or a cool but tiny hone charger could make the difference.
• Teach your child to carry their pack in their arms, close to their chest, instead of wearing it.  I know that sounds a little weird.  But if the pack is small to medium in size, this is the best way to carry it to reduce strain on the back and neck.  And they still have a backpack like the other kids.  It might be a long shot to get a kid to change how they carry a pack.  Some kids can respond to reminders of how awful it is to be in pain, and how not being able to sleep or play sports is much worse than carrying that pack in their arms.
• Considering a rolling case?  Not so fast.  The twisting of the spine and the use of one arm to drag a rolling case may be worse than using a backpack.  Then there is the lifting and lugging of a case up non-ADA stairs.  Out of the frying pan……

Want a guide for helping the school-age hypermobile child?

Here you go!  My newest e-book, The JointSmart Child:  Living and Thriving With Hypermobility Volume Two:  The School Years is now available on  Amazon .  No Kindle?  No problem!  Amazon makes it easy to download it onto your iPhone or iPad.  

Read more about this unique book that empowers parents and makes treatment planning easier for therapists here: Parents and Therapists of Hypermobile School-Age Kids Finally Have a Practical Guidebook!

Looking for more information about hypermobility, low tone and back-to-school planning?  Check out Does An Atypical Pencil Grasp Damage Joints or Support Function In Kids With Hypermobility? and Great Mechanical Pencils Can Improve Your Child’s Handwriting Skills.  Before you wonder if all that fidgeting and leaning over the desk is a behavior problem, read Hypermobility and ADHD? Take Stability, Proprioception, Pain and Fatigue Into Account Before Labeling Behavior.  There are pencil grips that can really help kids with a weak grasp, so check out The Pencil Grip That Strengthens Your Child’s Fingers As They Write.

If your child is older and thinking about a career, please read Career Planning for Teens with JRA, EDS, and Other Chronic Health Issues for some important strategies to get them thinking about how to navigate higher education and make plans that make sense.