Is Your Child’s Backpack an Injury Risk?

By: Jessica Villerot DPT – Hampton Physical Therapy (Hampton & Seabrook, NH)

backpack-hptIt’s that time of year again when your child will be returning to school. But before you head out for that infamous back-to-school shopping, it is important to make sure your child’s backpack is making the grade. Although backpacks are still the best way for your child to carry their homework and school supplies, if worn or fit incorrectly, or overloaded in weight, it could be doing more harm than good. A child’s growing muscles and joints are more susceptible to injury when heavy loads are repeatedly placed and not properly supported on their backs.

A recent study, led by American Physical Therapy Association member, Shelley Goodgold PT, associate professor of Physical Therapy at Simmons College in Boston, found that 55 percent of children surveyed carried backpack loads heavier than 15 percent of their bodyweight, the maximum safe weight recommended by most experts. These heavy loads can cause harmful postures (i.e. forward lean, leaning to one side, arching the back) that could result in compression of the vertebral discs, muscle strain/sprains of the back and neck, or strain on the shoulder joints and nerves. The spinal and abdominal muscles are some of the strongest muscles of the body, and if backpacks are worn correctly, these muscle groups can work together to stabilize the spine and protect the body from injury.

So what can you do, as a parent, to help your child avoid injury? Follow these simple steps:

· Supply your child with a proper fitting backpack. The size of the backpack should fit the size of the child, NOT the amount of books/supplies the child needs to carry. The shoulder straps should fit comfortably on the shoulders and under the arms, so that the arms can move freely. The bottom of the pack should rest in the contour of the lower back, NOT sag down toward the buttocks.
· Use a backpack that has a padded back and shoulder straps to reduce pressure on your child’s back/shoulders.
· A waist belt helps distribute some of the load to the pelvis.
· Compression straps on the sides or bottom of the backpack that, when tightened, compress the contents of the backpack and stabilize the articles.
· Wear BOTH straps. Using only one strap, or a backpack with a strap that runs across the body and over only one shoulder, forces one shoulder to support the weight of the bag. Wearing both straps allows the body to support the weight of the backpack in a neutral spinal posture.
· Use caution when using backpacks with wheels. If the handle does not extend far enough, your child will be forced to bend forward or twist when pulling their backpack, both actions that can cause serious back injury. Also, remember that wheeled backpacks may present problems when trying to carry them up/down stairs or onto the bus.
· Try to monitor how much weight your child is carrying in their backpacks. It is recommended that children not carry more than 15 percent of their bodyweight in their bags.

back-to-school-backpack1Finally, look out for signs that your child may be negatively affected by an improper fitting/wearing backpack.

· Pain when wearing or shortly after wearing the backpack.
· Red marks on the shoulders.
· Numbness or tingling into the arms or fingers.

If your child is complaining of any of these symptoms, or if you feel your child would benefit from an evaluation of a medical professional, please don’t hesitate to call and speak with one of our Doctors of Physical Therapy at Hampton Physical Therapy with clinics in Hampton and Seabrook, NH.

We would be glad to help in any way we can! 603-929-2880
RESOURCES: Pediatric Physical Therapy: Fall 2002-Volume 14, Issue 3: 122-131. Backpack Use in Children. Goodgold, Shelley ScD, PT; Corcoran, Moira DPT, MSPT; Gamache, Diana MSPT; Gillis, Jennifer MSPT; Guerin, Jennifer MSPT; Coyle, Jennifer Quinn MSPT.

Grimmer KA, Williams MT, Gill TK. The associations between adolescent head-on-neck posture, backpack weight, and anthropometric features. Spine. 1999; 24: 2262–2267.

Common Golf Overuse Injuries

By Katy Salka, DPT Hampton Physical Therapy


It’s tee-time! Time to break out those golf bags, carts, classic attire, and (most importantly) a warm-up routine. Golf can be considered a rather benign activity, as long as overuse and injury are avoided. Injuries in this sport have been reported to affect at least 15-20% of golfers each year. Some of those injuries can be acute in nature, such as hitting a stealthy root submerged just below the grounds surface, however most golf injuries are those due to overuse (over 80%). Overuse injuries are more subtle and occur overtime – professional golfers reporting high incidences of low back pain, wrist, and shoulder injuries; while amateurs reporting more low back and elbow problems. These injuries in the amateur population are usually the result of poor technique, dysfunctional movement patterns, and a lack of warm-up routine.
This sport requires the player to have explosive power, and these actions when repeated over and over, can put stress on the tissues causing injuries. Studies have shown that a simple stretching/warm-up routine before you begin can significantly reduce your chances of sustaining an overuse injury.
Types of Golf Injuries:
Golfer’s Elbow (Medial Epicondylitis) – Inflammation of the tendons that attach your forearm muscles to the bone of the inner side of your elbow. These tendons can become irritated and damaged from repeating the same motion again and again, especially with forceful gripping of the golf club. Symptoms include pain and tenderness to inner side of elbow, as well as weakness of wrist flexor muscles. If already suffering from this – some treatment options include rest, splinting, and anti-inflammatories.
Exercises, Stretches, and Tips to help prevent this type of injury:
Wrist Curls/Reverse Wrist Curls

Forearm Stretching

Resistive Gripping

Slow down your swing to lessen the shock in the arm when the club hits the ball

Low Back Pain – The number one cause of low back pain can be attributed to the repetitive stress of a faulty golf swing, consisting of powerful rotation and extension motions during the swing. This motion can put excessive strain on your back muscles, stress and irritate the facet joints of the spine, and/or cause damage to the intervertebral discs – all resulting in pain and further dysfunction. Carrying one’s golf bag is another culprit of low back pain, thus making it important to adjust your straps to fit properly and strengthen your core to protect your spine when lifting or carrying the bag. Once faulty mechanics and poor posture are recognized, low back pain can be managed with the strategies listed below.

strenthening HPT

Exercises and Stretches to promote core strength and flexibility:

Lat Pull Downs

Yoga and Pilates

Swiss Ball Exercises

Low back, Buttock, and Lower Extremity Stretching

Plantar Fasciitis – Inflammation of the plantar fascia (fibrous sheath of connective tissue under the sole of the foot), at its attachment to the heel bone. Usually results from walking around on the golf course especially with poor footwear. Typical symptoms of plantar fasciitis include heel pain when walking, particularly in the morning when taking the first few steps of the day.


stretcfhing HPT
Exercises, Stretches, and Tips to treat and prevent this type of injury:
Proper footwear with appropriate arch support

Stretching before and after activity; focusing on calf and plantar fascia

Tennis ball massage to arch of foot

Shoulder Pain – Specific muscles in the shoulder are very active during your golf swing including the muscles of the rotator cuff (muscles situated around the shoulder joint), pectoralis major and minor (pecs), and latissimus dorsi (lats). These muscles can become damaged with the repeated stresses of a faulty golf swing, particularly with “Chicken Winging” (when the elbows are bent at ball contact), or with a “C-shaped posture” (when the lower back is rounded). Ice, anti-inflammatories, Neoprene shoulder sleeves, and physical therapy can help if already suffering from shoulder pain.

rowing for shoulder strength HPT

exercises to get in shape HPT
Exercises and Stretches to help prevent this type of injury:
Internal and External Rotation

Abduction in the plane of the shoulder blades

Rowing and Lat Pull Downs

General Tips and Advice:
Simple stretching routine to warm up your muscles before beginning your round

Hit a few balls on the driving range/warm-up area prior to hitting the course

Wear sunscreen, a visor/hat, and sunglasses to protect you and your eyes from the harmful UVA rays

Stay well hydrated during and after your game

When riding in the cart keep yourself, including your feet, inside the cart

Be aware of your environment and other players to avoid accidental soft tissue injuries…Fore!

Get sound advice from a professional regarding proper form, warm-up/stretching routines, and training techniques

Enjoy your golf season more by taking these tips and including them as part of your routine. Your game will likely improve and your body will thank you later. It is always good to have your golf swing checked by a professional to avoid poor swing mechanics, which can lead to compensation and overstressing your joints and muscles. Go get out there and have a great season! Most importantly be safe and have fun! For questions or consultation contact Hampton Physical Therapy

What Brand of Footwear is best?

by Kate Serodio, DPT Owner/Physical Therapist

On a daily basis I am asked “what brand of footwear is best” should I be buying New Balance or Nike? Or maybe Asics? Or how about those Sketchers that have a rounded bottom? I wish it was that simple but like most things in life, it’s just not. Our current “best practice” beliefs for the past 20 years suggests that you must know your foot type in order to know what sneaker/shoe is best for you.