Jamie's back hurt. But, this was not new. It hurt everyday. She complained about it for a while but no one seemed to listen. So, she accepted it as normal. But at 13 years of age, back pain is not normal. Jamie's back hurt from carrying a backpack the size of a small dog. In the pack, she stored books for the day, her lunch and a variety of school supplies. Jamie dutifully carried the pack, shifting it from one side of her body to another, everyday just like hundreds of other kids in her school. But not all of the other kids had back pain. Was Jamie's back pain from carrying a backpack that was too heavy or from something else?
In recent years, backpacks have been blamed for the rise in childhood and adolescent back pain. In some schools, educators have made rules limiting the hours that children can wear backpacks, the weight in the pack and California has even implemented a law requiring schools to issue two sets of books: one for school and one for home to reduce the need for a backpack. Yet, the back complaints continue.
The problem is not the backpack. Yes, a backpack filled with too much weight carried for too long, can cause back pain. But, something else appears in the studies on back pain and backpack use in children and adolescents: too much body weight.
Our children carry more bodyweight today than children did twenty years ago and the weight they carry is not extra muscle. It is fat. According to the National Institutes of Health, weight gain in children is an epidemic in the United States. One out of five children are overweight and seventy percent (70%) of overweight children grow up into overweight or obese adults.
Associated with the increase in weight gain is a decline in physical activity and a rise in television viewing. It seems that while children watch television (and you can add computers as well), they tend to eat more and, of course, move less. On average, overweight children watch 2-4 hours of television per day. The imbalance in energy expenditure, referred to as energy flux, is the root cause of the weight gain. In other words, overweight children consume more energy than they expend. The sedentary activity does not help children develop the physical capacity to carry a backpack either.
What to do? While educators and law makers in California understandably took steps to reduce the physical overload, what will be next? If children develop knee pain walking through the hallways, will we require scooters or wheel chairs? If they cannot bend over to tie their shoes because their back hurts, will we require slippers? While the answer to solving the problem of back pain with backpacks is not easy, there needs to be another answer besides lowering the physical demand.
As parents, here are things you can do to help your child avoid a lifelong battle with their weight and improve their physical capacity:
1. Reduce television, computer use and video games to less than two hours per day.
2. Get sixty minutes of any type of movement per day (adults need at least thirty while children need sixty). As a family, take a walk before dinner or go to a park and play catch with your son or daughter. Encourage your children to get involved in school sponsored activities or sports. While more demanding forms of exercise will eventually be important, any type of movement will help.
3. Eat meals together as much as possible. This slows the pace of eating and controls the portion size.
4. Avoid using food as a reward or punishment. This associates emotions (feeling happy or sad) with food.
5. Your children emulate you. They develop eating and activity habits from your choices. Avoid sugar added foods, quick and easy fast foods which are high in calories and low in nutritional value, and eat breakfast.
6. Love your children. Love is a choice not a feeling. Children who are overweight know they are overweight (as do adults for that matter) and do not need to be reminded repeatedly or nagged. They need to be loved for who they are not what they look like. They need support, encouragement and occasionally "tough love". Sometimes you have to say no when you really would prefer to say yes. Your children will later understand - as will their children. And, make a big deal of their successes no matter how small. We all need acceptance and every now and then some applause.
Jamie needs a stronger back not a lighter backpack. Let's help her do it.
Make today count - for your children.
Doug Kelsey
Author. Teacher. Therapist.
References:
1. http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.htm
2. US Department of Health and Human Services: Healthy People 2010: Understanding and Improving Health and Objectives for Improving Health, ed 2. 2 vol, Pittsburgh, PA: US Government Printing Office, 2000
