Abstract
n the article Encouraging healthy spine habits to prevent low back pain in children: An observational study of adherence to exercise [1] authors Hill and Keating address the potential for habitualisation of a short daily exercise programme that draws much needed attention to factors that are thought to keep the spine healthy. The authors suggest using these strategies in order to educate children and encourage healthy spine habits that may prevent low back pain (LBP) [1]. However, the authors did not address the factors that influence the onset of LBP with children [2]. The prevalence of LBP starts at an early age and can accelerate during an individual’s early teen years. One major characteristic of LBP in children is that it has a high recurrence rate and a high tendency to reappear with a greater intensity [4]. Although the initial intensity of LBP is relatively low, and generally only lasts for about a week, LBP can cause limitations in a child being able to carry out daily activities, absenteeism from school, and a reduction or a complete stop in physical activity [4]. Some of the most common causes of back pain in children include a muscle strain or a herniated disk [2].
As such, prevention is of the utmost importance. In particular, one factor the authors did not analyse was the onset of LBP in children due to carrying heavy backpacks. The recommendation is that students not carry a backpack that is greater than 10 to 20% of the child’s bodyweight. However, such recommendations have not been markedly effective in reducing the problem among children, due to children’s poor compliance with specified school bag limits [[3], [4], [5]]. There needs to be a focus on teaching children proper lifting and carrying techniques with a backpack, along with teaching the proper weight distribution of the backpack. The main issue with a child carrying a heavy backpack is the anthropometry of the child. A child carrying a backpack that is 20% or more of a child’s bodyweight, impacts the child’s center of mass and center of gravity, causing a child to adopt an inappropriate posture in order to counteract the weight of the backpack, thus creating poor posture in the child [3].
Further research is indicated to address the issues of children carrying too heavy of a backpack. In addition, the importance of reinforcing injury prevention through proper body mechanics training is also indicated. Adhering to proper body mechanics will encourage healthy spine habits throughout a child’s life and into adulthood.Conflict of interest: None declared.
Citation
Letter to the Editor re ‘Encouraging healthy spine habits to prevent low back pain in children: An observational study of adherence to exercise’