While backpacks are one of the most convenient ways to carry books and school supplies, an overloaded and/or improperly worn backpack gets a failing grade.
Wearing backpacks improperly or ones that are too heavy put children at increased risk for musculoskeletal injuries.

Recommended tips for safe backpack use:

Wear both straps. Using only one strap causes one side of the body to bear the majority of the weight of the backpack. By wearing two shoulder straps, the weight of the backpack is better distributed, and a well- aligned symmetrical posture is promoted.
Put on and remove backpacks carefully. Keep the trunk of your body stable and avoid excessive twisting. Wear the backpack over the strongest mid-back muscles. Pay close attention to the way the backpack is positioned on the back. It should rest evenly in the middle of the back near the child's center of gravity. Shoulder straps should be adjusted to allow the child to put on and take off the backpack without difficulty and permit free movement of the arms. Straps should not be too loose, and the backpack should not extend below the low back.

Lighten the load:

Keep the load at 10 to15 percent or less of the child's bodyweight. Carry only those items that are required for the day. Organize the contents of the backpack by placing the heaviest items closest to the back.

Encourage activity:

Children who are active tend to have better muscle flexibility and strength, which makes it easier to carry a backpack. When selecting a new backpack, consider ergonomically designed features that enhance safety and comfort: A padded back to reduce pressure on the back, shoulders, and underarm regions, and enhance comfort; Wide, padded shoulder straps instead of narrow straps, which can hinder circulation, causing numbness or tingling in the arms and, over time, may cause weakness in the hands; Hip and chest belts to transfer some of the backpack weight from the back and shoulders to the hips and torso; Multiple compartments to better distribute the weight in the backpack, keep items secure, and ease access to the contents; and reflective material to enhance visibility of the child to drivers at night.

Backpacks with wheels were a good option for younger students who did not change classes or need to go up and down stairs frequently. However, there are precautions to take with "rolling backpacks" as well. Be sure that the extended handle is long enough so that the child is not forced to twist and bend, and that the wheels are sufficiently large so that the backpack doesn't shake or topple. Some students have two sets of books so they don't have to carry heavy textbooks to and from school. In addition, an alternative to conventional backpacks may be considered, such as one that allows the wearer to carry the load evenly on both sides of the body, rather than solely on the back.

Parents and children can avoid injury by recognizing the following warning signs that the backpack is too heavy:

• Change in posture when wearing the backpack
• Struggling when putting on or taking off the backpack
• Pain when wearing the backpack
• Tingling or numbness in arms and legs, mostly arms
• Red marks on the shoulders

From youngsters playing their first game of tee- ball to the last team standing at the Little League World Series in August, spring and summer baseball is a rite of passage in schoolyards and fields worldwide. But in their attempts to throw the farthest and fastest, millions of Little Leaguers put themselves at major league risk of arm and shoulder injuries.

Little League pitchers can throw more than 100 pitches per game -- almost twice that of a professional pitcher -- placing substantial stress on a young, still developing arm. Kids sometimes mistake strength for proper pitching mechanics and may be trading six innings of excitement for years of debilitating arm and shoulder problems.

The pitcher runs the greatest risk of injuries resulting from overuse or improper mechanics, leading to a condition known as "Little League Elbow." A chronic inflammation of the growth plate in the elbow joint, Little League Elbow can feel like tendonitis. Children as young as 8 years old are presenting with this condition. Pitchers who continue to pitch through the pain can eventually cause the growth plate to separate from the joint, requiring surgery to re-attach it.

Baseball's Safety Advisory Committee recommends that the first pitch introduced to Little Leaguers should be the fast ball at 8 years old, followed by the change- up at 10, the curve ball at 14, the knuckle ball at 15, and the slider and fork ball at 16. This is because a fast ball features a standard grip, and pitchers don't have to deviate and flex their wrists to throw it. When young pitchers start throwing curve balls, Little League Elbow can start to surface. Younger pitchers don't possess the neuromuscular control and stability in their bones to withstand the forces that are placed across the elbow when throwing more technical pitches.

Most Little Leaguers mistakenly throw with the force coming from the arm instead of the trunk. When a child presents with Little League Elbow, they should be told that the key to throwing harder is not arm strength, but trunk, leg, and hip strength. Too often emphasis has been placed on strengthening the arm with little or no lasting results.

Direct the front shoulder and hip toward the target. Let the legs and trunk supply the power, and let the arm function like a whip.

Shoulders are also in danger during a pitch. Because the shoulder is the most mobile joint in the body, it is also the most unstable. The four muscles surrounding the shoulder, called the rotator cuff, are stressed during the acceleration and deceleration phases of pitching. These excessive forces can damage ligaments and muscles within the shoulder joint. To reduce the risk of injury, it is important that the muscles of the trunk and shoulder girdle be strong, stable, and flexible.

Because children tend to be less aware of their physical limitations, it is especially important that parents and coaches watch their children carefully for correct throwing mechanics, while advocating proper conditioning and pre- and post-game stretches. Attentive parents and coaches will maximize their child's chances of having a healthy season. Three important upper body stretches are recommended: the inferior shoulder stretch, the posterior shoulder stretch, and the rotator cuff stretch. Once kids understand the proper way to throw, they need to concentrate on a pitching maintenance program that consists of exercise, stretching, proper pitching rotation and volume, and periods of active rest.

PHYSICAL THERAPIST TIPS ON HOW TO AVOID INJURING YOUR ARM

The following is recommended for Little Leaguers...and their coaches:

• Above all, teach young athletes to be mindful of how their bodies feel. Pain is the first sign of a problem, and athletes of all ages need to pay close attention to any type of muscle twinge, tightening, or burning sensation.
• Coaches should carefully observe their pitchers' techniques. Success on the field may be fleeting if the pitches ultimately are damaging a young player's shoulder.
• Conditioning and strengthening exercises are most effective after mechanics are learned and put into action. If possible, begin a conditioning program at least a month before the season begins. A basic stretching regimen should be used before a player ever picks up a baseball.
• Players should start with short tosses and gradually work up to throwing the ball a greater distance. Increasing the velocity should be the final step.
• If the arm region is sore or tight, apply ice to the area for 10-15 minutes to help diminish the amount of blood that might otherwise leak into the muscle. When there is microscopic tearing of the muscle tissue, blood is leaking into the surrounding muscular tissue, causing pain and muscle spasms. Using ice will help reduce the pain, spasms, and inflammation associated with this condition.