Kessler News

Kessler Institute for Rehabilitation Helps to “Lighten the Load”

Specialists offer tips for carrying backpacks, bags and briefcases

September 16, 2009

West Orange, NJ – With school underway, a lot of attention is focused on backpack safety. But the predicament of carrying heavy bags, briefcases, computers, luggage and even handbags affects just about everyone.

"We are seeing an increasing number of injuries to the shoulder area, neck and upper back musculature, and the low back in both children and adults as the result of carrying bags that are too heavy or too large," said Jeffrey M. Cole, M.D., Director of Electrodiagnostic Medicine and Musculoskeletal Rehabilitation at Kessler Institute for Rehabilitation, ( "Strains and sprains of the muscles and ligaments are the most common injuries and can be extremely painful, even causing permanent damage in some cases. While most injuries can be treated with medication, rest and occupational therapy, the best 'cure' is avoiding injury in the first place."

According to Kim Hreha, MSOTR/L, Proficient Occupational Therapist, Kessler Institute for Rehabilitation and a chairperson with the New Jersey Occupational Therapy Association, the problem goes way beyond backpacks. "Students of all ages load books, computers and other paraphernalia into their backpacks each day without ever thinking about how much they are carrying. The same holds true for workers who pack their computers, files and more into their briefcases. Women, who choose to carry fashionable, but oversized and overstuffed handbags are also at significant risk of injury. Even travelers face possible injury when they overpack their luggage, carry it incorrectly and lift it improperly."

To help "lighten the load" and avoid some of the potential risks of injury, Kessler Institute offers the following recommendations:

General guidelines

  • Choose a bag that is proportionate in size to the individual and no larger than what is really needed.
  • Pack bags properly with the heaviest objects at the bottom or closest to the body and pack only what is necessary.
  • Bags should be less than about 10-15 percent of body weight.
  • Lift bags correctly and carefully, using your legs rather than your back.
  • Choose the right size back for the student, one that will fit snugly and rest in the curve of the lower back, but no more than four inches below the waist.
  • Adjust the shoulder straps so the pack fits snugly across the back and weight is evenly distributed. If the bag has a waist strap, use it.
  • Load heaviest of items closest to the back of the pack and arrange smaller items so they don’t slide around.
  • If the backpack is heavy on a consistent basis, consider using a bag on wheels.
  • Choose bags with padded straps and built-in compartments to help distribute weight more evenly.
  • Look for lighter materials and durable construction in a briefcase.
  • Switch shoulders or hands frequently to avoid muscle fatigue.
  • When traveling, carry a suitcase that is made of light material such as vinyl or canvas with wheels and extended padded handles.
  • Plan in advance what you will wear in advance and pack only those items. Consider using two small suitcases as opposed to one large one.
  • If stowing luggage overhead on an airplane, lift slowly and carefully on the seat, then lift it into the compartment.
  • Choose a handbag wisely, using smaller compact purses whenever possible.
  • Eliminate unnecessary items and use travel size make-up and/or toiletries.
  • Alternate hands or shoulders when carrying bags. Also, try not to lift your shoulder to keep the straps from slipping.
  • Distribute contents among several bags, rather than putting everything in one.
  • Avoid carrying all your purchases in on hand. Use both hands.

"By understanding basic body biomechanics and taking a few simple precautions, individuals can help to minimize the risk of injury," emphasized Dr. Cole.

This year, in fact, the American Occupational Association is working to build awareness about bag and backpack safety as part of their "Living Life to its Fullest" initiative. "Our goal," explained Hreha, "is to help educate people of all ages about the potential risks of carrying backpacks and other bags and offer preventative strategies to help avoid injury."

About Kessler Institute for Rehabilitation
Kessler Institute for Rehabilitation, the nation’s largest single rehabilitation hospital, provides comprehensive care and specialized treatment to address the complex needs of individuals with spinal cord injury, brain injury, stroke, amputation, neurological disorders and orthopedic conditions. Kessler is one of only six federally-designated Model Systems in the nation for the treatment and research of both spinal cord and brain injuries. Ranked as one of the top two rehabilitation hospitals in the nation and best in the East by U.S.News & World Report, Kessler has three hospital campuses in West Orange, Saddle Brook and Chester, N.J., and more than 75 outpatient centers throughout the state. For more information, visit

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