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 Back at It This Fall
September 2019        Issue # 103    
Unpacking Adolescent Back Pain
It's that time of year again when school supplies are on sale and buses will be back on the road. It might also be time to pick out a new backpack to replace last year's bag still covered in spilled lunches and grass stains. But with studies reporting such varied statistics like, 11-71% of 14-17 years will experience at least one episode of back pain, it may be hard to feel like you're making the right (and most fashionable) choice.

While specific causes of low back pain in children are unknown, a wide variety of studies have investigated for risk factor and associations. Some evidence suggests that smoking and psychological factors such as stress may increase the risk of developing pain. Others posit that young women may be more susceptible to low back pain than young men. But studies examining bag characteristics, posture, and lifestyle generally report inconclusive results. Despite a lack of concrete evidence, school bags have traditionally been linked to reports of pain. 

A 2018 study published in the British Medical Journal examined results from 69 previous studies to look for a correlation in backpack characteristics as a risk factor for back pain. While the current guidelines for "safe loads" recommend keeping a bag's total weight between 10-15% of the carrier's bodyweight, researchers have not found any suggestive or meaningful relationship between backpack weight and pain, stating any relationship is "minimal at best." But if the bag itself isn't a factor, then what is? Two studies cited did report the perception of heaviness or difficulty carrying the bag was associated with back pain and persistent symptoms. This suggests that muscle weakness in the back and postural muscles may be a more influential factor, as prolonged usage results in muscle fatigue and strain. Promoting a healthy lifestyle that includes exercise and activity away from the school desk can help correct muscle imbalances and ease pain. You can also check out our Backpack Safety Tips for fitting and wear recommendations.

There's a Strap for That. Are Ergonomic Devices Worth It?
If you're settling back in at work after an active summer, this might mean the return of some old aches and pains. It's reported that 10-20% of the population experience neck problems, with 54% of individuals having experienced pain in the last 6 months. Most people with neck pain do not have full relief of symptoms, with 50-85% reporting pain again in 1 to 5 years. With these numbers so high, an entire market has boomed over the last decade marketing an array of ergonomic products claiming to reduce pain and "correct posture."

When studied, the effectiveness of devices such as orthotics, lumbar supports (e.g., braces, belts, and back rests), workplace modifications, and education on lifting techniques and sitting position have not been found to be effective at preventing or reducing episodes of neck or low back pain. Despite this evidence, many health care providers and mainstream media sources continue to provide "advice" that reinforces the fear-inducing belief that slouching is damaging to the spine. 

So what provides relief? While ergonomic strategies have held up poorly to research, exercise proves to be an answer. Moderate to strong evidence shows that exercise programs can reduce the risk of new neck pain episodes by half. So next time, skip the expensive office upgrades and get moving. To get started, head over to our exercise portal to view our Back to Work program with videos. You can also print out a PDF version to leave at your desk as a reminder. 

Play It Safe with This Youth Soccer Program
School is in session and it's time for fall sports. Young athletes are at a greater risk of injury than adults as their bodies are still growing. During the season, players frequently face injuries in games or practice. These injuries are often due to quick changes in direction, collisions, or falls. Integrating injury-prevention training into youth programs can be a game changer for keeping kids on the field. 

One of these programs, known as 11+ Kids, has proven its effectiveness in multiple studies. This program includes various drills for running, pivoting, hopping, and fall technique that strengthen the leg and core muscles, and in turn improve agility and reactive balance. These seven exercises should be performed in succession. All participants should start at level one and progress through in difficulty to level five. Players should move to the next level when they can perform the exercise in the allotted time. It is a simple program that takes about 15-20 minutes. When implemented with youth soccer programs ages 7-13 and tracked over the course of a year, researchers found the 11+ Kids program decreased injury rates by 58%. Fractures, which were the most common injury in both the study and control group, were reduced by 49%. This program's focuses on fall technique, balance, and core stability are likely key to its success, as it mimics the scenarios that kids encounter that lead to injury during play in a controlled setting.

Some injuries in this age group can lead to longterm impairments or time away from sports and school activities. Consider how the 11+Kids program can keep your young athlete healthy and happy. You can also schedule a free injury screen with one of our physical therapists who can assess your child's strength, neuromuscular control, and injury risk. 

Curated and Edited by: Andrew DeStefano, PT (Boston Office)
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