Joanne Lee has a backpack for every outfit, every occasion.
The 14-year-old freshman at Diamond Bar High school, has a JanSport for khakis, an Old Navy for light-colored jeans and another for dark. When she really wants to look sharp, she straps on one of two diagonal, one-strap packs.
"It's as important as shoes or a belt," says Lee. "I make my choice depending on what I'm wearing that day."
It's not all style over substance.
Lee loads up her packs with a book and binder for each of five classes, not to mention her makeup, hairbrush and ponytail scrunchie, pager and, occasionally, a change of clothing.
But when the one-strap packs are too full, they pull at the shoulder. And the two-strap packs, some of which have thin, nonelastic straps, dig into the skin.
"If union workers were made to carry such heavy bags," said Dr. David L. Skaggs, an orthopedic surgeon at Childrens Hospital Los Angeles, "they'd go on strike."
As often as once a week, the hospital receives complaints from parents who say that excessively heavy knapsacks are hurting their children's backs, according to Skaggs, who adds that three years ago the hospital received such complaints about once a month. These days parents blame inadequate locker space at school and increased academic demands for the heavy packs.
Nearly one-third of all children experience back pain of some kind, says Skaggs, who specializes in pediatric spinal surgery. Although parents assume knapsacks are largely to blame, as yet there is no conclusive evidence. He is waiting for permission from the Los Angeles Unified School District to conduct a study of students and their knapsack-wearing habits.
The American Academy of Orthopedic Surgeons has added the issue of children's back injuries sustained from knapsacks to its agenda during its upcoming annual convention, scheduled to be held in New York in October.
The only data collected on the subject so far comes from the National Back Pain Assn. The London-based organization claims that 80% of schoolchildren it surveyed in the summer of 1997 were either using poorly designed bags or wearing them improperly. Younger children are most at risk, the survey concluded, with the average 11- to 12-year-old carrying about 13% of his or her body weight, and sometimes as much as 60%.
To play it safe, students should wear packs close to the body, recommends Skaggs. Packs should have two, preferably padded, shoulder straps and, better yet, a belt around the hip, to distribute weight evenly. The bag should not be too low on the back but rest in the middle. Heavier objects should rest close to the back.
Parents will find alternatives to traditional backpacks. Some resemble suitcases with wheels and retractable handles. Other options include one-strap, messenger bags worn diagonally across the torso.