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Review and response to the discussion post from below (provide at least two reference):
A common daily activity that is detrimental to human muscles is carrying a backpack, particularly if the backpack exceeds 10-15% of one’s body weight and/or if it is worn improperly (1, 2). This common daily activity can lead to muscle imbalance, tightening of muscles, musculoskeletal problems, including general neck and back strain, and problems involving posture, since it leads to an uneven weight distribution that results in one to leaning their head and trunk forward for sustained periods of time (1, 3). It can also cause straining of the shoulders and neck pain. It is a common problem in students, especially for females who are typically smaller yet carry similar loads as male students, as most reports indicate that students’ backpacks weigh more than what is advised (1, 3).
According to the American Occupational Therapy Association, an improperly worn backpack can cause abdominal muscle and back muscle damage, since they are both involved in carrying a backpack. Muscle strain can occur when a backpack is not the correct size for an individual, leading to unequal weight distribution, which can be detrimental to their posture (1). It can also occur when a backpack is worn loosely, resulting in the weight pulling one backwards. Furthermore, a study done in New Zealand found that a sample of students were wearing backpacks that were 10-13% of their body weight, and 77% of the students reported musculoskeletal issues in their shoulders, neck, and both upper and lower back. These issues can have other contributing factors, but backpacks are still believed to play a significant role (1).
As mentioned, a backpack worn loosely can result in the backpack being worn lower and the weight of it pulling one backwards; thereby, provoking the individual to lean forward for sustained periods of time. Furthermore, another study compared participants wearing backpacks that were 5%, 10%, and 15% of their body weight and at different positions on their back when walking on a treadmill (2). Specifically they used a wireless electromyography (EMG) device to measure trapezius, erector spinae, and latissimus dorsi muscle activation. It found significant differences between those carrying a backpack of 15% their body weight in trunk and head flexion, the lower lumbosacral angle, and corresponding muscle activation compared to other other weight percentages. It found that backpacks carried at the L3 position of the spine resulted in the highest waist discomfort, and backpacks carried at the T7 position resulted in the greatest shoulders and neck discomfort, as well as head flexion. This study suggests that the T12 position is the most optimal position for wearing a backpack (2). Another study compared the musculoskeletal effects on posture and gait in groups walking with no backpacks and those that do. It found that the participants’ gait was significantly impacted when wearing a backpack while walking, suggesting a biomechanical overload on skeletal muscle structures (4).
It is also common for people to wear backpacks over one’s shoulder for style and comfort purposes. However, this act can lead to muscle strain that results from the uneven weight distribution needing to be compensated for (3). This muscle imbalance occurs due to the spine leaning to one side puts stress on that side of the lower and mid-back and its surrounding muscles, as well as the ribs, which can lead to muscle spasms too. As a result, one may experience back pain at first and could potentially deal with more serious back issues down the line (3).
One solution to alleviate potential damage caused by backpacks involve excluding unnecessary items from one’s backpack to reduce the weight, so that the overall weight is less than 5% of what the individual weighs (1). One can build up/strengthen their back muscles, including their deltoid muscles, trapezius, erector spinae, latissimus dorsi, and other muscles involved in carrying a backpack, including the abdominal muscles that assist in twisting/turning, if they wish to do backpacking. Other solutions to decrease injury and pain risk include ensuring that the backpack fits properly and comfortably, which includes getting a backpack with padded shoulder straps and padding at the posterior part of the backpack that lies against the back, as well as not wearing it too low or over one’s shoulder (1).
Rai, A., & Agarawal, S. (2013). Back problems due to heavy backpacks in school children. IOSR Journal Of Humanities And Social Science (IOSR-JHSS), 10(6), 22-26.
Chen, Y. L., & Mu, Y. C. (2018). Effects of backpack load and position on body strains in male schoolchildren while walking. Plos one, 13(3), e0193648.
A heavy backpack affects posture. Lamberti Physiotherapy. (2015, October 12). https://lambertiphysiotherapy.co.za/backpacks-for-school-children/. Links to an external site.
4. D’Addio, G., Donisi, L., Mercogliano, L., Cesarelli, G., Bifulco, P., & Cesarelli, M. (2019, September). Potential biomechanical overload on skeletal muscle structures in students during walk with backpack. In Mediterranean Conference on Medical and Biological Engineering and Computing (pp. 262-266). Springer, Cham

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