Back pain is the leading cause of disability amongst the UK’s working-age population. Recent research shows that increasing numbers of children are suffering too, with 72% of primary and 64% of secondary children reporting back and/or neck pain during the past year at school – and this doesn’t include the majority of cases going unreported. This has resulted in many having to seek treatment and take medication. They can also be absent from school because of it which can impact their long-term learning.
Children spend approximately 30% of their waking hours at school, yet there are no regulations to keep posture and back health in check. This is despite the recognised benefits to concentration, health and learning it also brings.
Studies show that children who suffer from back pain are 4 times more likely to experience it as adults. This means that prevention and the formation of good habits during childhood are really key. Back health is important for our children and the good news is, schools can help.
According to UK research, the top 3 risk factors for back pain in school children (as reported by children) are:
Primary aged children:
- Sitting in assembly
- Sitting on the floor
- Sitting on school chairs
Secondary aged children
- Carrying school bags
- Sitting on school chairs
- Sitting and working at school desks
A sidelong view of a healthy spine looks like a letter “S” with 3 curves, rather than a single curved, unhealthy “C”. Our heads are heavy and need to be “efficiently balanced” on top of our spine. From behind, a healthy spine is straight and upright.
As a society, we have become increasingly sedentary. Technology now plays a huge part of our children’s lives, both at school and at home. However, very little consideration is given to the postures children frequently adopt – hunched over handheld mobile devices, working at laptops flat on tables and desks, sitting awkwardly on the floor, sitting on one-size-fits all furniture (despite 11-year-olds now often varying over 50cm in height), spending more time sitting in the car going to structured activities and to/from school because of safety fears.
For younger children, there is less opportunity to simply play and develop the strong core muscles they need to maintain a healthy spine. Children should be encouraged, and learning environments arranged, to allow healthy postures and movement wherever possible.
Lorna Taylor is a paediatric physiotherapist with over 15 years’ experience. She is a passionate and active campaigner for improved postural health and wellbeing within the educational sector. She is also the founder of Jolly Back and has developed a range of products that can help prevent problems from occurring. She’s put together 10 great tips that schools can implement to protect children from potential damage:
Tip 1: Improve back health/posture using EdTeach
When using tablet equipment, children should use a protective case with stand or raise the tablet up so it is at an angle for viewing and typing. If used on a flat desk, an unhealthy, curved posture will be adopted – and we know bad habits are hard to break!
This is an example of unhealthy, curved posture. Back and neck muscles are working hard to support the head which results in repetitive neck movements when looking up at the teacher and then back down at the screen. Reduced circulation occurs due to chair pressure behind the knees.
A tablet stand allows for improved spinal alignment, circulation, digestion, comfort and energy flow.
Tip 2: Use the correct ergonomic furniture
Trial and invest in quality, versatile, ergonomically designed school furniture which supports healthy sitting and active learning. Furniture and learning space design should be seen as an investment in pupils’ health and concentration now and for their futures.
All Jolly Back products have been designed by a physiotherapist to support postural health for children and adults working and learning in the education and childcare sectors. They contribute to a healthier, more productive learning environment for children and demonstrates a school’s commitment to the health and wellbeing of its pupils and staff.
The Jolly Back Maxi Wedge offers a simple, effective solution to improve posture when sitting on the floor or firm based chair. It also offers a comfortable chest support to lie over and extend the spine – helping to counteract flexed sitting postures during the day.
Laptops may be more portable but best practice suggests children and adults should use computers with the top of the screen level with their eyes. If using a laptop on a flat desk or table, raise the screen (on books, a stand or Jolly Back Low Table) and use a separate keyboard and mouse. This applies at home too.
Tip 3: Limit time in any one position
Limit floor sitting for primary aged children to a max of 10 mins at any one time. Alternatively, allow them to move and sit with their legs in front of them, to alternate sides or sit on a posture-improving cushion. These positions help wake the nervous systems as they are more active than the traditional crossed-legged sitting position which forces their spine into an unhealthy slumped shape. Active sitting improves digestion and oxygenation to the brain too and helps aid concentration.
Flexed, curved postures should be limited for children and staff where possible with regular changes of position and movement encouraged. Introduce a “20:20:20 stretch and wriggle” – every 20 minutes, move and stretch for 20 seconds and gaze 20 meters into the distance to rest eyes from screen use.
Make sure children have a clear view of the board, they should be able to view it without twisting around. If not, they should turn their chair around or move position. They should also move places during the term so they do not develop muscles imbalances. Incorporate movement and standing into lessons where possible.
Tip 4: Encourage children to speak up if they are sitting uncomfortably
Understand that if children are fidgeting, they are likely to be uncomfortable and are trying to adjust their posture. Allow them to stand up and move before sitting down again. Pupils are likely to be more focused afterwards.
Encourage children to tell a member of staff if they are uncomfortable at school and be aware of any emotional stress a child may be experiencing as this can influence back pain experienced. Physical and mental health are intertwined.
Teach children to touch type. This reduces repetitive neck movements when looking between the keyboard and the screen and benefits computer users hugely.
Encourage children to have a sight check if you are concerned they are hunching over and looking very closely at their work or a screen.
Although back pain is becoming more common in children, it should never be considered normal. All episodes of back pain lasting more than 2 weeks should be reported to a GP. Ask if anyone in your class has back/neck pain and what do they think contributes to it. Encourage them to report any discomfort to a parent/carer.
Tip 5: Participate in and share the new free Health Working MOVE eLearning course
Developed by Cardinus Risk Management in conjunction with the Health & Safety Laboratory. Healthy Working Move explains to young people how using electronic devices, carrying school bags and adopting different postures when working and relaxing can affect their bodies. It teaches them how to use technology in a healthy, comfortable and safe way.
There are versions for 7-11 years, 12-17 years and post-18, along with free advice sheets for teachers and parents. It takes about 20 minutes to complete and can be accessed via www.ergonomics4kids.com.
Tip 6: Actively encourage physical activity
Physical activity and healthy movement are fundamental to postural health – helping to build up muscle strength, co-ordination and to maintain flexibility. It should already be an integral part of your school day which is great. Remember to avoid restricting break and PE times and encourage physical activity during breaks. 5 -18 year olds should have at least 1 hour of aerobic exercise every day.
Ensure adequate warm up/cool down before and after PE to help reduce musculoskeletal injury.
Tip 7: Encourage adequate hydration and healthy eating
The shock-absorbing discs of the spine are 80% water so adequate hydration is essential for optimum back health. Can your school provide water stations and prompt children to drink it?
Continue to encourage healthy eating with an emphasis on “5 a day”. A healthy weight/body mass index limits stress on the joints and muscles supporting the spine.
Tip 8: Ensure school bags are not causing spinal damage
School bags should weigh a maximum of 15% of a child’s body weight as studies have shown spinal damage can occur if they are heavier. It’s safest to aim for 10%.
Try to check how much pupils in your class are carrying. Studies have shown that children are often carrying a quarter of their body weight which is the equivalent of a 70Kg (11st) adult carrying 17.5kgs (2st 10lbs) in weight.
Tip 9: Teach children how to use and pack school bags safely
A mono/single strap bag should be worn across the body (not on one shoulder) and children should remember to swap carrying sides regularly. A ruck sack should be worn over both shoulders – this will keep the spine symmetrical and upright.
When packing, they should keep the bag balanced by placing the heaviest items first and closest to the spine.
It’s important they only carry what’s needed. Encourage children to repack their bag each evening to keep it as light as possible. Where possible, current schoolwork should be placed in lighter folders to prevent children carrying all their subject work.
Lockers and safe storage areas are beneficial, especially to Year 7 pupils who normally weigh less but have to carry similar amounts to larger Year 10 pupils.
Avoid detentions for forgetting a book/piece of equipment as this can encourage children to over-pack their bags.
Tip 10: Teach pupils safe techniques for lifting chairs and helping teachers move equipment
Young, growing spines are susceptible to injury which can occur when pupils incorrectly lift, carry and/or move heavy or awkward objects. If pupils do move chairs and equipment, make sure they know how to do it safely.
Would your school be covered if a pupil injured themselves? All postural health awareness and education to benefit children for their future is great!
Remind children of the 5 steps for safer lifting (this applies for adults too):
- Get close to the object
- Place your feet wide apart to keep steady
- Get a good grip
- Move down and up using hips and knees, not your back
- Use a smooth action (avoid rushing or twisting)