Backpacking Without Back Pain

By Dr. Jolie Bookspan

Backpack placement for best posture and to avoid backpain

Many backpackers have back pain after long days carrying packs. It is not the pack that causes the pain. It is not whether you wear the pack on one or both shoulders, or high or low. It is a simple matter of how you stand when you carry it.

1. The first problem that causes back pain is allowing your lower back to overly-arch instead of standing straight against the load.

Look at the photo of the backpacker. The upper arrow shows how his upper body is tilting backward instead of being straight from mid-hip to shoulder. The lower arrow shows how the lower body (the hip) is tilting forward in front and sticking out in back. Between the two arrows, his lower back is overly arched and pinched. The weight of his upper back, plus the weight of his pack is pressing down on the joints and soft tissue of the lower back. This is how overarching causes lower back pain. It is not the backpack, but the position while carrying it. There is too much inward curve, called hyperlordosis. Instead, the hip (and arrow) should be straight from mid-hip to the top of the leg bone. The other hiker standing near the sign is also overly arching the lower back.

Increasing lower back arching may occur automatically when standing, and may seem "natural," but it is not healthy. Wetting your pants is natural too, but you have to learn to control it. To reduce the unhealthy overarching (hyperlordosis), you just use your muscles to stand right. Try this:

- Stand up and lift your ribs to allow your upper body to lean backward. Allow your hip to tilt down in front and stick out in back. You may feel a familiar pressure in the lower back.

- Straighten your lower body by tucking your "tailbone" under you so that your hip is straight from the top of the upper leg bone to the middle of the crest of the hip bone, not tilted.

- Straighten your upper body by bringing ribs back down to level. Do not slouch or round forward; just stand straight without lifting your ribs.

- The motion of tucking the hip and pulling the upper body straight is like doing an abdominal crunch standing up.

- Your "tailbone" tucks under you so it is not tilted out in back, and the large inward curve of the lower back becomes a small inward curve.

Whenever you are carrying a backpack, standing, walking, running, or exercising, use the same hip tilt to normalize your spine position and prevent overarching. It is not healthy and is poor body ergonomics to walk around or exercise with your behind stuck out in back. The muscles you use to hold your spine from overarching are your abdominal muscles, you get a free built-in abdominal muscle exercise just by standing in healthful position.

2. The second source of back pain when carrying backpacks is rounding and leaning forward.

With posterior loads like backpacks, it's common to lean or round forward to counter the weight, instead of holding the weight using muscular effort. Leaning forward is easier because you don't have to support the load with your muscles. But, by leaning forward, you shift the weight of the load onto your spine bones. That means your spine does the work instead of your muscles. You lose free exercise, promote round-shouldered posture, and cause back pain.

Cartoon of poorly fitted backpack

Instead of rounding forward, stand straight. Use your muscles to keep your body upright and your chin in. You will get a free core muscle workout and you won't be sore after a day of carrying.

To help understand and remember how to stand and carry things in healthful ways, watch other people. Watch how they move, carry, and sit and send me photos of the good and the bad. There will be prizes for the best ones.

Thank you to Kim Pierro,

for the backpacker photo. Drawing is copyright by Jolie Bookspan.

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