Do some children carry the world on their shoulders? Here are some simple lessons for your kids to avoid 'book ache' from bags and classroom tables and chairs.

The Chartered Society of Physiotherapy (CSP) says back and neck pain in school age children can be caused by heavy and poorly packed school bags, poor posture, inactivity or the wrong activities, and ill-fitting classroom furniture.

The CSP and chartered paediatric physiotherapist Janice Clark have put together a 'school day chart' for parents and children showing how, during the school term, they can help reduce the chances of back pain occurring.

Janice Clark said: "Both parents and children need to be aware of protecting youngsters' backs. You can replace your school bag, but you can't replace your back. While it might not be cool to carry school bags properly, it would be a lot more uncool to end up with debilitating back pain, leaving kids unable to enjoy even simple activities."

BackCare recommends children do not carry more than 10 per cent of their body weight. However, a study by the American Physical Therapy Association shows more than half of children there carry bags weighing over 15 per cent of their body weight.

"Children need to be able to walk and cycle easily, without straining under really heavy bags. If your child can't stand upright easily or they complain the bag limits their movement, then it is too heavy," said Janice.

Children should only carry what they need each day to school and schools should try to have lockers available. But it is not only heavy bags that are to blame, says Janice, the way they are carried can be equally as important in avoiding injuries. "School backpacks need to be worn over both shoulders, to avoid over-stressing one side of the body," she said. "Poor posture and excessive stresses can change postural shape and speed up degeneration on parts of a growing spine.

As well as back pain, postural changes can also affect a child's general health, stamina and physical performance levels."Children can be taught postural awareness in the classroom, such as showing them the difference between a bad sitting position and a good one, and when a chair or table doesn't fit or suit their needs. Sitting comfortably upright in a good chair that fits and supports the contours of the spine can reduce the chances of back and neck pain and also help prevent conditions such as Repetitive Strain Injury (RSI).

CSP school day timetable:

8am
Packing your bag:

• Use backpack-style bags with two wide, padded straps and a waist-belt to redistribute weight from shoulders and back to the pelvis.
• Ensure the bag is packed correctly. Heavy objects should be packed first and placed on the inside, close to spine and pelvis. Take only what you need.
• Adjust the shoulder straps and fasten the waist-belt.
• Lifting the bag: Stand the bag up on the bed, with the straps facing towards you. Sit in front of the bag, with your back to it, then pull the straps on over both shoulders before standing up. Stand up straight. If you have difficulty doing this, then the bag is too heavy and you should take something out

8am - 9am
Walking or cycling to school:

• Carry the backpack on both shoulders at all times. This is vital, as putting all the weight on just one side of the back can lead to curvature of the spine.
• Stand up straight, with shoulders back, ensuring best posture. This distributes the weight evenly along the shoulders, back and pelvis. If it makes you slouch after a short while, it is too heavy.
• Where possible, use a locker at school to avoid carrying backpacks around all day. Carry only the items necessary between classes.

9am - lunch
Sitting in class:

• Make sure your table and chair fit appropriately. Your feet should sit flat on the floor, your thighs should be supported and the chair should support you in an upright position. The table should be at elbow height when you are sitting up tall.
• Do not slouch. While working at a table, try to get kids to imagine a string is attached to the top of their head, lifting them into a tall upright position.
• Sit up straight, making the most of support in the chair by bringing it close to the table and sitting back in the seat rather than in perching on the edge.
• Try not to cross the legs.
• Teachers should encourage students to get up, move around and stretch during long lessons.
• Lighting and room temperatures should be comfortable for students.

Lunchtime
Running, jumping, playing:

• It is important to wear appropriate footwear for play and sports.
• Stand up straight when walking and standing around.

Afternoon lessons

• See sitting in class above

After School
Homework:

• If possible have an adjustable homework desk and chair that allows for growing legs.
• Prop textbooks up so you don't have to hunch over your work.
• Use correct sitting position. See above.
• If using a computer, have the monitor with the screen at eye level.
• Move the keyboard about 10cm from the edge of the desk and place the mouse within easy reach. Keep shoulders relaxed and elbows at 90 degrees.
• Watching television, playing computer games.
• Try to sit up on a chair or with your back supported by something if sitting on the floor. An over-sized couch will make you slouch. Do not lie on your front, looking up at the television, or lie on your side, supporting all your weight on one arm.
• Change positions and get up and walk around to loosen muscles up. Don't forget to give your fingers, arms and shoulders a gentle stretch.

• The best way to strengthen muscles in the stomach, back and shoulders in order to support the spine is through daily exercise. Evidence suggests a sedentary lifestyle can contribute to back problems, which can lead to pain.

Further back care information can be found at www.csp.org.uk and www.backcare.org.uk