You make them wear helmets when they ride their bikes. You remind them to look both ways when crossing the street. And you keep your prescription medicines under lock and key.

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But despite parents' best efforts to protect children from getting hurt, one of the greatest sources of potential injury often gets overlooked even when it's in plain sight: the backpack.

Considered the most efficient way to carry books and other items that kids need for school, backpacks, when overstuffed, may actually be causing the pain and fatigue that as many as 50 percent of kids experience.

Compared to satchels or briefcases, backpacks are typically safer for kids because they distribute weight evenly across the body and are supported by the back and abdominal muscles. Furthermore, children and teens prefer them because they are fashionable, hold more items and come with multiple compartments that help them to stay organized.

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But despite their usefulness, a major study reported by the American Physical Therapy Association has found that more than 50 percent of children surveyed carry backpacks heavier than 15 percent of their body weight.

Avrom Gart, M.D., a medical director at the Cedars-Sinai Institute for Spinal Disorders, explains that over time, children carrying this kind of weight can develop serious back pain and other problems that can require treatment.

To manage the load, children sometimes arch their backs or lean forward, causing them to develop poor posture as they grow, said Dr. Gart. Wearing a backpack on one shoulder can also cause the child to lean to one side to compensate for the extra weight and can result in an asymmetrical spine, back pain, and a strained shoulder and neck.

In severe cases, children can develop a condition called scapular winging, in which the nerve that supplies the shoulder muscle becomes pinched, causing paralysis.

If you notice that one of your child's shoulder blades is not moving or not symmetrical, a doctor should be consulted immediately, said Dr. Gart.

To help your child wear backpacks safely, Dr. Gart recommends the following:

• Make sure your child isn't carrying more than 15 percent of his or her body weight. Work with your child to determine how much weight should be carried in his or her backpack. Weigh each item separately, so that your child can determine which items should be carried versus what can be left at home.
  
• Keep backpack use limited to necessities only. See that your child cleans out his or her backpack daily by removing any items that can be left at home or in a locker.
  
• Use both straps. Make sure that the weight of your child's backpack is evenly distributed across the back to promote good posture and to avoid shoulder strain and/or a pinched nerve.
  
• Recognize signs that the backpack is too heavy. Pay attention to whether your child is slouched or leaning to one side when wearing a backpack, or is experiencing any type of back pain, tingling or numbness in the shoulders or arms.
  
• Select the proper backpack. Enhance comfort and safety by purchasing a backpack with multiple compartments, so that weight is more evenly distributed. Padded straps can also help to prevent straps from cutting into shoulders. Newer backpacks with wheels are also an option, provided that the handle extends long enough to allow children to stand upright while pulling it. The backpack and wheels must also be sturdy enough so that it does not topple over.
  
• Teach your child how to pick up his or her backpack by demonstrating how to bend at the knees and grasp the pack with both hands before putting it on.

Do you know of any other threats to your kids that are hiding in plain sight? Share them with us, and you could see your comments in a future story on TRUE.com!

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