Fullständig transkription av Walking Post podcast 62: Backpacks and the back

be deaf anyway and not listening 00:02:23.009 --> 00:02:26.430 to music. But why listening to music from the 00:02:26.430 --> 00:02:30.289 60s and before makes you old, I have no idea. 00:02:30.849 --> 00:02:34.030 It's International Day of Non -violence. World 00:02:34.030 --> 00:02:37.439 leaders, please take note. It's Guardian Angel 00:02:37.439 --> 00:02:39.979 Day, and I don't think it means the baseball 00:02:39.979 --> 00:02:42.599 teams, the Guardians and the Angels. I think 00:02:42.599 --> 00:02:45.680 my Guardian Angel is on vacation. And another 00:02:45.680 --> 00:02:48.719 interesting one, it's Name Your Car Day. It's 00:02:48.719 --> 00:02:50.800 a bit odd because if you do name your car, you 00:02:50.800 --> 00:02:53.620 probably do it when you get it, not wait until 00:02:53.620 --> 00:02:56.919 October the 2nd. I've had lots of cars over the 00:02:56.919 --> 00:02:59.879 years and I think the only one I ever named was 00:02:59.879 --> 00:03:02.919 the first one. And that's only because the license 00:03:02.919 --> 00:03:06.939 plate started with TWB, so I called it Tub. And 00:03:06.939 --> 00:03:09.879 as it was a Citroen 2CV, it did look like an 00:03:09.879 --> 00:03:12.599 upturned Tub. Other than that, I've never named 00:03:12.599 --> 00:03:15.259 a car. But if you do, I'd love to hear your names 00:03:15.259 --> 00:03:17.860 for them. Other than the profanities that you 00:03:17.860 --> 00:03:20.740 call it when it won't start. For events, it's 00:03:20.740 --> 00:03:25.560 the day in 1766 that the Nottingham cheese riot 00:03:25.560 --> 00:03:29.199 broke out because of the rise in the cost of 00:03:29.199 --> 00:03:33.300 cheese. I wonder if times have repeated themselves. 00:03:33.580 --> 00:03:37.039 Here we are in 2026 and everything has gone up, 00:03:37.340 --> 00:03:40.379 and the size of food packaging has gone down. 00:03:40.800 --> 00:03:43.530 No riots though, thankfully. although I don't 00:03:43.530 --> 00:03:46.610 read the Nottingham newspaper. For births, Richard 00:03:46.610 --> 00:03:51.469 III, Gandhi, Groucho Marx, Sting, Mike Rutherford 00:03:51.469 --> 00:03:54.729 from Genesis, I actually recognised quite a lot 00:03:54.729 --> 00:03:58.129 of names on the very long list this week. Right, 00:03:58.310 --> 00:04:00.689 last time on the podcast we talked about hiking 00:04:00.689 --> 00:04:04.610 in and visiting Antarctica with Amanda Hunter, 00:04:04.889 --> 00:04:08.129 the operations manager of Terra Nova Expeditions. 00:04:08.620 --> 00:04:11.759 This time we're talking backpacks or rucksacks 00:04:11.759 --> 00:04:14.360 or knapsacks or whatever you want to call them, 00:04:14.460 --> 00:04:17.519 but not about brands or how they are made. A 00:04:17.519 --> 00:04:20.740 few weeks ago I read an article about how backpacks 00:04:20.740 --> 00:04:23.980 can cause damage, especially in younger children. 00:04:24.160 --> 00:04:26.459 Obviously that doesn't apply to all backpacks 00:04:26.459 --> 00:04:29.860 and it also doesn't apply in all cases, but when 00:04:29.860 --> 00:04:33.060 our son first started at high school or secondary 00:04:33.060 --> 00:04:35.939 school his backpack weighed about as much as 00:04:35.939 --> 00:04:39.160 two small vehicles and the school doesn't have 00:04:39.160 --> 00:04:42.879 lockers. So no wonder he was exhausted and sore 00:04:42.879 --> 00:04:45.839 every night. So we are talking about the best 00:04:45.839 --> 00:04:48.660 practices for carrying them and what damage they 00:04:48.660 --> 00:04:52.240 can do if not worn or carried properly or if 00:04:52.240 --> 00:04:56.220 they're overloaded with an expert, Dr. Bayan 00:04:56.220 --> 00:04:59.720 Aghdasi, an orthopedic surgeon based in California 00:04:59.720 --> 00:05:03.420 who specializes in spine surgery. And just to 00:05:03.420 --> 00:05:05.920 be clear, this is not a conversation about whether 00:05:05.920 --> 00:05:08.750 you should carry a backpack. Almost everyone 00:05:08.750 --> 00:05:12.009 does, and I will keep carrying mine. After all, 00:05:12.089 --> 00:05:15.110 you need one. I'd be lost without mine, and it 00:05:15.110 --> 00:05:17.389 doesn't even feel like a proper hike without 00:05:17.389 --> 00:05:20.750 one. This is more about what happens when a pack 00:05:20.750 --> 00:05:23.769 is too heavy or worn the wrong way, and what 00:05:23.769 --> 00:05:26.250 to watch for. But before we get going, if you 00:05:26.250 --> 00:05:29.230 do have news, guest ideas, or even subjects to 00:05:29.230 --> 00:05:32.009 cover, or comments, or if you want to advertise, 00:05:32.230 --> 00:05:35.550 please get in touch at walkingpost .com or you 00:05:35.550 --> 00:05:40.009 can just email me at jim. at walkingpost .com. 00:05:50.819 --> 00:05:53.839 Right, backpacks. I think I have about six of 00:05:53.839 --> 00:05:56.920 them and I can honestly say I've never really 00:05:56.920 --> 00:06:00.779 had one that I love everything about. I've definitely 00:06:00.779 --> 00:06:03.519 had ones that an hour into the walk I've wanted 00:06:03.519 --> 00:06:06.800 to throw off a cliff into whatever sea I'm walking 00:06:06.800 --> 00:06:10.579 alongside but I'm not about to litter and also 00:06:10.579 --> 00:06:13.600 I want to keep the stuff that's inside it. The 00:06:13.600 --> 00:06:16.540 main reason was both of those packs were massively 00:06:16.540 --> 00:06:19.759 uncomfortable and actually after a while started 00:06:19.759 --> 00:06:23.100 to hurt. So what is the best way to carry one 00:06:23.100 --> 00:06:25.720 and what damage can they do? How much weight 00:06:25.720 --> 00:06:28.370 should you carry? I don't know the answer to 00:06:28.370 --> 00:06:31.769 these, so this week on the podcast we have a 00:06:31.769 --> 00:06:34.089 conversation with someone who does know what 00:06:34.089 --> 00:06:37.009 the problems are, because he's an expert in the 00:06:37.009 --> 00:06:41.550 field. Dr. Bayan Aghdasi is an orthopedic

surgeon 00:06:41.550 --> 00:06:45.449 specializing in spine surgery. So let's get right 00:06:45.449 --> 00:06:49.540 to it. Hi, Dr. Aghdasi. It's so good to have you 00:06:49.540 --> 00:06:51.639 on the podcast today. I'm really looking forward 00:06:51.639 --> 00:06:55.699 to learning about backpacks. Maybe to start, 00:06:55.860 --> 00:06:57.560 you could give us a little bit of background 00:06:57.560 --> 00:07:01.899 on your background. I practice spine surgery. 00:07:02.300 --> 00:07:05.660 I'm a board certified orthopedic spine surgeon. 00:07:06.180 --> 00:07:10.040 I was trained in orthopedic surgery on the East 00:07:10.040 --> 00:07:12.759 Coast. My undergraduate studies were at UCLA 00:07:12.759 --> 00:07:16.579 and my spine surgery training was at Johns Hopkins 00:07:16.579 --> 00:07:19.899 University. I've been in private practice six 00:07:19.899 --> 00:07:24.079 years now. I kind of specialized more into the 00:07:24.079 --> 00:07:27.459 minimally invasive, reconstructive forms of spine 00:07:27.459 --> 00:07:31.160 surgery, which are ways of doing more advanced 00:07:31.160 --> 00:07:34.939 surgeries through smaller and less invasive incisions. 00:07:35.199 --> 00:07:41.199 I use advanced robotics and navigation softwares 00:07:41.199 --> 00:07:44.860 and techniques to get that job done. I've done 00:07:44.860 --> 00:07:47.500 maybe, I don't know, several thousand minimally 00:07:47.500 --> 00:07:50.959 invasive spine surgeries in my years and happy 00:07:50.959 --> 00:07:54.759 to kind of reflect on those with you to figure 00:07:54.759 --> 00:07:57.699 out how to avoid getting into the operating room, 00:07:57.879 --> 00:08:01.180 right? How to keep people's necks and backs healthy 00:08:01.180 --> 00:08:06.079 for as long as possible. Sure. Is the field of 00:08:06.079 --> 00:08:08.939 medicine that you work in, does that change very 00:08:08.939 --> 00:08:12.100 much? Does it evolve over time or is it pretty 00:08:12.100 --> 00:08:16.759 much? what you learned years ago is still the 00:08:16.759 --> 00:08:21.319 way that it's done. Well, I'm sure a great majority 00:08:21.319 --> 00:08:25.160 of the principles remain the same, although it 00:08:25.160 --> 00:08:30.699 is perhaps the most liquid and fluid branch of 00:08:30.699 --> 00:08:34.720 orthopedics, primarily because of the complexity 00:08:34.720 --> 00:08:38.059 of the spine, such that the science of surgery 00:08:38.059 --> 00:08:41.419 on the spine is nowhere near its maturity, as 00:08:41.419 --> 00:08:45.120 opposed to hand surgery with trigger fingers 00:08:45.120 --> 00:08:48.840 or carpal tunnel or even joint replacement surgery 00:08:48.840 --> 00:08:51.419 that has been around in its current form for 00:08:51.419 --> 00:08:54.820 30 plus years with very little change to those 00:08:54.820 --> 00:08:58.799 procedures. Spine surgery has undergone a rapid 00:08:58.799 --> 00:09:02.320 evolution over the past, I don't know, 10 years, 00:09:02.360 --> 00:09:05.379

20 years. It continues essentially to rapidly 00:09:05.379 --> 00:09:10.039 evolve. Different approaches, front, side, back, 00:09:10.500 --> 00:09:15.120 different techniques. open versus less invasive 00:09:15.120 --> 00:09:19.279 versus ultra minimally invasive robotics navigation 00:09:19.279 --> 00:09:22.320 and arguments around all of those different decisions 00:09:22.320 --> 00:09:26.980 so there is no clear true standard of care around 00:09:26.980 --> 00:09:30.120 these finer points about the techniques so it 00:09:30.120 --> 00:09:32.919 actually remains in a very fluid state and I 00:09:32.919 --> 00:09:35.740 would say it'll take another 50 to a hundred 00:09:35.740 --> 00:09:40.460 years to reach full maturity the way other branches 00:09:40.460 --> 00:09:42.659 of medicine are really set in stone, really. 00:09:43.200 --> 00:09:45.820 Right. And before we actually get onto backpacks, 00:09:45.940 --> 00:09:48.340 I was just wondering, as you were saying that, 00:09:49.059 --> 00:09:53.159 are lifestyle changes altering the physiology 00:09:53.159 --> 00:09:55.840 of the body? Is the back changing? People are 00:09:55.840 --> 00:09:58.480 more sedentary than they ever were. They're not 00:09:58.480 --> 00:10:01.740 outside walking as much. Are there changes that 00:10:01.740 --> 00:10:04.799 you're seeing over time? Yeah, absolutely. There's 00:10:04.799 --> 00:10:07.879 been quite a bit. I could take a look at a patient's 00:10:07.879 --> 00:10:10.750 x -ray and MRI. and tell you a great many things 00:10:10.750 --> 00:10:15.309 about them, not just genetics and what their 00:10:15.309 --> 00:10:19.149 body shape and form is like, not just obesity, 00:10:19.850 --> 00:10:23.149 but also wear and tear phenomena, mechanical, 00:10:23.590 --> 00:10:27.730 chronic degenerative changes, and even metabolic 00:10:27.730 --> 00:10:30.830 stressors like things related to lifestyle, what 00:10:30.830 --> 00:10:33.889 their diet has been like, what their exercise 00:10:33.889 --> 00:10:36.559 regimen has been like. and what kind of substances 00:10:36.559 --> 00:10:39.700 they've been using, alcohol or nicotine. Even 00:10:39.700 --> 00:10:43.139 those produce effects to the internal structure 00:10:43.139 --> 00:10:47.340 of your body that are long standing. And so I 00:10:47.340 --> 00:10:50.700 think, yeah, we can tell a lot about the modern 00:10:50.700 --> 00:10:54.139 population and how our lifestyles are impacting 00:10:54.139 --> 00:10:58.759 our musculoskeletal health. Today, kids especially, 00:10:59.539 --> 00:11:02.379 but adults as well. A lot of people carry backpacks. 00:11:02.500 --> 00:11:06.039 Is that generally safe? Yeah, good question. 00:11:06.500 --> 00:11:09.440 I think, and this is kind of my opinion to some 00:11:09.440 --> 00:11:12.440 extent. It's an expert opinion, but an opinion 00:11:12.440 --> 00:11:16.580 nonetheless. My impression is backpacks are safe 00:11:16.580 --> 00:11:20.419 up to a point. And in reflecting on your questions, 00:11:21.059 --> 00:11:25.259 I suspect it has to do with a threshold of weight. 00:11:25.860 --> 00:11:28.059 It also has to do with how you carry the backpack. 00:11:28.179 --> 00:11:32.320 But I think the biggest issue is relative to 00:11:32.320 --> 00:11:36.139 your body size. How big is the backpack? And 00:11:36.139 --> 00:11:38.899 if it's something that you could sling over your 00:11:38.899 --> 00:11:42.340 arms and ideally carry on both shoulders to distribute 00:11:42.340 --> 00:11:47.559 the load evenly and not create asymmetrical biomechanical 00:11:47.559 --> 00:11:49.840 imbalance, which can accelerate wear and tear 00:11:49.840 --> 00:11:53.899 or exacerbate nerve root tension symptoms. I 00:11:53.899 --> 00:11:56.840 think if that weight is low enough where you 00:11:56.840 --> 00:12:02.889 can wear it and not feel fatigued or aches or 00:12:02.889 --> 00:12:06.549 pains in that body part for hour after hour, 00:12:06.850 --> 00:12:09.549 meaning if it's really light, I think that's 00:12:09.549 --> 00:12:12.269 safe. I think a backpack worn on both shoulders 00:12:12.269 --> 00:12:15.169 that's really light, that's worn kind of high 00:12:15.169 --> 00:12:17.769 and tight, so it's kind of sitting up on your 00:12:17.769 --> 00:12:21.309 back and not necessarily pulling you down or 00:12:21.309 --> 00:12:25.110 back, kind of distributing its load over many 00:12:25.110 --> 00:12:28.090 different vertebrae. And if it's quite light, 00:12:28.570 --> 00:12:30.909 I think that's a perfectly safe thing to do. 00:12:31.000 --> 00:12:34.659 I don't foresee that ever being a significant 00:12:34.659 --> 00:12:38.879 cause of disease or problems. You mentioned the 00:12:38.879 --> 00:12:42.240 asymmetry earlier. So I guess then distribution 00:12:42.240 --> 00:12:46.940 would fall under that. Yeah. So much of the time, 00:12:46.940 --> 00:12:49.899 I guess in the 1980s, we used to say like the 00:12:49.899 --> 00:12:52.539 cool kids would carry their backpack on one shoulder. 00:12:52.559 --> 00:12:55.659 Right. And I think there is a certain convenience 00:12:55.659 --> 00:12:59.330 to doing that. But certainly. When you do that, 00:12:59.590 --> 00:13:02.669 you asymmetrically load the shoulder girdle, 00:13:02.789 --> 00:13:06.830 the spine, the hips, the lumbar vertebrae, and 00:13:06.830 --> 00:13:10.529 you can propagate a pretty significant imbalance 00:13:10.529 --> 00:13:14.370 and create unilateral symptoms much more quickly 00:13:14.370 --> 00:13:18.809 because you're concentrating the load onto not 00:13:18.809 --> 00:13:21.629 just the anatomy, not just the focal points of 00:13:21.629 --> 00:13:25.570 the anatomy, but also on leverage asymmetry. 00:13:25.889 --> 00:13:27.929 So you can, you know, you've got the whole shoulder 00:13:27.929 --> 00:13:31.409 girdle, let's say, eight or nine inches off from 00:13:31.409 --> 00:13:33.370 the midline. And all of a sudden you're applying 00:13:33.370

--> 00:13:36.129 all that weight to one point, and you're going 00:13:36.129 --> 00:13:39.370 to drift the whole spine into one direction, 00:13:39.529 --> 00:13:43.049 and then compensatory adaptations down below 00:13:43.049 --> 00:13:46.529 and above in the other direction. And so I think 00:13:46.529 --> 00:13:51.049 asymmetry drives it, drives problems, load drives 00:13:51.049 --> 00:13:54.980 problems, and Yeah, and also duration, how long 00:13:54.980 --> 00:13:57.179 you're going to keep those two factors in place. 00:13:57.500 --> 00:14:01.279 So those three things, I think potentially over 00:14:01.279 --> 00:14:05.120 a lifetime would significantly shorten the lifespan 00:14:05.120 --> 00:14:09.809 of some of your vertebrae. Do you see injuries 00:14:09.809 --> 00:14:13.690 caused by backpacks and can that end up being 00:14:13.690 --> 00:14:17.830 permanent? You know, probably not like an acute 00:14:17.830 --> 00:14:21.350 injury, like we think of a fracture or a dislocation, 00:14:21.350 --> 00:14:25.830 but over the lifetime of usage of your arms and 00:14:25.830 --> 00:14:28.750 legs, I think the majority of the diseases that 00:14:28.750 --> 00:14:31.870 we treat are in fact degenerative disease types, 00:14:31.889 --> 00:14:35.450 meaning they come about after years and decades 00:14:35.450 --> 00:14:38.289 of wear and tear. So yeah, I'm sure the backpack 00:14:38.289 --> 00:14:41.149 plays a significant role. I mean, it's one of 00:14:41.149 --> 00:14:43.529 the biggest things we do is we wear, we carry 00:14:43.529 --> 00:14:46.750 things with us, right? And so wear and tear is 00:14:46.750 --> 00:14:50.350 the greatest source of disease in the spine. 00:14:51.490 --> 00:14:53.929 carrying things is probably one of the major 00:14:53.929 --> 00:14:56.809 contributors to that. So even though there's 00:14:56.809 --> 00:14:59.590 no studies that I'm aware of quantifying that 00:14:59.590 --> 00:15:02.210 problem, I'd be shocked if it wasn't a major 00:15:02.210 --> 00:15:05.909 contributor. Right. Associated with that, are 00:15:05.909 --> 00:15:10.330 there warning signs that people can take note 00:15:10.330 --> 00:15:13.649 of when they're feeling something in their back? 00:15:14.309 --> 00:15:17.909 Yeah, I think if you wear the backpack and within 00:15:17.909 --> 00:15:21.610 five or 10, 15 minutes, you start to have aches 00:15:21.610 --> 00:15:23.990 and pains and need to change sides or take it 00:15:23.990 --> 00:15:27.389 off I think that's too heavy and if you're wearing 00:15:27.389 --> 00:15:30.049 it on one side and you're noticing you have to 00:15:30.049 --> 00:15:32.470 switch sides or keep switching back and forth 00:15:32.470 --> 00:15:34.929 then I think you're not you're not wearing it 00:15:34.929 --> 00:15:37.250 properly you're not putting it on both shoulders 00:15:37.250 --> 00:15:40.830 and strapping it tight so it it rides high and 00:15:40.830 --> 00:15:43.090 spreads its weight over your back as

opposed 00:15:43.090 --> 00:15:46.590 to kind of just yanking on on your shoulder blades 00:15:46.590 --> 00:15:49.629 back and so yeah if you're starting to have aches 00:15:49.629 --> 00:15:52.580 and pains You're using unilateral or bad habits. 00:15:53.080 --> 00:15:55.539 The load is too much and causing you discomfort 00:15:55.539 --> 00:15:59.120 in a short time period. Those are all signs that 00:15:59.120 --> 00:16:01.259 you're probably not doing yourself any favors 00:16:01.259 --> 00:16:04.120 long term. Are you seeing more issues with things 00:16:04.120 --> 00:16:06.399 like this? Because there are like a hundred different 00:16:06.399 --> 00:16:08.840 kinds of backpacks. Now, when I was a kid, there 00:16:08.840 --> 00:16:12.320 was a backpack and now they have backpacks with 00:16:12.320 --> 00:16:16.100 frames and there's backpacks with vents in them 00:16:16.100 --> 00:16:20.700 and different sizes. Yeah, that's a good point. 00:16:20.980 --> 00:16:23.779 And there's probably more research to be done, 00:16:23.779 --> 00:16:26.980 certainly on my end, to really pin down whether 00:16:26.980 --> 00:16:32.279 these commercial adaptations are actually significantly 00:16:32.279 --> 00:16:35.960 modifying the general risk, the style, if it 00:16:35.960 --> 00:16:39.360 can sit up higher, if it's more square and projects 00:16:39.360 --> 00:16:42.019 further away from the body, or if it can be kind 00:16:42.019 --> 00:16:46.220 of flatter and sit more on your skin. Like you 00:16:46.220 --> 00:16:48.990 said, the vents or the frames. I'm not aware 00:16:48.990 --> 00:16:52.769 of any research that meaningfully differentiates 00:16:52.769 --> 00:16:56.730 those particular adaptations. Now, I know the 00:16:56.730 --> 00:16:59.250 roller bag where you kind of roll it on the ground 00:16:59.250 --> 00:17:01.970 behind you, that obviously is going to be better 00:17:01.970 --> 00:17:05.609 for your spine, but it doesn't look very cool 00:17:05.609 --> 00:17:08.849 and it's not very user friendly for hiking or 00:17:08.849 --> 00:17:11.170 camping or, you know, or just going in between 00:17:11.170 --> 00:17:13.650 university classes up and down stairs. You know, 00:17:13.650 --> 00:17:16.329 that can be a problem. So I'm not aware of an 00:17:16.329 --> 00:17:20.390 adaptation directly to the backpack itself, which 00:17:20.390 --> 00:17:23.049 would significantly alter the natural history 00:17:23.049 --> 00:17:27.750 of of loading the spine. Other kind of connected 00:17:27.750 --> 00:17:30.470 to that, too, is are there any recommendations 00:17:30.470 --> 00:17:35.329 or limits according to age? Because obviously 00:17:36.440 --> 00:17:40.000 10 year old doesn't have the same capacity as 00:17:40.000 --> 00:17:44.859 a 40 year old and also their body is still developing. 00:17:45.039 --> 00:17:48.839 Are there recommendations for capacity for weight 00:17:48.839 --> 00:17:52.319 for different ages or different heights? I think 00:17:52.319 --> 00:17:54.859 very young kids who have still not gone through 00:17:54.859 --> 00:17:57.519 puberty that are still going through their growth 00:17:57.519 --> 00:18:00.140 phases. And those are the ones that we tend to 00:18:00.140 --> 00:18:03.180 saddle with backpacks full of textbooks, unfortunately, 00:18:03.339 --> 00:18:07.029 right? There is a law called Wolf's Law. that 00:18:07.029 --> 00:18:10.670 states that bones will adapt to pressures. And 00:18:10.670 --> 00:18:13.549 so if you put a lot of weight through a bone, 00:18:14.069 --> 00:18:17.470 it actually will adapt and kind of shorten to 00:18:17.470 --> 00:18:20.210 accommodate or not grow as much if it's trying 00:18:20.210 --> 00:18:23.630 to grow to accommodate that load. And so just 00:18:23.630 --> 00:18:25.549 like if you wear really tight shoes as you're 00:18:25.549 --> 00:18:28.390 growing, your feet might be restricted in terms 00:18:28.390 --> 00:18:32.329 of their size. If our eight year olds and 10 00:18:32.329 --> 00:18:35.769 year olds are carrying, you know, 45 pounds, 00:18:35.910 --> 00:18:39.789 of textbooks on their backs all day and going 00:18:39.789 --> 00:18:42.470 from class to class, you know, 10 periods a day 00:18:42.470 --> 00:18:44.750 at school. I think that's going to significantly 00:18:44.750 --> 00:18:47.430 impact their development and could cause sometimes 00:18:47.430 --> 00:18:51.789 chronic issues. So I think prepubescent children 00:18:51.789 --> 00:18:54.369 should be cautious and avoid avoid those three 00:18:54.369 --> 00:18:56.690 things I mentioned earlier. And then also, as 00:18:56.690 --> 00:19:00.269 we age, our bones become softer. So especially 00:19:00.269 --> 00:19:04.430 females of fair skin over the age of 40. who 00:19:04.430 --> 00:19:08.289 are slender, I think that those are the categories 00:19:08.289 --> 00:19:12.430 of people more susceptible to osteoporosis. And 00:19:12.430 --> 00:19:16.049 so those are the ones who will also be more susceptible 00:19:16.049 --> 00:19:19.970 or prone to hip fractures or fragility fractures. 00:19:20.490 --> 00:19:24.569 And if you're loading their spines and they step 00:19:24.569 --> 00:19:28.589 awkward or step off a curb wrong, the risk of 00:19:28.589 --> 00:19:31.910 a fragility fracture in that population due to 00:19:31.910 --> 00:19:35.430 a loaded spine from a heavy backpack is also 00:19:35.430 --> 00:19:39.529 an increased risk. So at the extremes of youth 00:19:39.529 --> 00:19:44.329 and fragility, there is downsides to chronic 00:19:44.329 --> 00:19:47.849 shoulder based loading. And how about posture? 00:19:47.910 --> 00:19:50.470 Because clearly it changes posture a little. 00:19:50.690 --> 00:19:53.549 Are there, do you recommend to people specific 00:19:53.549 --> 00:19:56.250 postures, whether it's with or without a backpack? 00:19:56.809 --> 00:19:59.690 Yeah, absolutely. I think the healthiest posture 00:19:59.690 --> 00:20:05.349 is one where You

kind of stand square and upright 00:20:05.349 --> 00:20:09.089 without slouching and keeping your shoulders 00:20:09.089 --> 00:20:13.289 low and back. That's kind of a position of readiness 00:20:13.289 --> 00:20:17.630 for your body to respond to physical stressors, 00:20:17.769 --> 00:20:21.609 whether it's, you know, athletic or environmental. 00:20:22.170 --> 00:20:24.809 And so we can't all walk around looking like 00:20:24.809 --> 00:20:28.730 a bodybuilder, but you can be conscious of not 00:20:28.730 --> 00:20:32.029 slouching. not keeping your head position down 00:20:32.029 --> 00:20:34.789 as you type or you work on, look at our phones 00:20:34.789 --> 00:20:38.890 all the time. Those are all common errors that 00:20:38.890 --> 00:20:42.970 exacerbate and accelerate the hunching over that 00:20:42.970 --> 00:20:45.349 inevitably happens to all human beings as we 00:20:45.349 --> 00:20:48.769 age, especially the elderly fair skinned females 00:20:48.769 --> 00:20:52.130 that I mentioned earlier who suffer from disproportionately 00:20:52.130 --> 00:20:55.769 from osteoporosis end up developing these hunchback, 00:20:55.950 --> 00:20:59.730 very painful postures. And so, yeah. slowing 00:20:59.730 --> 00:21:04.069 that process down by maintaining upright shoulders 00:21:04.069 --> 00:21:08.069 back daily routines can be life -saving in the 00:21:08.069 --> 00:21:10.990 long term. Can it also affect other parts of 00:21:10.990 --> 00:21:15.430 the body like hips and thighs and legs? Very 00:21:15.430 --> 00:21:18.990 directly in fact sometimes if you create enough 00:21:18.990 --> 00:21:21.950 wear and tear through the spine whether it be 00:21:21.950 --> 00:21:25.329 from mechanical sources or metabolic stressors 00:21:25.329 --> 00:21:29.630 or sometimes obesity or nicotine you actually 00:21:29.630 --> 00:21:33.670 degenerate the discs to the point where the vertebrae 00:21:33.670 --> 00:21:36.710 collapse and pinch onto the nerves, the nerves 00:21:36.710 --> 00:21:39.769 that are exiting at each spinal segment. And 00:21:39.769 --> 00:21:42.269 those nerves go to all your organs and your arms 00:21:42.269 --> 00:21:45.250 and legs and bowel and bladder. Eventually, if 00:21:45.250 --> 00:21:48.730 you degenerate your neck or your back far enough 00:21:48.730 --> 00:21:52.190 into your 60s or 70s, those nerves will actually 00:21:52.190 --> 00:21:54.690 cause weakness and dysfunction. You'll start 00:21:54.690 --> 00:21:58.369 to get numbness and tingling and balance issues 00:21:58.369 --> 00:22:01.809 in your arms and legs. You may find it hard to 00:22:01.809 --> 00:22:04.630 walk, you know, be limited to shorter and shorter 00:22:04.630 --> 00:22:08.410 distances. And eventually people go from a cane 00:22:08.410 --> 00:22:11.990 to a walker to a wheelchair, oftentimes because 00:22:11.990 --> 00:22:15.190 of spinal degeneration. So, yeah, it has the 00:22:15.190 --> 00:22:17.390 potential to affect your whole body. Are there 00:22:17.390 --> 00:22:20.190 any recommendations that you have for people? 00:22:20.410 --> 00:22:22.829 You mentioned those three things earlier, like 00:22:22.829 --> 00:22:26.950 are there any things people can do to help themselves 00:22:26.950 --> 00:22:29.589 when it comes to carrying on their backs? I think 00:22:29.589 --> 00:22:33.750 a regular routine of resistance training exercise 00:22:33.750 --> 00:22:37.369 is really important. It's the low chronic loads 00:22:37.369 --> 00:22:42.210 that are degenerating more than the acute controlled 00:22:42.210 --> 00:22:46.690 muscular exercise that is really healthy. So 00:22:46.690 --> 00:22:49.960 instead of carrying something for you know, many, 00:22:50.299 --> 00:22:53.460 many hours, what you can do, I would prioritize 00:22:53.460 --> 00:22:57.339 three or four times weekly, 45 minutes of high 00:22:57.339 --> 00:23:00.339 intensity resistance training exercise. That's 00:23:00.339 --> 00:23:03.960 gonna build up skeletal muscle, decrease adiposity 00:23:03.960 --> 00:23:07.420 or fat, and make you more resilient to whatever 00:23:07.420 --> 00:23:10.839 tasks of carrying that you need to do. You'll 00:23:10.839 --> 00:23:14.680 feel more up to doing those tasks, more apt to 00:23:14.680 --> 00:23:17.799 executing them without incurring more wear and 00:23:17.799 --> 00:23:21.039 tear. if you're fit and lean and healthy. So 00:23:21.039 --> 00:23:24.799 I think exercise is a great way to slow down 00:23:24.799 --> 00:23:28.940 the wear and tear process. And how about for 00:23:28.940 --> 00:23:32.299 back injuries? Obviously, they're all different. 00:23:32.519 --> 00:23:36.920 But if somebody has fatigue or issues caused 00:23:36.920 --> 00:23:41.859 by a backpack, is it just a case of resting or 00:23:41.859 --> 00:23:46.039 carry less? So what are you thinking there? Yeah, 00:23:46.039 --> 00:23:48.549 I think in the more immediate time frame, you 00:23:48.549 --> 00:23:52.069 know, preventing the offending behavior and modifying 00:23:52.069 --> 00:23:56.170 it, decreasing load, increasing symmetry, decreasing 00:23:56.170 --> 00:24:00.789 duration is the obvious short -term stopgap. 00:24:00.910 --> 00:24:03.970 But ultimately, you need to figure out what's 00:24:03.970 --> 00:24:08.529 going on. Is it mechanical axial pain? Is it 00:24:08.529 --> 00:24:12.430 radiating periscapular nerve pain or sciatic 00:24:12.430 --> 00:24:15.670 pain down the legs? And then that would be diagnosed 00:24:15.670 --> 00:24:18.700 with x -rays and an MRI. And so, you know, getting 00:24:18.700 --> 00:24:20.799 to the bottom of exactly what's going on and 00:24:20.799 --> 00:24:23.839 how bad it is. Is it just a nuisance or is it 00:24:23.839 --> 00:24:26.359 quality of life? Is it interfering with your 00:24:26.359 --> 00:24:28.640 quality of life on a regular basis? And is it 00:24:28.640 --> 00:24:31.779 actually resulting in weakness or dysfunction? 00:24:31.920 --> 00:24:33.900 Or are you

avoiding certain activities because 00:24:33.900 --> 00:24:36.980 of it? So there's a spectrum of disease there, 00:24:37.240 --> 00:24:39.819 but I would say get checked out by a doctor. 00:24:40.240 --> 00:24:43.299 Don't be afraid of imaging. MRIs have no radiation. 00:24:43.569 --> 00:24:46.950 X -rays have very low dose radiation so they're 00:24:46.950 --> 00:24:49.589 not really considered a risk factor. I would 00:24:49.589 --> 00:24:52.730 say get checked out sooner than later so we can 00:24:52.730 --> 00:24:55.450 diagnose it and if there's nothing wrong then 00:24:55.450 --> 00:25:07.720 we'll keep carrying backpacks. A really informative 00:25:07.720 --> 00:25:10.700 conversation there. And I've already decided 00:25:10.700 --> 00:25:13.619 my strategy for distributing the load better 00:25:13.619 --> 00:25:17.140 the next time we go out filming. My son can carry 00:25:17.140 --> 00:25:19.720 it all. I'm just kidding for those who were taking 00:25:19.720 --> 00:25:22.680 it seriously and about to send me a nasty email. 00:25:23.220 --> 00:25:25.619 And a couple of things worth keeping in mind 00:25:25.619 --> 00:25:29.880 from that. Dr. Aghdasi did say that this is his 00:25:29.880 --> 00:25:32.759 expert opinion and that he isn't aware of any 00:25:32.759 --> 00:25:36.019 studies that put a number on how much backpacks 00:25:36.019 --> 00:25:39.680 contribute to long -term back problems. Maybe 00:25:39.680 --> 00:25:42.470 there's an opportunity there for a study. The 00:25:42.470 --> 00:25:45.650 points about wear and tear are general risks 00:25:45.650 --> 00:25:48.910 over a lifetime and not really a prediction for 00:25:48.910 --> 00:25:52.990 anyone who carries a pack on a walk. On kids, 00:25:53.410 --> 00:25:56.529 since weight came up, guidance does vary a little 00:25:56.529 --> 00:25:58.910 bit, but the figure that you'll most often see 00:25:58.910 --> 00:26:01.769 is that a child's pack shouldn't be any more 00:26:01.769 --> 00:26:05.740 than 10 to 15 percent of their body weight. So 00:26:05.740 --> 00:26:09.460 for a child who weighs 60 pounds or 27 kilos 00:26:09.460 --> 00:26:14.579 roughly that's about 6 to 9 pounds or 2 .7 to 00:26:14.579 --> 00:26:18.900 4 kilos. The 45 pounds that Dr Aghdasi mentioned 00:26:18.900 --> 00:26:21.880 there was just an extreme example and there are 00:26:21.880 --> 00:26:25.279 resources online that can give you tips on packing 00:26:25.279 --> 00:26:28.119 a backpack both for children as well as adults. 00:26:28.559 --> 00:26:31.539 The practical takeaways were, I guess, wear it 00:26:31.539 --> 00:26:34.700 on both shoulders, keep it snug and riding high, 00:26:34.819 --> 00:26:37.160 watch the weight and the weight distribution. 00:26:37.539 --> 00:26:39.660 And if you're getting aches within the first 00:26:39.660 --> 00:26:42.259 few minutes, or you have to keep switching things 00:26:42.259 --> 00:26:45.160 around, then that's probably a sign that something 00:26:45.160 --> 00:26:49.039 needs changing. And if the pain persists or worsens, 00:26:49.079 --> 00:26:52.220 then do get it checked sooner rather than later. 00:26:52.619 --> 00:26:55.480 Advice that I need to start heeding. There are 00:26:55.480 --> 00:26:57.880 times when I know that I'm going to be taking 00:26:57.880 --> 00:27:01.200 the backpack off a few times and so I'll carry 00:27:01.200 --> 00:27:04.579 it on one shoulder for a while. And yes, it does 00:27:04.579 --> 00:27:07.460 start to hurt right away. And there are also 00:27:07.460 --> 00:27:10.119 times that I add things in that I don't need. 00:27:10.299 --> 00:27:13.720 So it could definitely be a bit lighter or maybe 00:27:13.720 --> 00:27:16.720 even a lot lighter. Do I really need to carry 00:27:16.720 --> 00:27:20.079 five different tripods? My son is shaking his 00:27:20.079 --> 00:27:22.950 head right now. I know, I probably don't need 00:27:22.950 --> 00:27:26.970 the 1 meter AND the 3 meter sticks. And two lights, 00:27:27.190 --> 00:27:30.670 and 48 cables. And two extra sets of microphones, 00:27:30.970 --> 00:27:33.809 just in case. Never mind a suitcase, I think 00:27:33.809 --> 00:27:36.890 I should call my backpack the just in case. If 00:27:36.890 --> 00:27:39.589 you do have news or suggestions for podcast guests, 00:27:39.750 --> 00:27:42.609 please do get in touch through Jim at walkingpost 00:27:42.609 --> 00:27:46.019 .com We are always looking for guests, whether 00:27:46.019 --> 00:27:49.660 it's about a new trail, new book, a walking festival, 00:27:50.059 --> 00:27:53.700 or someone who has done an amazing, unusual or 00:27:53.700 --> 00:27:56.799 interesting walk somewhere. So I hope you enjoyed 00:27:56.799 --> 00:27:59.759 this week's walkingpost .com podcast and I hope 00:27:59.759 --> 00:28:02.480 that you have a great week ahead, hopefully with 00:28:02.480 --> 00:28:05.440 a walk somewhere, with or without a backpack. 00:28:06.220 --> 00:28:17.470 Until next time, happy trails! is an Ayr Coastal 00:28:17.470 --> 00:28:18.690 Media Limited production.