Oh, my aching back

MOST people probably wouldn't associate back pain with schoolchildren. It's an ailment of old and middle-age: a sure sign that our course is half-way run. The truth is that the causes of back pain in later life can be traced to our our childhood.

Physiotherapist Sarah Key, whose patients include the Prince of Wales, says incipient back problems often come to light when children go back to school after a long summer break.

That seems an odd thing to suggest. Why?

"Summer can bring on a growth spurt in children - all that outdoor activity and sun, combined with briefer periods of sitting hunched over desks and books - so that for a period of time the height of children can outstrip their newly emerging power to control that height," she says.

"Even as adults, people with back pain often link the appearance of their symptoms, or the development of curvature of the spine, to a growth spurt during adolescence."

Obviously, there's not much you can do about a growth spurt - it is a healthy and natural part of growing up. The best thing is simply to encourage your children to keep as physically active as possible.

"This enhances the conditions for growing by making their skeletons fully primed in strength, as well as being optimally pulled apart and loose, so that the bones and joints can grow out unfettered," says Sarah.

There are other aspects of going back to school that add to the strains on our children's backs, and over which we have more control. It's not just about those heavy school bags, either.

"I have never subscribed to the tut-tutting about school bags," admits Sarah, "though I know a lot of my fellow back professionals do. Certainly, school bags are heavy these days and I often feel a pang when I see my willowy 12- year-old daughter shouldering her heavy bag as she trudges off to school.

"But I know the very uncomfortableness of it will mean that before she has gone a hundred yards up the hill she will have slung it to the other shoulder, just to keep going.

"Tough as it may seem, kids benefit from this sort of postural training. With the worrying statistics emerging about fitness obesity in children, it does them no harm to carry their bags to school. Sometimes it is the only exercise they get!"

What really worries Sarah is the amount of time children spend slumped in front of a computer screen. There are a number of problems related to computers, she says: the long hours spent sitting, the unusually static nature of the pose - and the actual ergonomics of the computer setup.

"Children can sit for hours hunched over a computer screen, their only physical effort being a couple of keystrokes and pushing the mouse about," she says.

The base of the spine suffers because of so much sitting. It 'leaches' water out from the shock-absorbing intervertebral discs, Sarah says. "In earlier evolutionary forms we never sat, we squatted!" she points out.

But it is the upper end of the spine which suffers most. "The posture of a computer-user is that of head and neck stuck forward and face peering into the screen, with the thoracic part of the spine slumped into a deep crumple," she says. "Holding the arms aloft so the fingertips can hover above the keyboard makes matters worse - something you don't do incidentally with writing, where you rest the weight of your upper body on your forearms.

"The ultimate result for a computer back is that the cross-bar across your shoulders suffers profound and unabated postural strain.

You often see computer users lurch back in their chairs in pain, automatically arching their upper back."

So what can you do to ensure your child doesn't suffer from 'computer back'?

Apart from redesigning computers and restricting the hours of their use, there are a tips about how to set up the keyboard, chair and screen which may help, Sarah says - and there's also a simple yoga stretch which can be done daily to ease all skeletons - not just the growing skeletons of children - out of the crimps and kinks acquired during long hours at the keyboard.

Here are a few tips:

n Always have the screen and keyboard straight in front, with the screen positioned so you do don't have to peer to see it.

n Try swapping hands to use the mouse on alternate days.

n If you are a touch typist (and don't need to watch the keys) the top of the screen should be just below eye-line. Any higher requires too much effort of the back of your neck to tilt your head back. The poorer the typing skills the lower the screen should be.

n Keyboards are better flat; not tilted up from the back. This requires less cocking back of the wrists.

n The height of desk/keyboard should be such that your elbows are below 90 degrees when your fingertips are poised above the keys. A keyboard too high places added load on your shoulders.

n Ergonomic chairs should have the back support positioned close in behind the back and the chair as close as possible to the desk. If the chair is too far away you will lose the benefits of the contoured padding by leaning forward to see the screen.

n The chair seat should be angled down a few degrees at the front.

This encourages the lower back to maintain a better lumbar hollow which helps prevent the spine slumping.

How a simple yoga stretch can iron out those kinks:

Sitting close to an uncluttered wall, ease your bottom sideways into the base of the wall.

Swing your legs up the wall as you let your upper body down and turn onto your back on the floor.

Keeping your legs straight at the knees and your heels pushed towards the ceiling, take your arms over your head and interlace your fingers, turning the palms away.

With your elbows straight, hold this position for four or five seconds, breathing slowly.

Take your hands down to your hips to relax and let your legs bend on the wall to relax for ten seconds. Repeat three times.