(lifepr) (Selsingen, 11.06.2014) A glimpse in an orthopaedic specialist's waiting room gives some idea of how significant back health has already become for children and youth: increasing numbers of young people feature among the patients because many adolescents already suffer from backache. We spoke to Dr. Dieter Breithecker, Managing Director of the Bundesarbeitsgemeinschaft für Haltungs- und Bewegungsförderung e.V. (BAG - Federal Consortium for Posture and Exercise) about the background and prevention possibilities.

Dr. Breithecker, many people still think backache is typically an age-dependent condition. Is this viewpoint meanwhile out-of-date?

Yes of course: for many years now younger generations have increasingly been suffering from many so-called age-dependent conditions. As well as type 2 diabetes, these also include back problems. Between 23 and 48% of primary school children suffer from backache. The figures increase significantly as schooling continues. Up to 83% of school children struggle with various pain symptoms such as backache, migraine and abdominal pains. Recurrent and chronic pain in particular is a frequent reason for missing school. Backache thus impacts on the school's educational mission. It is associated with a diminished motivation to learn and reduced learning success in affected children and youth.

But why do so many children already suffer from backache?

There are many different reasons. Current research results show a complex interaction of physical, psychological and social factors in children and youth, influencing the course of backache. Here it is also always important to stress that children are still growing. That means that their bodies are going through important and above all critical biological maturing processes. They are therefore less capable of coping with loads, although this does not mean that they should be wrapped in cotton wool. But one-sided loads, incorrect strains from sitting for hours on poor, inadequately adjusted school furniture, poor posture from deficient muscle training or deficits in bodily perception and increasing psychic loads are poor guarantees for healthy back development.

What role does the modern development of society play?

As humans, we must always be seen in the context of our environment. In contrast to earlier times, today we are expected to perform far less physical activity. Secondary mobility with cars and escalators is increasingly replacing primary mobility, i.e. cycling or walking. Nowadays, children rarely walk to school. Increasingly they experience life and their environment at second hand from a sedentary position (watching television or using the computer etc.). Many children simply no longer have access to the classical physical challenges available in the diversity of a natural environment, such as climbing trees, for example. Instead, the scope for exercise is increasingly restricted and strictly organised in clubs, in the school yard or on playgrounds. This fails to address children's needs to learn by playing, being usually overprotective, boring and scarcely a challenge. As a result, on average children spend nine hours of each day sitting down, while exercising for only around one hour. And important stimuli for their physical, mental and psychic development are missing.


Plenty of exercise in childhood is therefore important for a healthy back. But does this always have to be sport?

Plenty of exercise - which means about three hours a day - plays an elemental role in the development of body, mind and psyche and thus also for the back. So the emphasis is initially on exercise in general rather than on sport in particular. The younger the children, the greater the emphasis on playful exercise stimulated and organised by the children themselves. In pre-school and primary school children, the main focus should be on diversity rather than specialisation. Complex physical activities such as climbing, balancing, brachiating, jumping, running, cycling and playing ball give important development stimuli for all biological functions. As children pass through primary school, parallel consideration can also be given to sporting interest and action.

And given the fact that children are spending more and more of their leisure time sitting in front of the television, computer and co., as far as possible this should be done on child-friendly furniture.

What does "child-friendly furniture" mean? And what is so harmful about sitting for long hours particularly at school and at home?

Sitting still for hours is very unnatural behaviour for all generations. This applies particularly to children as they need many development stimuli in the form of a wide range of exercise particularly during their maturing processes. A healthy child will also demand such exercise stimuli - just one reason why children often find it hard to sit still and will start to fidget or rock back and forth on their chair. This is the growing organism's natural, healthy "strategy" in protest against these unhealthy conditions. On the contrary, sitting for hours and sitting still in particular is stress for the back, for the mind and soul. Primary school children can sit still for maximum five minutes. They need a chair that takes account of their healthy agitation rather than blocking their instincts, and they should work at a standing desk more frequently.

What requirements do you make with regard to the ideal ergonomic workplace for children? What in your view makes good desks and chairs stand out?

When children have to sit for a longer period of time, first and foremost they should have a chair and a desk that can be flexibly adapted to the constant growth-related changes in their body proportions. Furthermore, they need a chair with a seat that moves in three dimensions. This takes account of their healthy agitation rather than blocking it. Even while the children are sitting, chairs like this will allow them to vary their own sitting behaviour in a natural, intuitive fashion in what we today call dynamic sitting. Furthermore, sitting sessions should be frequently interrupted with continued learning for example at a standing desk.

The Campaign for Healthier Backs awards the AGR seal of approval to particularly back-friendly chairs and desks. Certified products are available for example from aeris, moll, MOIZI and VS-Möbel. More information can be found on the AGR website at www.agr-ev.de/... in the category "Campaign for Healthier Children's Backs".

Final question: what do you do to keep your back healthy?

As a general rule I don't do any special back exercises. I try to integrate as much exercise as possible in my everyday routine. My office chair and my leisure chairs each have a seat that moves in three dimension and I can change my desk to a standing desk, which is something I use regularly. I stand up or walk around when I'm on the phone. I always use the stairs instead of lifts and escalators. I also live according to the motto "The path is the goal!" and try to integrate as many steps as possible in my everyday routine, without necessarily heeding the maximum of 10,000 steps each day. Sometimes I'll head to the gym, but only when it's cold and wet outside.

More information about back-friendly products for children marked with the AGR seal of approval can be found at www.agr-ev.de.

Giving children more backing: Campaign for Healthier Children's Backs

The "Campaign for Healthier Children's Backs" initiative by the AGR and BAG promotes the health of children and youth and extends an awareness among parents, teachers and children for a back-friendly environment and the need for plenty of exercise. Together with the sitting furniture and desks mentioned above, the seal of approval is also awarded to other back-friendly products for children, such as child car seats. Long car journeys can cause backache not only in adults: children's backs also suffer. Many commercially available seats tend to have an uncomfortable, unergonomic design. This is why child car seats not only have to fulfil all safety conditions but also satisfy the ergonomic requirements of a child's growing body. AGR-certified child car seats are available from kiddy (www.kiddy.de). Poorly made shoes can also quickly cause backache in growing children and youth. Many children and youngsters suffer from weak feet and in some cases even from initial foot problems which end up causing posture defects and backache. Products with the AGR seal of approval in this field include the chung shi® DUX Trainer Kids and the chung shi® DUXFree Kids (www.chung-shi.com).