With finals week upon us, textbooks, laptops and binders are just a few of the heavy items that spill out of backpacks as students stuff their bags to the brim. Despite the practicality of backpacks, they may endanger the health and safety of students.

“Since at least 1998, we’ve noticed backpacks getting bigger and heavier, and not in proportion to the kids’ sizes,” Dr. Karen Jacobs, a clinical professor at Boston University and spokesperson for the American Occupational Therapy Association, said to TIME Magazine. “Kids are saying ‘My back hurts, my neck and my shoulders hurt.’ A heavy backpack can also contribute to headaches and problems concentrating at school.”

Walking through the halls, students lug around backpacks that weigh an average of 18.4 pounds according to Consumer Reports.

“I always carry about two or three binders, a couple of folders and my history textbook in my backpack. Along with those items, I have a waterbottle, pencil pouch, calculator and lunchbox that I also have to carry,” freshman Rabiah Hilaly said. “It’s frustrating because there’s nothing I can do to lessen the load since teachers make us carry around the same papers, and the weight of them adds up over time.”

According to the U.S. Consumer Product Safety Commission, at least 14,000 children are treated for backpack-related injuries every year, while another estimated 5,000 are sent to the emergency room due to this issue.

“I would say that I carry a good 20 to 30 pounds in my backpack every day,” sophomore Katharine Segrave said. “My lower back has always been a struggle because of my backpack weight, and it has resulted in me having to go to a massage therapist and other rehab facilities that align certain muscles that have become out of place because of the weight of my backpack.”

According to orthopedist David Marshall, for those who suffer from scoliosis, a stress fracture, muscle strain or other spine or back related issues, heavy backpacks can aggravate the condition or delay recovery, just like the condition Segrave suffers from.

“I attribute my shoulder pain to my backpack because it puts a lot of strain on my left shoulder, so that is why I have to tape my shoulder and go to physical therapy twice a week. I noticed that  when I started middle school, my shoulder started getting really tense because of how much weight I was holding and over time it got worse,” Segrave said. “It became so bad that I have had to visit a doctor and a physical therapist, and it turns out that I have scoliosis. Over time, the ever-growing weight of my backpack contributed to this condition.”

However, students can prevent this issue by utilizing other methods to lessen the weight off of their shoulders.

“Lockers would be helpful to keep heavy items in, but my locker does not fit all of my books, even though I have one that is considered bigger,” freshman Jordan Russell said. “Luckily, my English teacher lets me keep my binder in her classroom so that I do not have to carry it around all day, and that is very helpful.”

There are also alternatives to the normal two-strap backpack, yet even rolling bags such as the one Russell uses pose other logistic issues.

“Since I do not have time to go to my locker, I have to carry all of my books in my backpack. When I use a two-strap backpack, my back hurts and the pain lasts all day, even when I get home,” Russell said. “I tried using a rolling backpack, but it was very time consuming, as I had to leave classes early just so that I could use the elevator and get through the hallways. Rolling backpacks are on the floor, but a good quality one is pricey. I paid $157 for my first one and $70 for my second one, but the straps get jammed in the bag part, so I don’t roll it.”

To combat this issue, both Segrave and Russell believe reducing the amount of paper we carry would help.

“The biggest issue I see is teachers not utilizing technology to its fullest. Since technology is becoming more widely used in schools, we need to put homework and textbooks online for students so that they’re able to access it without the weight of textbooks. Having more electronic access at school such as tablets would also lessen the weight since the weight of paper would not exist,” Segrave said.

Segrave stresses a need for students to be conscious about the weight they carry day-to-day.

“Awareness would definitely help my peers understand that heavy backpacks actually endanger your health,” Segrave said. “Even though it may just require small adjustments to lessen the weight you carry, the effects are huge.”