Evaluation of Muscle Work of Serratus Anterior in School Going Children with Normal Bmi in Secondary School Due to Heavy Weight of Bags

Abstract

Background

Kids aged 10–16 are still growing, so heavy schoolbags can cause back pain, poor posture, and muscle problems. Bags over 10% of their body weight are risky. One-strap bags can cause uneven shoulders and shoulder blade issues like “scapular winging.” The Indian government recommends schoolbags weigh 4–5 kg depending on grade. Doctors use BMI to check health risks and MMT to test muscle strength. Carrying bags the wrong way can lead to long-term joint and muscle issues.

Objective: To evaluate muscle work of serratus anterior in school going children with normal BMI in secondary school due to heavy weight of the bag, to find out weakness of serratus anterior muscle, to find out average bag weight they carry, to rule out any associated pain due to heavy bag.

Methods: A survey was carried out among 250 secondary school students with normal BMI using the MMT method. Eligibility criteria encompassed children with normal BMI and Children studying in secondary. Individuals with a history of shoulder joint injuries, recent shoulder-related fractures, or recent upper limb surgeries will be excluded.

Results: Out of 250 secondary school children with normal BMI who were involved in the study a total of 107 students (42.8%) exhibited weakness of serratus anterior muscle, as assessed using MMT. When grouped based on bag weight, it was found that, among students carrying bags weighing less than 3 kg, only 15 students showed weakness (2 bilateral, 5 right side and 8 left side). In contrast students carrying bags heavier than 3 kg has significantly higher incidence of weakness (92 cases), including 30 bilateral, 23 right side and 39 left sided muscle weakness. The majority of weakness cases (71 out of 80) were observed in students with normal BMI, followed by 8 cases in the underweight group and only 1 case in the overweight group. Within normal BMI category, left sided weakness (41) was most prevalent, followed by right sided (20) and bilateral weakness (10).

Conclusion: From this project, we can say that carrying heavy school bags every day can make the serratus anterior muscle weaker, even in school kids who are healthy and have normal BMI. This suggests that merely having normal body weight doesn’t mean a child is safe from muscle problems. The daily pressure on the shoulders from heavy bags can slowly affect muscle strength without any obvious signs at first. So, it’s important to keep school bags light, use both shoulder straps, and encourage good posture and simple exercises to keep the shoulder muscles strong and healthy. Taking care of this early can help prevent pain, poor posture, and other muscle issues later in life.