Children are back at school with fresh school supplies, a new set of books, and likely a larger load in their backpack.

But orthopedic surgeons are saying ill-fitting backpacks can put children at risk for muscle injuries, posture problems, and back, neck or shoulder pain.

Last year doctors and hospitals nationwide treated 10,000 children, ages 5 through 18, for backpack-related injuries, according to the U.S. Consumer Product Safety Commission.

And those injuries are avoidable.

Here are some tips from Nitin Khanna, spokeswoman for the American Academy of Orthopaedic Surgeons, published in brief through MedlinePlus, of the U.S. National Library of Medicine:

Use both shoulder straps to keep the backpack’s weight better distributed.

Adjust the shoulder straps to keep the load close to the back.

The backpack should be proportionate to the child’s size.

Teach kids to place heavier items low and toward the center of the backpack.

Children should bend their knees when lifting up their backpack.

Carry only items needed for the day, and drop off heavier books in a locker throughout the day.

If the backpack seems too heavy, have your children carry some books in their arms, to reduce the load on the back.

Numbness or tingling in arms or legs means the backpack is probably a poor fit or too heavy.