Typical Causes of Shoulder Pain Caused By Backpacks

Over the years, as both a hiker and a backpack designer, I have tended to come to the conclusion that there are four or five primary issues for shoulder pain caused by a backpacks.

I thought I would go into a brief bit of explanation of each of them, to give some insight into the cause and how to perhaps resolve them.

Primary Cause:

The first, and probably most common, issue that causes shoulder pain is a backpack that is not properly adjusted to fit your body.

This, of course, only applies to backpacks that are non-framed, but given the vast majority of hikers that suffer shoulder pain are using framed backpacks, it stands to reason that it is the foremost important issue to address.

Most backpacks on the market have some kind of internal structural support. Typically in the form of thin strips of aluminum or sometimes round rods bent in an inverted u-shape.

The vast majority of new hikers have no idea that these “stays”, as they are called, can, and should be, slightly bent to fit individual hikers spines. It is important to fit a backpack stays to conform to the shape of your back. This not only helps with the backpack being able to properly distribute weight, but it is an important part of helping to reduce both back and shoulder stress. The first part of this video that I was able to find on youtube shows and explains the process and importance of adjusting the “stays” on your backpack.

Now, there is a slow re-growth of the ‘external frame’ style backpacks in the outdoor market. Within the USA there are two companies that I can think of making external frame backpacks that are worth taking note of, the Vargo ExoTi backpack, and the Zpacks Arc Frame backpacks. These type of backpacks, while having a frame, really do not offer any type of spinal adjustment. Rather, because of their design, the frame is held away from direct contact with your spine, for the most part. For these type of backpacks, it becomes all the more important that the next two possible causes are given the highest of priorities.

It is also important to learn and understand how to properly use hip belts, load lifters, shoulder strap adjustments, and even those sternum straps that I typically see hikers always fiddling with.

Secondary Cause:

The second leading cause of shoulder pain is usually a result of an improperly sized backpack. Specifically what is called the “torso size” of a backpack.

It is important to know that there is no ‘standard’ when it comes to the torso sizing of backpacks. Many backpack manufacturers tend to follow a basic standard, but there is none and it is very important to check with the company to know what their torso sizing is. These days a lot of the cottage companies have detailed information on their website about how they approach the torso sizing of their backpacks. Most big box companies, sadly, do not.

There are two aspects to all of this: first is the individual hikers torso length, and second is the backpacks height.

As not all backpacks are the same height, duh, it is important to first know what your own torso length is, and from there, as mentioned above, try to find out from the manufacturer’s website, which of their backpacks will have the torso height that is correct for you. I found this video on youtube that gives a really good explanation of how to determine your own torso height.

There are some companies out there, such as Six Moon Designs, that have designed their backpacks to have adjustable torso sizing. My all time favorite backpack, the Six Moon Designs ‘Flight 30’, is one such example of a backpack with an adjustable torso height adjustment system.

Third Cause:

Probably the third biggest cause of shoulder pain caused by backpacks is the result of hikers just doing a bad job in properly loading, or balancing, their backpacks.

Like pretty much all things, there is no ‘right way‘ to load every backpack that has ever been made. Every backpack that I currently own I end up loading slightly different, because they all handle load weight distribution (that is, how the backpack transfers the weight of the backpack off your shoulders and down to your hips, which is what a properly designed backpack should do.)

I am not going to go into the details of how to load your backpack, but if you know that the previous two possible causes are not the issue, I would suggest trying to redo how you load your backpack. Perhaps try putting heavier items up against your back, or, perhaps try loading your backpack vertically instead of horizontally as most hikers tend to do.

And please, do not stop thinking about proper loading of your backpack as only the items inside your backpack. I often see hikers with a whole lot of crap inside of their hip belts. Remember that putting additional, heavier, items inside of your hip belt can change the counterbalance of your backpack too. It might seem like a little thing, but hipbelt pockets can have an affect on things. Not a lot, but it might just be enough to screw with the counterbalance of your backpack and how it rides and distributes the load weight of your pack.

Fourth Cause:

The next issue, and one I rarely see hikers think or talk about, are shoulder straps that are just not the right size, or shape, for a hiker.

This is an issue I struggle with and have to admit that until I started having shoulder pain issues, it was not something I had ever given even the slightest bit of thought too. However, after I started switching from backpack to backpack, from the pile that I had in my gear room, in an attempt to reduce shoulder pain, I started pondering on the different designs of the backpacks, and eventually my thoughts came around to how wide most of the shoulder straps were on the backpacks that I own, and how a couple of the backpacks had very narrow shoulder straps. At some point a lightbulb moment happened and I realized that the backpacks with narrower shoulder straps caused me less shoulder pain. Yes, less. Typically it is the other way around – the theory going that a wider shoulder strap causes a larger distribution, but for me, it turns out, that a narrower shoulder strap actually results in less stress on my shoulders, at least with the backpacks that I own that have narrower shoulder straps.

Now, unfortunately, there are not many, if any, backpacks manufacturers out there that offer different width of shoulder straps, so it might mean you needing to try out a few different backpacks with different shoulder strap widths, to see if this is a possible cause for your shoulder pain.

Another option to consider is to switch away from the standard “j straps” and “s straps” that are found on almost all backpacks, and try to find a backpack that offers “vest straps”, sometimes called “pectoral straps”. These type of shoulder straps have a more straight down design, but offer a very wide strap design in the pectoral region. This design, when properly designed, allows the shoulder straps to greatly reduce the pressure off of the shoulders. They do require a bit more attention to getting properly adjusted, but once you get them dialed in, they provide the greatest amount of load weight distribution off of the shoulders than any other type of shoulder strap on the market. I highly recommend pectoral straps, and with the exception of one small volume backpack, I have switched to only using backpacks that have pectoral straps.

Fifth Issue:

Finally, you might need to consider a different shape backpack. It might sound odd, but perhaps a tall and narrow backpacks is just better for you than a short and wide backpack, or vise-versa.

This is one of those issues that has to do with (a) load weight distribution, (b) backpack torso height, and (c) pack load/balance of gear, all put together. In a way, a combination of multiple issues already talked about above.

Over the years I have learned that my back and my shoulders have less stress at the end of the day with a narrow backpack. Dimensionally a ‘narrower’ backpack might only be 2.5 inches narrower than another backpack, but when put together with the height of the backpack, and the load, and how you have it loaded, it can all work together to work against you. With the exception of external frame backpacks, I have had to completely stop using backpacks that tend to be on the wider side.

The chances of this being an issue for the vast majority of hikers is pretty slim, but it is worth addressing, as it is something that I and other hikers that I have spoken with have all realized over the years.


Most like, somewhere in these five issues are the result of probably 95% of shoulder pain caused by backpacks. There are, of course, other issues that can cause shoulder pain. The biggest being hikers that overload their backpacks – that is, putting more weight in them than what the backpack is rated for. However, that is not the fault of the backpack, but the hiker, so it does not really fall into the scope of “pain caused by backpacks“. And there are those who sometimes choose to use backpacks that do not have hip belts, yet have to heavy of a load for the hip beltless backpack – again, not the backpacks fault. And there are situations where hikers are just not aware of how to properly fit their backpack – yeah, I know, I started all of this talking about that, but the point just needs to be made again.

Thanks for reading!
+John Abela

Photo by Tim Bogdanov on Unsplash.

4 thoughts on “Typical Causes of Shoulder Pain Caused By Backpacks

  1. Thanks for the great article. Let me add #6, carrying too much weight. Remember, 40 pounds of high tec stuff still weighs 40 pounds. I had a Gregory pack The straps were adjustable, it transferred weight to my hips, it fit my body like a glove, and even torso length was adjustable. But it weighed more than 6 pounds. Now I carry a Mountain Laurel Designs Prophet at a total weight with water, 4 days food, and fuel at 14 – 16 pounds. I walk upright instead of leaning forward like a Neanderthal. I’m 60 and God willing I’ll be hiking for many more years.

    1. Hey John. Absolutely a big issue is overloading a backpack. It is all too easy to overload a backpack, and it seems the higher volume a backpack is, the easier it is to overload it. Strange that, huh.

      Backpacking is one of those unique outdoor activities that is mostly age non-relevant. Guys like Nimblewill Nomad ( https://nimblewillnomad.com/ ) are the heroes in the hiking world that I look up too.

  2. John, thank you for a great write up. I’d like to add my own experience with the shoulder pain – hope it will help somebody.

    So I’m an ultralight backpacker and also an amateur photographer and lately also a filmmaker. I was carrying all my photo gear in a chest photo bag which is designed with a single shoulder strap. Needless to say, it was overloading left shoulder too much despite my gear is pretty light. My solution to this problem was:
    1) separating photo gear into two groups:
    a. the one I need ready to use pretty fast (lenses, camera, filters, different grips, GoPro, spare battery, …)
    b. another one that I put into my pack and take out only on stops (drone, tripod, …)
    2) all of the gear from category “a” I put into ZPacks multipack and all gear from category “b” into an Arc Zip Backpack.

    So far so good.

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