There's an injury making the rounds that gives a whole new meaning to the phrase "fashion emergency." The problem involves an often ignored body part (the shoulder), and the culprit is all the rage—one of those fabulously trendy, stylishly oversize bags that wreak havoc on us.

Not that there's anything wrong with owning a big, gorgeous tote. The trouble starts when you load it up—wallet, laptop, comfortable pair of shoes, cell phone, PDA, bag lunch, water bottle, book or magazine, maybe both, along with a makeup kit and a few work files—and lug the thing everywhere.

Soon you may start to notice a nagging ache that runs down your neck, across the top of your shoulder blade, and over to your arm. That tiny curved crescent of discomfort gets worse and worse until you do something seemingly innocuous—in my case, I reached out to hug a friend—and suddenly you're in agony. About 10 minutes after that hug, I called my husband from the freeway to tell him to come looking for me if I wasn't home soon, because there was a good chance I was going to have to pull over and pass out.

The new purses are so big that they've even spawned a kangaroo trend of little bags tucked inside them to organize the wide-open spaces, making them almost impossible to carry unless you scrunch up your shoulder to hold them in place. The 8 to 10 pounds of drag from the purse may cause problems in two ways, according to Neal Elattrache, MD, a specialist at Los Angeles's Kerlan-Jobe Orthopaedic Clinic. First, it pulls on a web of nerves that can cause aching or shooting pain from the neck down the arm. In addition, every time you sling your fashion statement over your shoulder, the upper back muscles that stabilize the shoulder blade must struggle to counterbalance that weight; eventually they get overworked until a yoga move or hug sends you into anguish.

And the problems don't stop there, according to physical therapist Gail Wehner, who runs a practice in Santa Monica. Load 10 extra pounds onto one side of the body, and it can cause the trunk to tilt sideways to compensate, adding lower-back pain to the list of woes. Sooner or later, your torqued body will betray you, and then you've got to stash your new carryall in the closet while you take the cure—in my case, physical therapy and exercises that rebalanced all the unhappy muscles. As the stiletto heel is to your foot, the designer handbag is to your upper back.

Women are at a disadvantage long before buying a jumbo pocketbook, says Elattrache, who has ministered to some of the most famous shoulders in professional sports. We may have made great strides toward equality, but on a literal level, we still don't stand up for ourselves the way we should.

"Boys are taught to walk in a shoulders-back, chest-out posture," he says, "whereas that has not been considered a modest posture for women, so the shoulders come forward." When we get to the gym, we tend to work only on the arm muscles that show, the biceps and triceps. "It's a cascade of events that's headed for a problem," Elattrache says. "Carrying that purse is the final insult."

The question is, how best to compensate, short of abandoning the gorgeous new bag. Chiropractor Isis M. Medina told us how to buy a bag that's both good-looking and therapeutic, and Elattrache and Wehner have a few recommendations of their own for six big-bag syndrome cures.

As a reminder, always consult your doctor for medical advice and treatment before starting any program.


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