Is your purse causing backaches?
Photo: Plamen Petkov
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.

1. Posture
This matters more than anything. The ideal stance, Wehner says, is "shoulders relaxed, back, and down, and no leaning to one side." To see how far off you are, Elattrache suggests sitting in a chair and looking straight at the wall. Do you have to cock your head back? If so, it means your chest is sunken in and your shoulders rolled forward. "Sit up straight and put a little arch in your back, and your neck doesn't have to bend like that," he says. One way to remind your body of proper alignment is to place a round pillow against the small of your back when you sit. "Just the trigger of the lump in your back subconsciously tells your muscles to get you some support," Elattrache says.

2. Strength
Make sure your workouts include not only the core muscles of the lower back and abdomen but also the shoulder blades. One of Elattrache's favorite preventive exercises—and, since my episode, my favorite—is what my daughter laughingly calls "the penguin," which works either on dry land, if you use an exercise band, or neck-deep in a swimming pool: Keeping upper arms at sides, elbows bent 90 degrees, start with palms facing each other, almost touching. Slowly bring both hands out to the side, pinching your shoulder blades as you press them together against resistance; then return to the starting position. Two sets of 10 repetitions every day, or every two days, will start to make a difference, Elattrache says.

3. Stabilizing
It can be as simple as slowly shrugging your shoulders while sitting at your desk or watching TV, doing up to 10 repetitions at a time.

4. Strap-Hanging
If your bag has a strap that rides diagonally across your body, use it. "That should distribute the weight better," says Wehner, "and you don't have the feeling it will slip off, so you're less likely to hike your shoulder." Also, swap sides so you're not always using the same shoulder.

5. Switch It Up
Carry the big bag some of the time, but either pack less into it or alternate with a smaller bag. And try to vary styles. "There are issues with any kind of bag," Elattrache says. "What you really don't want to do is overuse a single position."

6. Forget the Saying "Beauty Hurts"
Warning signs that you may be on your way to a big-bag injury include an ache in the shoulder blade area and frequent neck stiffness. Headaches—after sitting for long periods of time or at the end of the day—and pain radiating down the arm are also symptoms. If you're noticing these signs, and if ice and rest don't make them better after a week or so, grab a very small wallet, your cell phone, and car keys; pat your purse goodbye; and head for the orthopedist's office.

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


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