If you have heavy gear, I'd suggest looking into some type of hip pack (I use Tamrac). Think Tank also makes a waist belt, and you can buy all the modular pieces you wish to add to it. I bought Think Tank's padded waist belt and their Digital Holster 30 which holds my Nikon 70-200 f/2.8 mounted with my camera. Fourteen years ago I had a car accident that left me with some back issues plus I have small tears in my rotator cuffs. Shoulder bags tend to bother my shoulders and upper back, but with either Tamrac's hip pack or the Think Tank Belt, it isn't a problem to carry gear.