What Parents Should Know About Trampolines to Keep Their Children Safe
For the past few decades, health officials have recommended against the use of commercial at-home trampolines by children. In spite of their recommendations and reports of injuries as severe as paralysis in children from cervical spine injuries, trampolines continue to be sold and now are part of a market for indoor trampoline parks as well as competitive sport events. In a recent review of trampoline safety, researchers report that the addition of safety equipment does little to nothing toward keeping a child safe from injury.
According to an updated report from the American Academy of Pediatrics (AAP) and recently published in the journal Pediatrics, Susannah Briskin, MD, a pediatric sports medicine specialist with University Hospitals Rainbow Babies & Children's Hospital strongly advises parent against the use of home trampolines by their children.
According to the report, after earlier studies reported on trampoline injuries, manufacturers of trampolines began outfitting the newer models with safety equipment. Examples of safety equipment included padding and covers to protect or lessen the extent of injury when children fall and strike the springs or trampoline frame. Some even went so far as to include walled netting around the trampoline to prevent a child from falling off the trampoline onto the ground.
However, in spite of such measures that appeared reasonable toward decreasing the number of injuries, the latest numbers uncovered in the published report tells us that the aforementioned measures have done little to nothing in stemming reports of injuries.
At its peak in 2006, the estimated number of trampoline injuries was nearly 110,000 with approximately 4,800 hospitalizations. In 2009, the estimated number of trampoline injuries is nearly 98,000 with approximately 3,200 hospitalizations. While at first glance the number of trampoline injuries has decreased since the last review, the authors of the report believe that it is only a reflection of decreased sales since the 1990s, and not because of increased safety measures.
Injury types encompass a wide range with at-home trampoline use. According to the report, ¾ of the injuries occurred when multiple people were on the trampoline at the same time. Furthermore, when children of different sizes are playing together on a trampoline, the smaller of the children are injured the most because of the greater impact forces transferred from a larger child to a smaller child during a collision.
Falls from a trampoline are another cause of injury that can be severe and account for approximately 27% to 39% of all trampoline-associated injuries. As mentioned earlier, the use of barriers around a trampoline do not appear to adequately prevent this cause of injury.
Injuries resulting from impact with the springs and frame of a trampoline account for approximately 20% of trampoline-related injuries. Again, just as with netting barriers to prevent falls off of a trampoline, padding too, appears not to make a statistically significant difference toward preventing injury.
Trampoline injuries are typically musculoskeletal injuries. The most common injury on a trampoline is that of an ankle sprain, which accounts for 34% to 50% of the injuries. The upper extremities come in as second most common accounting for 24% to 36% of cases of injury, of which approximately 60% were fractures.
However, one factor that appears to make a difference in injury type is that of age. According to the authors of the report, "Although most trampoline injuries are sprains, strains, contusions, or other soft tissue injury, younger children seem to be more prone to bony injury." They found that children 5 years and younger appear to be at increased risk of fractures and dislocations from trampoline use.
The worst injuries of all are the ones that occur to the head and neck—typically from a failed somersault or flip. According to the report, head and neck injuries account for 10% to 17% of all trampoline injuries, with 0.5% resulting in permanent neurologic damage. The forces behind a fall and awkward positioning of the head and neck lead to hyperflexion or hyperextension of the cervical spine.
While it appears that trampolines for at-home use will continue—and thereby an expectation of continued injuries—the authors of the report list the following key recommendations for pediatrician and parents:
• Pediatricians should advise parents and children against recreational trampoline use.
• Current data on netting and other safety equipment indicates no reduction in injury rates.
• Failed attempts at somersaults and flips frequently cause cervical spine injuries, resulting in permanent and devastating consequences.
• Homeowners with a trampoline should verify that their insurance covers trampoline injury-related claims.
• Rules and regulations for trampoline parks may not be consistent with the AAP guidelines.
• Trampolines used for a structured sports training program should always have appropriate supervision, coaching, and safety measures in place.
For a more thorough review of what parents should know about trampolines and ways to keep their children safe, a copy of the entire report is available free online to the public.
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Reference: “Trampoline Safety in Childhood and Adolescence” Pediatrics; originally published online September 24, 2012; DOI: 10.1542/peds.2012-2082; Susannah Briskin, MD et al.