Why parents should be concerned about trampolines

(CNN) — With so many parents wanting their children to get more exercise, a backyard trampoline might seem like a good option.

So it might come as a surprise that the nation’s leading group of pediatricians warns that “the home use of trampolines is strongly discouraged.” The American Academy of Pediatrics cites additional data about “catastrophic injuries,” including those that involve the spinal cord and result in permanent neurological damage.

Home trampoline use remains popular, and as a parent, I know that plenty of playdates and parties occur in commercial venues with trampolines. What else should families know about trampoline use? How dangerous is it really? What injuries can occur, and which kids are especially vulnerable? Is it safer to use a trampoline in someone’s home or go to a commercial venue? And are there certain precautions that can make trampolining safer?

To help with these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore’s health commissioner and is the mother of two school-age children.

CNN: How dangerous is trampoline use for kids? 

Dr. Leana Wen: There were over 800,000 reported injuries associated with trampolines between 2009 and 2018, according to a 2022 study published in the journal Pediatric Emergency Care.

More than 36,000 of those cases resulted in hospital admission. More than one-third of injuries involved bone fractures. The most common injury site was arms and legs, though more than 1 in 5 children suffered head and neck injuries, including concussions. Children suffered a variety of other injuries, such as damage to internal organs.

There are a lot of ways kids can get hurt on trampolines. Children collide with one another while jumping at the same time. They can land wrong on the trampoline, which is especially dangerous if they are trying dangerous maneuvers such as somersaults or flips. If the trampoline is elevated, kids can fall off the trampoline and on the ground. They can hit the springs or the frame. If there are multiple jumpers at once, one jumper can land and send another into the air, who could crash into someone else.

The American Academy of Pediatrics issued a statement in 2012 to strongly recommend against the use of recreational trampolines in kids. The academy reaffirmed this in 2020, citing the frequency of injury as well as the possibility of severe, irreversible injury, notably permanent neurological damage from injuries to the head and neck.

CNN: Are there certain factors that are associated with greater injury, and is it known which kids are at higher risk?

Wen: Yes. Jumpers on the same apparatus increases injury risk, especially for the smallest individuals, according to the AAP. This is why pediatricians recommend that — if you’re going to use a trampoline — that its use should be restricted to a single jumper on the mat at one time.

In addition, research has shown that children 5 years and younger are at increased risk of fractures and dislocations due to trampoline-related injuries. The AAP strongly recommends against children younger than 6 years jumping on any trampolines.

Moreover, some maneuvers, such as flips and somersaults, are especially associated with risk of head and cervical spine injury. These moves should be avoided in recreational settings. If children are learning trampolining as part of a structured sports program, parents must ensure there is specific coaching to develop the skill.

Also, contrary to popular belief, having padding and enclosing the trampoline space may not prevent large numbers of injuries and “may provide a false sense of security,” according to the AAP. Padding and netting can help, but it should be in good condition. The trampoline should also be set on the ground as falls off the trampoline can also cause injury.

CNN: Is it safer to use a trampoline in someone’s house or go to a commercial venue, such as a trampoline park?

Wen: The short answer is that it depends. Both carry risks.

One meta-analysis, published in 2020, found that injuries that occurred at trampoline parks carried double the risk of requiring surgery compared with home trampoline use. The report also found that injuries from full-size trampolines had a six times higher risk of requiring surgery compared with injuries from mini-size trampolines.

Another study, published in the journal Pediatrics in 2023, reported that 11% of injuries sustained at trampoline parks were significant. Overall, injuries occurred at a rate of 1.14 injuries per 1,000 jumper hours in the parks.

Other research suggests that the rise in trampoline injuries can be attributed to the rising popularity of these commercial venues. That’s because trampoline parks are often crowded, with multiple jumpers at once. There is a matter of physics; the commercial equipment could allow jumpers to jump higher and therefore fall from greater heights and with greater force, leading to more injuries.

I think there could also be a false sense of security; parents may think that trampolines in a facility are safer than trampolines at home, and they may take comfort in thinking that there are lots of other adults there, but they should carefully read the disclosure statements of these facilities — these commercial venues certainly understand the possibility of injury.

CNN: Are there things that parents and guardians can do to make trampolining safer?

Wen: If you are going to someone’s house who has a trampoline, look at the apparatus before you have your child use it. It’s best if the bouncing surface is as close to the ground as possible and not close to other objects, such as trees and walls. Look out for worn nets and pads and hooks and springs that are sticking out.

If you are going to a trampoline park, try to avoid busy times of the day to reduce the risk of collision. Stay close to your child and instruct them not to try dangerous maneuvers like flips. If they really want to learn gymnastics moves, they should join structured sports programs where they can learn them under close supervision.

Watch out for small kids in particular. Kids younger than 6 years old really should not be using trampolines. And if you have a trampoline in your home, make sure to check your homeowners insurance prior to inviting other people over, as many policies will not cover guests if they get hurt on trampolines.

CNN: Knowing all of this, would you let your kids use trampolines?

Wen: I’ve treated enough patients who have had injuries on trampolines to understand their dangers. At the same time, I think it’s hard to avoid trampolines altogether, given how popular they are.

For my family, we have taken a harm-reduction approach — understanding that recreational trampoline use can be dangerous, we are reducing the harm by minimizing the frequency and reducing the highest-risk activities.

We don’t have a trampoline at home. We try not to have playdates at people’s homes who have trampolines. If our kids do go to a home that has trampolines, we try to steer them away from the trampoline. If they really want to try it, we will watch them the entire time and have them jump one at a time.

The one instance that’s harder to avoid is when they are invited to a birthday party at commercial venues that have trampolines. It’s hard to ask kids to miss out on their best friends’ parties. Here, we set rules in advance — for instance, no somersaults, stay within eyesight of a parent and leave the jumping area if there are much bigger kids in the same space.

Other parents will have different risk-tolerance levels. The key is to understand the risks so that each family can make their own evaluation and reduce risk when possible.

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