Sports physician advises against recreational trampoline use in new AAP report

Susannah Briskin, MD, a pediatric sports medicine specialist with University Hospitals Rainbow Babies & Children's Hospital, is the co-author of an updated report from the American Academy of Pediatrics (AAP) strongly cautioning against home trampolines. The report provides updated data on the number of and types of injuries caused by trampolines.

The new report's key recommendation against recreational trampoline use remains consistent with AAP's previous policy statement from 1999 and reaffirmed in 2006.

In the updated statement, "Trampoline Safety in Childhood and Adolescence," appearing in the October 2012 issue of the journal Pediatrics (published online Sept. 24), the AAP provides pediatricians with guidelines on patterns of injury with trampoline use, the efficacy of current safety measures, and unique injuries attributed to trampoline use.

The US Consumer Produce Safety Commission's National Electronic Injury Surveillance System (NEISS) in 2009 estimated almost 98,000 trampoline-related injuries in the United States, resulting in 3,100 hospitalizations. The rates of trampoline injury appear higher for children than in adults.

Trampoline injury rates have steadily decreased since 2004, although Dr. Briskin notes that trampoline sales have also decreased in number. "So we believe the risk of using the trampoline and suffering an injury is still high, despite safety measures which the industry has put into place," she said.

"The AAP strongly discourages use of a home trampoline," said Dr. Briskin, who is also an Assistant Professor of Pediatrics at Case Western Reserve University School of Medicine. "It bears significant injury risk - especially when somersaults are performed or there are multiple jumpers on the mat at one time." Dr. Briskin co-authored the policy statement with Michele LaBotz, MD, a sport medicine physician with InterMed in South Portland, Maine.

According to the report, about 75 percent of trampoline injuries occur when multiple people are jumping at the same time on the mat. The youngest participants are at increased risk for significant injury, specifically children under age five. Forty-eight percent of injuries in this age group resulted in fractures or dislocations.

The authors write, "Although most trampoline injuries are sprains, strains, contusions, or other soft tissue injury, younger children seem to be more prone to bony injury."

They also state that falls from the trampoline can be severe and accounted for 27 percent to 39 percent of all injuries.

Although safety recommendations consistently advise adult supervision when children play on a trampoline, about one-third to one-half of injuries occurred despite adult supervision. According to the report, "Many parents and supervising adults do not appear to be aware of key components of trampoline safety such as limited the trampoline to 1 user at a time, and this may contribute significantly to current injury rates."

The AAP policy statement also addresses the safety of trampoline parks. The AAP suggests that the precautions outlined for recreational use also apply to all commercial jump parks. Injury rates at these facilities should continue to be monitored.

The report includes key recommendations for pediatricians and parents, including:

• 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.