Kids and Trampolines – Risk of Neck Injury

In a policy statement published this week, the American Academy of Pediatrics (AAP) reaffirmed its position against the recreational use of trampolines, citing statistics highlighting the risk of head and neck injuries from trampolines, as well as other problems. Although the rate of trampoline-related injuries has declined in recent years there is still concern that safety advice is not being heeded, putting very small children at risk of permanent neurological damage, neck pain, back pain and other symptoms.

Childhood Trampoline Injuries

The statement was published in the journal Pediatrics with authors Susannah Briskin, MD, and Michele LaBotz, MD, both pediatricians and sports medicine physicians, expressing particular concern over the use of trampolines by those between five and fourteen years old. In 2009, the rate of injuries were 70/100,000 for those under the age of five, and 160/100,000 for five to fourteen year olds. These rates are similar to injury rates for more common childhood activities such as cycling, swimming and playground-based play. However, these activities are frequently undertaken with knowledge of relevant safety information whereas most parents and children themselves have little idea of safety guidelines for trampoline use.

Biggest Neck Injury Risks for Children

The biggest problem it seems is when more than one child uses the trampoline at the same time, whereupon smaller children are placed at higher risk because of less developed motor skills and their lesser weight. Most trampoline injuries in children are due to falling off the equipment (27-39% of all injuries). When the trampoline is on an uneven surface this risk is increased. Children under six years old account for some 22-37% of all injuries seen in the emergency room and these injuries are usually centered on the feet or ankles (making up around 60% of cases).

Permanent Neurologic Damage from Trampoline Accidents

While ankle sprains from a trampoline are worrisome in themselves, it is the risk of head and neck injury on a trampoline that frightens most parents. These types of injuries make up 10-17% of trampoline-related injuries and 0.5% of all trampoline injuries gave rise to permanent neurologic damage according to this new report. What’s more, padding did not seem to diminish the risks and a third to a half of all injuries took place when children were under adult supervision.

Cervical Spine Injuries – Flips are Out

The risk of neck injury from falling off a trampoline, or landing awkwardly when bouncing or doing somersaults means that the AAP is calling for pediatricians to advise against recreational trampoline use. They also suggest that parents see if trampoline injuries are covered by their insurance policy, especially if having a childrens’ party where lots of kids are bouncing on the trampoline together. This is another point of advice from the AAP, that children should only use the equipment one at a time and that regular inspections of the trampoline should take place, with faulty or damaged equipment disposed of. The AAP report also states that “Cervical spine injuries often occur with falls off the trampoline or with attempts at somersaults or flips.” Parents may wish to advise their children against such activities.

What to do in the Event of Injury

Children, and adults, who fall off a trampoline are at risk of spinal cord injury, spinal fracture, and nerve damage, as well as severe bruising and other injuries. Where serious accidents do occur it is important not to move the patient and to call for medical assistance. Even when the first reaction is to get a small child to the hospital as soon as possible it is vital to remember that the slightest movement of someone who has fallen could further damage the nerves and create irrevocable spinal cord damage and paralysis.

Rebounders and Neck Injury

Whilst small rebounder (jogger) trampolines may be advised for low impact exercise for adults, these may still be dangerous for infants who can fall and injure themselves. Neck pain in children has many causes, most of which are short-lived and fairly easily treated, neck injury from trampoline use may, however, cause a lifetime of problems.

Reference

Briskin, S, and LaBotz, M., Trampoline Safety in Childhood and Adolescence, Pediatrics. Published online September 24, 2012.