AAP Reaffirms Position Against Trampoline Use

Larry Hand

September 24, 2012

September 24, 2012 — The American Academy of Pediatrics (AAP) has reaffirmed its position opposing recreational use of trampolines in a policy statement published online September 24 in Pediatrics.

Coauthors Susannah Briskin, MD, and Michele LaBotz, MD, both pediatricians and sports medicine physicians, write, "Although trampoline injury rates have been decreasing since 2004, the potential for severe injury remains relatively high."

They write that trampoline injury rates were 70 per 100,000 for 0- to 4-year-olds in 2009, increasing to 160 per 100,000 for 5- to 14-year-olds. Injury rates for those ages are similar for bicycling or playground equipment, as well as swimming pools. However, the authors write, population exposure is "significantly greater" for bicycling and playground equipment, and evidence-based safety advisories for swimming pools are broadly publicized, whereas such advisories for trampolines are not as well disseminated.

Multiple Users, Smallest Jumpers Most Susceptible

Most trampoline injuries occur when multiple people are using it at the same time, and the smallest individuals are up to 14 times more vulnerable to injury because of weight differences and their less-developed motor skills, according to the statement. Falling accounts for between 27% and 39% of injuries, and the risk for falling rises when the trampoline in use is on an uneven surface.

Use of padding does not seem to abate the risk for injury, and a third to a half of all injuries occur under adult supervision, the authors write. Children younger than 6 years account for between 22% and 37% of injuries presenting to emergency departments.

Although foot and ankle injuries, such as ankle sprain, are most common (more than 60% in one study), 10% to 17% of injuries affect the head or neck, "and 0.5% of all trampoline injuries resulted in permanent neurologic damage," the authors warn.

Several recommendations are contained in the policy statement, including:

  • Pediatricians should advise against recreational trampoline use.

  • Homeowners should verify whether trampoline injuries are covered by their insurance policies.

  • Any trampoline use should be restricted to a single user at a time.

  • Adults familiar with safety guidelines should supervise any trampoline use.

  • Trampoline conditions should be inspected regularly, and trampolines in disrepair should be discarded.

The policy statement also says that until further safety information is available on trampoline parks and structured trampoline sports programs, "the cautions outlined here" should be observed for those as well.

The AAP previously issued policy statements on trampoline use in 1977, 1981, and 1999. Injury rates are based on injuries reported to the US Consumer Product Safety Commission's National Electronic Injury Surveillance System. However, no data source exists regarding injuries in structured trampoline sports programs.

In summary, "Pediatricians need to actively discourage recreational trampoline use. Families need to know that many injuries occur on the mat itself, and current data do not appear to demonstrate that netting or padding significantly decrease the risk of injury," Dr. LaBotz said in a news release.

The authors have disclosed no relevant financial relationships.

Pediatrics. Published online September 24, 2012. Full text