Q: My kids love having friends over to jump on the trampoline in our backyard. However, some parents have told me they will not allow their children to jump on the trampoline. I was also scolded by our pediatrician for having a trampoline at home.
This surprised me greatly given the increasing problem of inactive, obese children. Is there such a thing as a safer trampoline?
A: The trampoline was originally called a "bouncing table" by its inventor, George Nissen. In 1937 he renamed it "the trampoline", after he observed circus tightrope walkers and trapeze artists perform twists, spins and somersaults into safety nets.
Over the years, trampolines have become increasingly popular. However, the increasing numbers of trampoline-related injuries have concerned mainly emergency room doctors and those interested in injury prevention. More and more pediatricians have mixed feelings, because they want children to be physically active, but in a safe manner. Influential pediatric organizations such as the American Academy of Pediatrics (AAP) tell their members to support a ban of trampolines --- the AAP thinks it is such an important issue that they have an official policy statement on this topic (see www.aap.org and do a search by entering the word "trampoline" in the search box)
The Canadian Pediatric Society (CPS) does not have a position statement yet. I suspect they support the AAP's anti-trampoline position. (At least, when one does a search on the CPS web site, one comes up empty-handed --- there are no matches under the word "trampoline")
Most serious trampoline injuries involve the cervical spine. Death as a result of trampoline remains extremely rare. According to data collected by the Consumer Product Safety Commission, lower extremity injuries result from falling off the trampoline, usually on a hard surface, resulting mostly in sprains and strains. The upper extremity injuries involve fractures mostly. Thirty percent of ER visits related to trampoline injuries involve fractures.
Lacerations of the head and face contribute to a third of injuries and are more like to occur in the very young----especially when they use mini-trampolines.
Despite education the numbers of injuries are on the rise. Between 1990 and 1996 there was a 140% increase in trampoline-related injuries.
Some factors which may increase the risk of injury are:
- Somersaults, both forwards and backwards, done by the very young especially.
- The use by more than one person at a time.
- The lack of adult supervision or supervision by trainers and spotters.
A recent study published in the journal Pediatrics, compared mini-trampoline with full-sized trampolines. The patients ranged in ages from 1 to 80 years. The majority of injuries occurred at homes. Although injuries associated with mini-trampolines were less likely to require admission, head lacerations were more common when these mini-trampolines were used. The take-home message is that mini-trampolines are not safer than full-sized trampolines.
None of the research done by the AAP in preparing its position paper looked at the use of a recent and increasingly popular trampoline: the spring free trampoline.
This trampoline is the invention of a concerned dad. An engineer by training, this dad decided to think outside of the box and came up with a trampoline which drew much attention in major national media outlets (see www.springfreetrampoline.com). A number of exercise experts have endorsed the use of the spring free trampoline. The device has a safety net surrounding a standard-sized trampoline; there are no springs and the potential risk of injury is significantly less.
Most experts and parent would instinctively agree that supervision by an adult may make a difference---it does not according to research published by the AAP. Neither do warning labels and public education.
The AAP suggests that trampolines not be sold for use at home; that they not be used for physical education in schools; that trampolines be banned in playgrounds; that they should not be placed close to fences and trees; and that trampolines be lowered to ground level.
Young children have higher center of gravity which makes them more prone to fall head-first. Their immature strength and coordination make them more susceptible to head and extremity injuries. Children under 6 years should therefore be guarded extra carefully.
There certainly is a need for both the Canadian Pediatric Society and the AAP to revisit some data regarding the safety of spring free trampolines. Until then, parents should remain extra vigilant; discourage somersaulting; ensure that only one child uses the trampoline at a time and that children with litigious parents be discouraged from jumping on the backyard trampoline.
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