Editor’s Note: Courtney Duckworth, MD (she/her) is a resident physician in pediatrics at The Boston Combined Residency Program (Boston Children's Hospital/ Boston Medical Center). She is interested in the intersection of sports medicine and chronic disease, which she hopes to combine in her career as a pediatrician at an academic medical center. Within the realm of chronic disease, she is passionate about health equity with ongoing work to increase access to diabetes technology. – Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics
Trampoline parks, which first opened in 2004, are indoor facilities with wall-to-wall trampolines and various activities, including free jumping rooms, high-bounce mats with foam pits, climbing ropes, ninja courses, basketball, and more. There are currently over 1,500 trampoline parks globally. In the US, there are approximately 310 trampoline parks with the number of parks growing at a rate of about 8% a year.
Trampolines, both in homes and in parks, are associated with injury. In 2018, approximately 110,000 people were treated in emergency departments for trampoline injury. The most common injuries are soft-tissue injury, fracture, and, rarely, permanent neurologic damage or death.
The majority of trampoline injuries occur in trampoline parks, with musculoskeletal injuries occurring at a rate about twice as high as home trampolines. This is thought to be due to the differences in manufacturing of commercial trampolines and the confluence of trampoline mats, which transmit force from multiple jumpers at one time. In an article and video abstract being early released by Pediatrics this week entitled, “Trampoline Park Injury Trends,” Dr. Warwick Teague and colleagues from Monash University and Deakin University in Australia assessed risk of trampoline injury at 18 Australian trampoline parks from 2017 to 2019 (10.1542/peds.2023-061659). Using exposure-adjusted risk, expressed in jumper hours (one participant jumping for one hour), risk of trampoline injury can be better compared to those of other sports, and trends can be followed over time.
Specifically, the study found the following:
Overall, trampoline park injuries occurred at a rate of 1.14 injuries/1000 jumper hours, or 1 injury every 887 jumper hours. This is lower than the overall injury rate for other common Australian sports, including:
- Australian football: 24/1000 hours
- Rugby: 2.18/1000 hours
- Tennis: 1.19/1000 hours
Highest rates of injury occurred during:
- High-performance jumping, defined as jumping involving advanced skills on trampolines designed for greater bounce height (2.11 injuries/1000 jumper hours)
- Jumping in inflatable bag/foam pits (1.91 injuries/1000 jumper hours)
- Free jumping, defined as jumping in large rooms with interconnected trampolines (1.88 injuries/1000 jumper hours)
Eleven percent of these injuries were considered “significant,” meaning that they required medical attention (eg, fracture, laceration, or head or nerve injury). There was 1 significant injury every 9090 jumper hours.
Most often, injury occurred in 10–14 year olds (41.3%) followed by 5–9 year olds (24.6%).
Of note, the sites studied were compliant with Australian Trampoline Parks Association standards, which require education for jumpers, safety grip socks, and supervision and first aid training for park staff. When a new standard of safety was launched for Australian trampoline parks in October 2018 that included manufacturing recommendations, weekly equipment inspections, and annual inspections, the rate of significant injuries sharply declined. However, the authors state that it is currently estimated that only around half of Australian trampoline parks comply with these safety standards.
In the US, trampoline parks are regulated by the International Adventure and Trampoline Park Association (IATP), which has safety requirements, such as manufacturing and layout specifications, adequate training for employees, and a maximum number of jumpers. Since 2021, IATP requires a third-party inspection to maintain compliance. However, the authors note that not all parks are IATP compliant.
As pediatricians caring for active, fun-loving patients, it is our job to both encourage physical activity and provide guidance to keep them safe in the process. This study suggests that trampoline park injury risk is lower than other common sports, and that the risk of severe injury can be further decreased through parks maintaining safety standards. For the growing number of young people who frequent trampoline parks, recommending IATP-compliant parks and counseling on higher risk trampoline activities can help protect our patients and decrease incidence of injury.
