Why children's legs often break on trampolines

When children and young people let off steam or play sport, they are unfortunately often part of the game: Broken bones, sprains or strains. Although the number of injuries suffered by children and young people in their leisure time has not changed significantly in recent years, the type and circumstances in which these injuries occur have.

Five to ten years ago, doctors at the Inselspital emergency centre in Bern tended to treat climbing or snowboarding accidents, but now the so-called trampoline fracture is one of the «new» childhood and adolescent injuries. This describes a fracture that usually affects the tibia just below the knee.

Trampoline fractures: sharp increase in recent years

«Trampoline fractures have increased significantly in recent years,» says Daniel Garcia, Head of the Children and Adolescent Emergency Centre at Inselspital Bern. In 2003, the doctors at the «Inseli» treated 13 injured children. By 2009, the figure had risen to 86 - more than six times as many. Today, the numbers are probably higher, if only because there are more and more trampolines in people's gardens.

A recently published study from the USA shows just how topical the issue is. The American study published in the specialist journal «Pediatrics » shows that the number of children injured on trampolines has increased. In 2010, around 600 children were injured; by 2014, the figure had risen to 7,000, a twelve-fold increase.

No matter how you fly, it usually breaks in the same place.

Daniel Garcia, emergency doctor

But what happens in the skeleton when a trampoline fractures? The bone breaks at so-called predetermined breaking points. These are sensitive points in the young skeleton that are particularly susceptible to fractures during the growth phase of children and adolescents. «You could also say that no matter how you fly, it usually breaks in the same place,» says Garcia. What's more: «If two children are jumping on the trampoline at the same time, uncontrolled jumps or collisions are inevitable».

The problem with trampoline fractures is that they are often not always immediately recognisable as such, explains the emergency physician. «These special fractures are not always immediately recognisable on X-ray images for doctors who don't regularly deal with them, or only after a few weeks».

Parents also often initially assume a sprain or strain until they react. For example, it often happens that a child suffers from pain for a long time and moves without a plaster cast until the parents take them to the doctor. And although it is rare, a trampoline fracture that is not treated immediately can cause bone growth disorders.

Always alone on the trampoline

A trampoline breakage can happen if several children jump on a trampoline at the same time. This significantly increases the risk of accidents, especially for the child who weighs less. This is because the trampoline surface adapts to the heavier person.

If a larger child jumps off while a lighter child lands, the legs of the lighter child can be strained so much that they break. This is why doctors and the Federal Office for Accident Prevention (bfu) recommend that children and teenagers should only be allowed on the trampoline one at a time.

Trampolining is healthy, it strengthens the muscles and promotes balance.

Daniel Garcia, emergency doctor

Nevertheless, Daniel Garcia doesn't want to take the fun out of trampolining for children and parents. On the contrary: «Trampolining is healthy for children and young people, it strengthens the muscles and promotes balance».

The doctor can also reassure parents who fear that trampolining could cause disc problems in later adulthood. «There is no evidence of this». Trampolining is sometimes even used specifically to strengthen the back muscles, which can have a preventative effect against disc problems. «With the necessary precautions and the right amount of exercise, the trampoline is therefore a wonderful and entertaining way for children and young people to exercise».

Lighter footballs, more serious injuries

It is not always trendy sports equipment that should be treated with a certain amount of caution. New materials in sport can also harbour new sources of injury, as is the case with footballs, for example. Today, they are made from lighter materials. As a result, the balls fly faster and, depending on how hard the ball is kicked, develop enormous force.

New footballs are lighter and faster. The force they develop can break bones.

This always ends painfully for the goalie. «Broken arms or head injuries that occur when deflecting the ball are now routine in an emergency,» says Garcia. Similar to trampolining, the injuries resulting from this have increased significantly in recent years, says the emergency physician.

Travelling safely on the slide

And now and again, it is even the parents who unwittingly pose a safety risk - usually because they are overly cautious. «We keep seeing children who break a leg or even both legs because they go down the slide with their parents». As they slide down, the child's foot gets under the adult's legs. At the end of the slide at the latest, the child's leg gets caught between the edge of the slide and the parent's leg - and breaks.

The emergency physician's advice: «The child's legs should never hang out to the side or slide around loosely. Make sure that both of the child's legs are resting on the father's or mother's thighs». With these simple precautions, parents and child can continue to slide down the slide in the future without any worries.