Chelsea Carlton had to think fast. It was the start of the 2019 holiday season, but a Christmas light event she and her daughter Nell, then two, were planning to attend had been abruptly canceled. Hoping to skirt Nell’s disappointment, Carlton thought of a trampoline park nearby she’d passed many times. She pulled up its website on her phone: It was open, had a toddler area, and it wasn’t typically too busy on a Friday evening. This would do.

Nell’s father, Sean, met Chelsea and Nell shortly after they arrived. Nell was having a ball, plenty of space to herself, when out of nowhere, her knees buckled upon descending back on the trampoline, landing her in a seated position. She cried a little but it didn’t look like anything too bad. Then she put weight on her legs and cried louder. Her parents wondered if maybe she was tired and ready for bed, or maybe pulled a muscle.

The family headed home and called Children’s Hospital Colorado, who recommended urgent care if they saw Nell’s leg swelling. They gave her Tylenol, no swelling in sight, but she was definitely uncomfortable and still crying. Nell fell asleep in her parents’ bed that night. By 2 a.m., the swelling was so severe, Chelsea saw it while Nell was still covered with a blanket.

A Lesser-Known Warning

The American Academy of Orthopedic Surgeons recommends that no children under six jump on a trampoline, though statistics suggest low awareness of this recommendation. According to data from 50 trampoline parks taken from April to June 2019, 13 percent of all jumping was done by children ages one to five years old, reports Roller, a company that makes software for leisure businesses.

While disappointing for parents to hear, says Dr. Gaia Georgopoulos, an orthopedic surgeon at Children’s Colorado, many parents get a false sense of security when trampoline parks have a toddler area. It’s a good idea in practice to separate toddlers from older kids who are jumping, however the majority of trampoline injuries she’s seen in the under-five group have occurred on the trampoline itself—not from falling off. “Bones at the toddler age are more like plastic,” says Georgopoulos, and the impact of jumping alone is sometimes too much.
Increase in Injuries

In November 2019, Georgopoulos and a team of researchers released their findings from a study on pediatric trampoline-related fractures, which trended up from 35.3 per 100,000 people in 2008 to 53 people per 100,000 in 2017. By age group, age zero to four accounted for 25.5% of all trampoline fractures across the study period, 41.9% were ages five to nine, 28.3% were 10 to 14, and 4.2% 15 to 17, according to data the Children’s Colorado team pulled from the National Electronic Injury Surveillance System.

The uptick in injuries correlates with the surge in popularity in recreational trampoline parks nationwide: The first trampoline park opened in the United States in 2004, and today there are more than 800, according to the International Association of Trampoline Parks (IATP). Colorado has more than a dozen trampoline parks, most of which note specified areas for children under seven or five on their websites.

Georgopoulos hopes pediatricians are talking to parents about the risks trampolines pose, especially for the younger set. “Nell’s mom had no idea it wasn’t safe for her toddler to jump on a trampoline,” she says. When a child jumps and the trampoline bounces back to meet the child’s legs, bones can break. Lower extremity fractures are common in younger age groups; in fact, many patients visit Children’s Colorado with tibia fractures from jumping on the trampoline. It happened to Nell.

A Bad Break

It turned out that Nell had broken her femur. They’d arrived at Children’s Colorado after 2 a.m., and Nell went into a four-hour surgery with Georgopoulos at 6:30 the next morning. Two small plates and six small screws were fabricated especially for Nell, then she was placed in a spica cast that immobilizes one or both legs as well as the waist.

In the weeks following the surgery, Nell’s “personality shriveled away to nothing,” Chelsea says. Nell took to wearing aviator sunglasses all day, every day. The formerly social little girl—who’d never met a stranger she didn’t like—became afraid of others and did not want to be touched. Because Nell was normally in daycare, Chelsea started working from home, rising at 2 a.m. to do her job until Nell woke up at 7 a.m., and thus began the full day of constant Nell care. She developed hacks—like carting Nell in a wagon and lining her diaper with maxi pads so urine wouldn’t trickle into her cast.

Before You Leap

Nell had the cast removed right before Christmas 2019. She developed a bad limp that eventually resolved—but not before another child called her “weird” during a bookstore outing.

Though Nell went back to daycare, socializing normally, and is healing well, her journey is not quite over: In late June, Nell will have another surgery to remove the pins and plates. While Chelsea is proud of her own resilience and grateful for the help they received from loved ones, the lasting emotional implications and ongoing pangs of guilt have made her a more nervous parent.

“A break like this is so much more than just a cast,” she says. “If something feels like it’s worth a Google search to assess safety, Google it three times.”

Dr. G’s Three Simple Rules

Regardless of whether the trampoline is in your backyard or at a recreational facility, this shortlist will ensure the best protection against injury. Georgopoulos notes that the percentage of injuries related to home trampolines is slightly less given the rise of trampoline parks, yet the overall number of injuries has increased.

  • Jumpers are most often injured when they’re on the trampoline with someone else, Georgopoulos says. One jumper at a time is the best way to prevent injury. The IATP also advocates this safety guideline, says Bethany Evans,
    executive vice president of IATP.
  • Trampolines should always be set up on a soft surface like grass or sand, never on a hard surface like a patio or a concrete driveway.
  • Adults should always supervise kids while they’re on a trampoline. Georgopoulos says many parents send their kids out back to jump on the trampoline and that’s that, but trampoline use needs to be monitored. Also, children under age six should not be jumping on trampolines.