According to the National Injury Surveillance System, more than 100,000 people annually are treated in emergency rooms for injuries sustained on trampolines. Despite being in wide use in private residences as a plaything for children, the bouncy fun can invite a laundry list of mishaps that parents may not be aware of.

In a 2012 policy statement discouraging the use of trampolines, the American Academy of Pediatrics noted that falls or flip attempts can result in cervical spine injuries and that the trampoline, originally designed for gymnasts and aviators, wasn’t really intended as a toy.

Among their concerns, the AAP indicated that more than three-quarters of injuries occur when multiple users are on the trampoline at once, especially if there are heavier children playing with smaller or younger partners. Jumping and landing outside the boundaries of the mat can also contribute significantly to ER visits. Ankle and elbow fractures remain the most common results of an awkward landing.

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The organization also notes that safety measures—padding over springs, netting, and adult supervision—haven’t displayed any correlation in reducing mishaps. Meanwhile, data on trampoline parks is too scarce to draw any conclusions about safety in commercial businesses.

Homeowners should also be aware that, for insurance companies, trampolines can occupy the same “attractive nuisance” space as swimming pools, with similar mandates for keeping access restricted with gating.

Some trampoline manufacturers have argued that trampolines present no greater danger than other physical activities like cycling or sports. If a trampoline remains a presence in your backyard, it’s best to limit use to one child at a time, avoid any flips or other maneuvers that limit control of how a child lands, keep the apparatus on even ground, and have netting and padding inspected regularly.