Trampoline parks are a fun and easy outlet for active kids. The huge indoor facilities give them a place to roam, jump, play dodgeball, navigate obstacle courses and practice their best ninja moves. They’re a favorite spot for birthday parties.

But parents need to understand the risk they could present, especially for preschool and early elementary-age children.

Dr. Christian Turner knows them well judging from the litany of lower leg injuries – or worse – he sees in his practice at Novant Health Pediatric Sports Medicine - Midtown. He also recognizes the risks as a parent to three young children ages 8, 6 and 1. That’s why when a recent birthday party invitation came for his 6-year-old son to a trampoline park, he politely declined and didn’t mention it to his son.

“It's fun when you're there and most kids do totally fine,” Turner said. “But I think the risk is higher than I’m interested in having them take for a half-hour of fun.”

Turner knows most parents will still be comfortable sending their kids there, but he recommends they take certain precautions.

“I try to be pragmatic with it and say, ‘I realize these things are fun,’” Turner said. “’But know the risks ahead of time. Almost everybody does fine that goes there but there's a decent injury risk, especially for little kids and kids who haven't done it before.” A 2016 study by the American Academy of Pediatrics found that emergency rooms had seen a greater increase in injuries from trampoline parks from 2010 to 2014. During the same period home trampolines injury statistics remained the same.

If you’re a parent and never really dared to ask whether trampoline parks are safe for children, Turner answers that question and more:

Q. The danger at trampoline parks is greater for younger children. Why?

If you have 3- and 4-year-old kids who aren’t yet able to tie their own shoes and struggle running up and down a hill and struggle on stairs, putting them on a trampoline which gives them a lot of extra energy is a risky idea. How much energy they take will vary with each jump and the people jumping near them. It’s not the same as a high school kid, who's an athlete who is doing it for training in gymnastics, or even an older kid who has better body mechanics and body control.

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Q. What are some injuries you see with trampoline park accidents?

It's usually lower extremity injuries. I've seen a few kids with head injuries like concussions either from bumping into somebody or bumping into some harder piece of equipment there. But the ones that stand out are the younger kids, preschool and early elementary-age kids, who come in with bad ankle injuries or fractures. I’ve seen tibia fractures from trampoline parks and ankle sprains and fractures around the knee.

Q. Are backyard trampolines any safer, especially with the modern variety that have netting or fencing around them?

Looking at the data, there's seems to be a higher risk of more substantial injury for trampoline park injuries versus backyard trampoline injuries. If you get hurt at a trampoline park, your risk of it being an injury that requires something else to be done – like being admitted to the hospital or needing surgery – seems to be higher.

Often, it’s caused more from the force of the trampoline causing a lower leg injury than flying off the trampoline and landing on another surface.

Q. Are there any ground rules parents can set to help limit the risks?

I tell families “If you’re doing trampoline parks or if you have a backyard trampoline, the rule should be one person at a time and no equipment on the trampoline, like balls.” I understand it's not as fun when you're jumping by yourself, but it’s definitely riskier with other people or objects on the trampoline.

Q. Is the big problem the threat of the “double bounce?”

When I was a kid, we used to do this on purpose. We’d say, “OK, jump next to me right as I'm about to hit it” because it'll give you more force so you can fly in the air higher. But knowing that it's going to happen and being able to prepare for it and respond to it biomechanically is hard.

When you’ve got multiple people jumping around, somebody's going to get double-bounced, especially if they're not expecting it. And if the person that gives that extra bounce is bigger than they are, it's going to be a heck of a lot of force for them. The unexpected double bounce is probably the most substantial cause of these injuries.

Q. If parents don’t adhere to the one-at-a-time rule, is there anything else they can do?

If you've got multiple people on there at once, having the size of kids be similar would be preferable. I'll see kids where a parent was on the trampoline with a little kid. A big discrepancy in size and weight is riskier for the small person.

Q. Would you say bounce houses are safer than trampoline parks?

Yes, I think that's probably fair. It's definitely not as much energy and force going on, and they're probably a little more geared toward smaller kids and you probably have less weight variation. It may be more like 2-year-olds, or 5 and 6-year-olds as opposed to having teenagers in there at the same time as smaller kids, which seems pretty common with trampoline use.

Q. Do you consider trampoline parks safer for older elementary school kids?

I think the older kids are probably better suited to handle the normal mechanics of it. It is fairly complicated to use your muscles to jump safely on the trampoline over and over, especially with somebody else around you.

Q. When your children turn 10 and they’re invited to a trampoline park birthday party, are you letting them go?

I guess that depends on what else they have going on and if I’m interested in putting them at risk of missing something else. If it's about to be basketball season and my kid who loves basketball is potentially going to get hurt and miss time from something else he really wanted to do, we would have a talk about it. But I think middle school age and up, I'd be less concerned about (it).