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Avoiding Recreational Hazards

How To Take Preventive Steps To Avoid Injuries

While it's no secret that children often get more than their fair share of cuts and bruises growing up, many parents don't know that certain play activities carry greater risks for injuries that can have long-term effects on their child's health and development.

According to Dr. Robert Bernstein, pediatric orthopedic surgeon and director of the Orthopedic Center at Cedars-Sinai Medical Center in New York, N.Y., injuries that can cause serious harm to children occur from falls and crashes playing on trampolines, bicycling, participating in roller sports such as rollerblading and/or scooter riding, and from accidents that occur on the playground.

"Falls are the leading cause of injury in children of all ages, and while you cannot protect your child from every mishap, you can take some preventive steps to avoid serious injuries," says Dr. Bernstein.

The Trouble With Trampolines

Nearly 92,000 hospital emergency room-treated injuries were due to accidents on trampolines in the year 2001, according to the U.S. Consumer Produce Safety Commission (CPSC). And while most of the children injured were under the age of 15, as many as 11 percent were under the age of 5. Most of these injuries were caused by a collision with another person on a trampoline, landing improperly while jumping or doing stunts, falling or jumping off the trampoline and falling on the trampoline springs or frame.

To avoid these injuries, Dr. Bernstein recommends that parents or other adults supervise all play activities on trampolines. "Kids should never be left to themselves to play on a trampoline," he says. "They must have a competent adult to watch them. Parents should also not allow their child to do somersaults or other high risk jumps, because injuries from these maneuvers can result in serious fractures and even paralysis if the child lands on his head or neck. Beyond that, only one child should be on the trampoline at one time to avoid crashing into another person."

The Bad News About Bikes

Falls and collisions with stationary objects or with another bicycle are perhaps the greatest cause of injury for children. In fact, according to the American Academy of Orthopaedic Surgeons, the greatest number of recreational injuries to children in the year 2000 occurred while the child was riding a bicycle. Although the report is quick to point out that most of these injuries were from bruises, broken arms and wrists, there were more than 125,000 fractures among bicycle riders.

"Fractures, breaks or a crack in a bone can be particularly serious in children because the bone is growing," says Dr. Bernstein. "The fractures frequently involve the growth plate (that area from which the bone grows), and any injury to the growth plate can cause the bone to stop growing or to grow in an abnormal direction. For this reason, injuries to children can be more serious – they are not just small adults."

His advice: "Make hard fast rules for your kids as to when, where and how they can ride their bike. Younger children have not yet fully developed their balance and coordination and are thus more likely to steer into oncoming traffic."

To reduce your child's chances of being injured while riding a bike, younger children should not ride their bicycles at night when it's hard for motorists to see them.

"Riding a bike at night takes skills that younger children have not developed, so parents need to rule out night riding for their younger kids," says Dr. Bernstein. "Teens, on the other hand, are bigger and usually more visible. But common sense dictates that they should use reflectors, wear bright-colored clothing and have a light on their bike so that they can see what's in their path as well as be seen by motorists."

Traffic poses another problem for young riders, who do not yet know how to navigate it. "Don't let your young children ride their bikes on busy streets," says Dr. Bernstein. "On the other hand, kids must be taught early on to obey all traffic signs, particularly stop signs and to walk their bicycles across busy streets. Above all, they should wear a helmet that fits properly to avoid head injury."

Rockin' and Rollin'

It's no surprise that anything to do with children on wheels can be potentially dangerous. Children can easily lose their balance or can lose control if they go too fast. Either scenario can lead to a collision or fall and is especially the case when they are rollerblading, skating, skateboarding or riding a scooter.

According to the American Academy of Orthopaedic Surgeons, accidents from "roller sports" accounted for nearly 300,000 medically treated musculoskeletal injuries among 5- to 14-year-olds in the year 2000.

"Beyond obeying specific rules for any of the roller sports, parents should make sure that their kids learn the basic skills of the sport, particularly how to stop, before venturing outside to practice," says Dr. Bernstein. "Parents should also make sure that their kids are wearing the right size of helmet to protect them from head injuries and to wear wrist guards to protect them from fractures that can occur should they have to catch themselves from a fall. Knee and elbow pads also help to avoid other minor but nevertheless painful injuries."

Although Dr. Bernstein acknowledges that it's not uncommon for kids to aspire to do the tricks and stunts that seem to go along with most roller sports activities, parents should only allow their children to practice these in an environment where they can be closely supervised.

Prevention on the Playground

Close supervision should also occur on the playground – where the majority of injuries are caused by falls to the ground. "Whether the playground be at school or a park, parents need to check out the playground to find out what equipment their kids will be playing on and how the playground is surfaced," says Dr. Bernstein. "Surfaces should be soft to cushion falls and not made of concrete, dirt or even grass, because the ground underneath it can still be too hard."

Swings are the most likely pieces of moving equipment on a playground where children will get hurt either by taking a fall, colliding with another child on a swing or because the equipment is old and unsafe. According to the National Safety Council, swings should be set far enough away from other equipment so that children won't be hit by a moving swing, and only two swings should be in each supporting framework.

Slides should also be anchored firmly in the ground, have firm handrails and good traction on the steps, so kids don't slip. Seesaws should be spring loaded (not chained in the middle) and have an object mounted underneath the seat to keep it from hitting the ground as children go up and down. Merry-go-rounds should have good handgrips, and the rotating platform should be level and clear the ground enough to prevent kids from getting their arms or legs caught underneath.

Climbing equipment such as monkey bars and jungle gyms are responsible for 40 percent of all playground injuries, according to the National Safety Council.

Dr. Bernstein warns that children under the age of 4 should not play on this equipment and that parents or other responsible adults should watch kids closely. "Climbing equipment is great for helping kids develop upper body strength and agility, but parents should 'spot' and watch younger kids closely to prevent a serious fall," he says.

For more information on any of the orthopedic or pediatric programs at Cedars-Sinai Medical Center, please call 1-800-CEDARS-1 or 1-800-233-2771.

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