Preventing Common Childhood Summer Injuries

  •   July 5, 2018
  •  Nancy Littke, PT

To many people, the dog days of summer mean that children are outside enjoying fun summer activities. Taking part in informal summer activities is a great way to help children meet the Canadian Pediatric Society’s physical activity recommendations for children and youth.

However, in emergency rooms across the country, this time of year is known as “trauma season” due to the significant increase in traumatic injuries related to higher risk summer activities. Three common activities lead to the many of these injuries – playing on trampolines, bikes and skateboards, and playground equipment.

Active, outdoor play is important to our children’s health, well-being, and development. The risk of injury from activity needs to be balanced against the long-term health risks of inactivity.

Trampolines

As the snow disappears, covers come off the backyard trampolines and, unfortunately, trips to the emergency departments increase. According to Alberta Health Services (AHS), in 2015 more than 1,900 emergency room visits were by children aged 0 – 14 for trampoline-related injuries. Children aged five to nine had the highest injury rate. Of the 1,919 ER visits in 2015, 39% of the young children had limb fractures, 20% had dislocations of ankles, or feet and 7% suffered head injuries.1

As parents, we often feel secure if we have a trampoline with a safety net around it and pads over the springs. It may be a false sense of security, however, as most of injuries appear to result from improper use, multiple users, or unsupervised use.2 According to the Canadian Paediatric Society, less than 30% of trampoline injuries result from children falling off the mat while 35% occur when there are multiple children on the mat at one time. When more than one person or child is on the trampoline, the risk of injury for the lightest individual is five times greater than for the heavier jumpers.2 The Government of Canada identifies collisions with another person as a common cause of injury on trampolines.3

AHS, the Canadian Paediatric Society and the Government of Canada recommend the elimination of all trampolines in the home environment.1,2,3 If they are used these groups strongly recommend that as parents we follow some simple rules:

  • Provide appropriate adult supervision
  • Allow only one person on the mat at a time
  • Install a safety net or enclosure
  • Allow no participation for children younger than six years of age

It is important to remember that inflatable play structures may pose similar risks to young children. These should be used with caution and with adult supervision.

Cycling, inline skating, skateboarding

What do all of these have in common? They have wheels, go fast and children are frequently injured using them.

There is good evidence that wearing the correct helmet when participating in these activities may result in a 65% to 88% decrease in the risk of head and brain injuries.2 In Alberta it is the law that anyone under 18 must wear a helmet when on any type of bike, or when riding in an infant bike carrier, bike trailer or on a trail-a-bike.4 While it is not mandatory for adults to wear a bike helmet, it is recommended that everyone who cycles should wear one. The adult brain is injured as easily as the child's brain when the skull hits the pavement or another object during a fall or collision.

Children look to parents and trusted adults as examples. We can make our smaller children wear their helmets, but it is only by setting a good example that we can encourage older children and teens to wear their helmets when we are not around.

There are different helmets for different activities and it is important to ensure we and our children not only have the appropriate helmet, but that it fits properly, is worn correctly (straps are done up), and that it is replaced when it has been damaged or is no longer the correct size. Take the AHS Bike Helmet Yes Test to make sure you have the right helmet for the activity and that it fits correctly.

By law, in Alberta, all bikes must also be equipped with:4

  • Adequate steering and brakes
  • A warning device such as a horn or bell
  • A headlight, red tail light, and a red rear reflector if riding after dark

Playground injuries

Most communities have playgrounds where our children can run, climb, jump, slide and play with others. These playgrounds have changed over the years as more high-risk structures have been removed, surfaces under equipment have changed, and play structures have become more age-specific, and constructed of safer materials.

The Canadian Paediatric Society position statement on preventing playground injuries states that at least 29,000 children under 15 years of age are treated for playground injuries each year in Canada and that children aged five to nine are most at risk.5 Children in this age group may have the physical ability to play at greater heights but may lack the sense of danger and judgment needed to play or climb safely. This position statement identified that up to 75% of injuries occurred from falling from a climbing structure, with fractures of the arm being the most common injury.

AHS has some key messages for all parents:6

  • Ensure the playground equipment is age appropriate, in good condition, and free of hazards. The safety of the outdoor playground our children use can be checked by taking the Playground Safety Yes Test.
  • Dress children for safe play. This includes appropriate footwear, having long hair tied back and not wearing clothing with drawstrings, scarves or anything that is loose fitting.
  • Never allow helmets to be worn while on playground equipment as this can result in strangulation or a child getting stuck in the equipment.
  • Teach safe playground rules and etiquette.
  • Actively supervise young children when on or around the play structures.

The Canadian Paediatric Society has an excellent resource on playground safety.

In summary

Helping children to be physically active every day can include encouraging safe participation in free play, cycling, climbing, or jumping. Safety includes making sure our children have the appropriately sized equipment, wear the appropriate safety gear, understand the rules of play and etiquette to follow, and that we provide adequate supervision when our children are playing on equipment or in environments that put them at risk of injury.

For more suggestions for managing the risks when children participate in these fun summer activities, check out AHS’ Summer Safety resource.

The best case scenario is to avoid summertime injuries, but if you or your child have suffered an injury click here to find a physiotherapist who can help.


  1. Alberta Health Services (2017). Position Statement: Private Residence Trampoline Safety. [Internet] Available at https://www.albertahealthservices.ca/assets/healthinfo/ip/hi-ip-position-statement-trampoline.pdf Accessed May 28, 2018.
  2. The Canadian Paediatric Society (2016). Position Statement: An update to the Greig Health Record: Preventive health care visits for children and adolescents aged 6 to 17 years – Technical report. Available at https://www.cps.ca/en/documents/position/greig-health-record-technical-report. Accessed May 28, 2018.
  3. The Government of Canada (2014). Trampoline and bouncy castle (inflatable play structure) safety. Available at https://www.canada.ca/en/health-canada/services/injury-prevention/trampolines-bouncy-castles-inflatable-play-structures.html?wbdisable=true. Accessed May 29, 2018.
  4. The Province of Alberta (2018). Traffic Safety Act. Available at http://www.qp.alberta.ca/documents/Acts/t06.pdf. Accessed May 28, 2018.
  5. The Canadian Paediatric Society (2012). Position Statement: Preventing playground injuries. Available at https://www.cps.ca/en/documents/position/playground-injuries. Accessed May 29, 2018.
  6. Alberta Health Services (2017). Preventing Playground Injuries. Available at https://www.albertahealthservices.ca/injprev/Page4860.aspx. Accessed May 30, 2018.