Nicole Villalpando - Austin American-Statesman
Every year, about 220,000 kids younger than 14 show up in U.S. emergency rooms with injuries from a playground. That's just the ones who go to the ER. Others seek care at their pediatrician's office, an urgent care center or a pediatric orthopedic surgeon's office if their injuries are severe enough.
Know that "playground injuries are super common," said Dr. Catherine Sargent of Central Texas Pediatric Orthopedics.
Many happen when kids fall off something and try to brace their fall ineffectively.
Another common injury scenario, Sargent said, is when parents of a baby or toddler put the child on their lap or an older sibling's lap and head down the slide together. The child's leg gets caught, the parent or older child is heavier and can't stop sliding. The baby or toddler fractures their leg, usually the tibia, one of the smaller lower leg bones.
"The parent feels terrible," Sargent said. "They're trying to make it fun for the kids."
The good news is that injury on kids that age tends to heal well, she says, but it could all be avoided.
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Another common injury is kids falling off the monkey bars and trying to brace themselves with an outstretched arm and breaking an elbow, forearm or a wrist.
Sargent tends to see this injury at the beginning of the school year when kids have come back from summer break and are back on the school playground. They have grown since the last time they were on those monkey bars and they are out of practice. They assume they will be able to do the same tricks as the last time they were on those bars and that's just not true.
Playground injuries don't just happen at the park or at school. Sargent also sees a lot of injuries with backyard playgrounds.
Parents send kids out to play, and because the kids are in the backyard, they are not supervising them like they would if they were at a park.
"If you have more than one kid, they get into real shenanigans," Sargent said.
Kids then do things like jump off the top of the slide or jump off the swing or walk up the slide or hang from a part that wasn't meant to be a hanging-off spot. They break their ankles or wrists, elbows or forearm when they land.
Another common backyard injury comes from trampolines. It happens when more than one person is on a trampoline at a time and someone lands on top of another person or they get bounced off the trampoline. Often they break the top of their tibia.
How to play safely
Supervise play. Kids do daredevil things like jump off things that weren't meant for that or going the wrong way up a slide. They need that adult to tell them not to do that. "This is where fun goes to die," Sargent jokes.
Use the appropriate playground for your child's age. Many public playgrounds will have suggested ages on signs. If you're not sure, ask yourself: Can my child get on and off the playground by themselves? If you have to put your child on the playground, it's too big for them.
"They should be able to navigate it themselves," Sargent said.
For toddlers: these things are age appropriate according to the U.S. Consumer Product Safety Commission's playground guide: Climbing equipment that is less than 32-inches high, ramps, step ladders or stairways, small slides, spiral slides that make less than a 360-degree turn, spring rockers, only swings with bucket seats.
For preschoolers: Horizontal ladders (monkey bars) less than 60 inches high for ages 4 and older, ramps, rung ladders, stairways or step ladders, swings that are belt, bucket seats or tire spring rockers, spiral slides up to 360-degrees.
For grade-schoolers: Arch climbers, chain or cable walks, free-standing climbers, ladders of any kind, ramps and stairways, overhead rings, ring treks, track rides, vertical sliding poles, swings that are belt or tire but not bucket.
Check the layout of the playground. Can a child easily see all around the structure or are there things blocking their line of sight? Can you see them easily?
What is the playground set on? Grass or concrete make for hard falls. Look for pea gravel, wood chips, mulch, sand or rubber bits to soften the blow. That surface should be 12 or more inches deep and spread out 6 feet in all directions.
What safety features are in place? In playgrounds for older kids, are there rails or nets for anything 30 inches above the ground.
What is the condition of the playground? Is there rust? Sharp edges? Peeling paint? Warped or brittle boards? Insect nests? If yes, play somewhere else.
No jumping off. No walking up the slide. No sliding head first. No multiple kids on the same swing, slide, bars, etc.
What to do after an injury
If your child does get injured, transport them immediately to a children's hospital emergency room if these things happen:
You can see bone through the skin.
They cannot wiggle their toes or fingers.
You cannot get their pain under control.
They've had a head injury.
There is uncontrolled bleeding.
Call 911 if they are unresponsive or having trouble breathing.
If not, you can call your pediatrician's office, the after-hours nurse line or a pediatric orthopedic practice and get an appointment to come in the next day. They will give you instructions for controlling pain such as ibuprofen or acetaminophen and how to control swelling or immobilize the limb.
The good news, Sargent says, is that most kids' bones heal better than adults' bones and they are able to regain their range of motion. Pediatric orthopedic surgeons will want to monitor the growth plates to make sure the limb grows evenly and at the same pace as the other limb after a break.
About Dr. Catherine Sargent
Dr. Catherine Sargent is affiliate faculty for the Department of Surgery and Perioperative Care at Dell Children’s Medical Center. She is a graduate of Baylor College of Medicine. She completed an orthopedic surgery residency at the Tulane University Health Sciences Center and earned her fellowship in pediatric orthopedics at the Scottish Rite Hospital of Atlanta.
Dr. Sargent is board-certified in orthopedic surgery and is a member of the American Academy of Orthopaedic Surgeons, the Pediatric Orthopaedic Society of North America and the American College of Sports Medicine. In her free time Dr. Sargent enjoys experimenting in the kitchen, scuba diving, and spending time with family.
Click here to request an appointment with Dr. Sargent at Central Texas Pediatric Orthopedics!