Copyright 2017 American Academy of Orthopaedic Surgeons
Playground Safety Guide

Playgrounds are exciting places for children to be outdoors and active, and to make friends. Despite these great benefits, playgrounds are also common places where kids get hurt. Each year, more than 220,000 children under age 14 are treated in hospital emergency rooms across the United States for injuries occurring on playgrounds.

There are several things that parents and caregivers can do to help make the playground safer for children. This includes providing strong supervision, ensuring that equipment is free of potential hazards, and steering kids to age-appropriate play areas. Here are a few other tips on how to prevent playground injuries from occurring and to lessen the severity of injuries that do occur.

Types of Playground Injuries

Although minor bumps, bruises, and cuts frequently occur on playgrounds, many playground injuries are more severe. Broken bones, sprains and strains, internal organ injuries, dislocations and concussions are the most common playground-related injuries that require a doctor's care.

Although it rarely happens, deaths have also been associated with playground equipment. In a recent ten-year timespan, 147 children (14 years or younger) died from playground-related injuries: 82 strangulations and 31 falls.

While most playground injuries occur on public playground swings and climbing equipment, 70 percent of deaths occurred on home playgrounds.

Common Causes of Playground Injuries

Falls

Most playground injuries are caused by falls from monkey bars and other equipment.
Thinkstock

Falls from the equipment to the ground are the top cause for childhood emergency room visits due to playground-related injuries. Children fall because they slip, lose their grip, or lose their balance while playing on monkey bars, swings, slides, merry-go-rounds, and seesaws.

Even something as simple as the drawstrings from a hooded sweatshirt can catch on a piece of playground equipment and lead to a fall. Often children are hurt not only by the fall, but by being struck by the equipment as they fall.

In a natural effort to protect themselves, children will often fall on an outstretched hand and break the bones involving the elbow. This type of elbow fracture (supracondylar fracture of the humerus) is the most common injury that requires a trip to the operating room for treatment.

Slides

Many injuries also happen on slides. One study found a relationship between shinbone (tibia) fractures and young children going down a slide on the lap of an adult. In many of these cases, the child's leg became stuck, but the adult and child could not stop moving down the slide. In other cases, the child's leg became twisted during the ride down.

Other Causes

A smaller number of playground injuries occur on teeter-totters and seesaws. To lesser degrees, injuries result from contact with sharp edges of equipment, impact with stationary equipment, and falling after being struck with some type of equipment other than what the child was playing on-for example, walking past a moving swing. Playgrounds with poor maintenance present extra opportunities for injuries from trash, rusty play equipment or damaged fall surfaces.

Injury Prevention

Supervision

Steer children to age-appropriate playground equipment.
Ruslan Dashinsky/iStock/Getty Images

Close supervision by a responsible adult may be the most important factor in preventing or minimizing playground injuries. Age-appropriate equipment and carefully designed playground layouts, by themselves, won't be enough to prevent all injuries that may occur. Adults must provide focused supervision. They must instruct children in the proper use of the equipment, and monitor and enforce playground rules.

Parents, relatives, teachers, babysitters, or anyone who sends or brings children to the playground should periodically inspect the facility for hazards. Report any problems to the proper officials. Don't let your children use that playground until the authorities have completed repairs.

Playground Design

Whether playground injuries are caused by falls or other types of contact, attention to three major factors can help to reduce the incidence of injury. These factors are:

  • Playground surface
  • Playground plan
  • Equipment installation and maintenance

Playground surface. The type of surface on the playground is the most important factor in the number and severity of injuries due to falls. The number and severity of injuries can be reduced by using softer surfaces, such as wood mulch or chips, shredded tires, or sand. Hard surfaces, such as asphalt and concrete, result in the most severe injuries and are unsuitable under any playground equipment. Soil, packed dirt, grass, and turf are not recommended for surfacing either, because their ability to absorb shock can be affected greatly by weather conditions and wear.

Playground plan. A well-planned playground should offer activities to encourage the development of perception and physical skills, including running, walking, climbing, dodging, swinging, sliding, throwing, catching, pulling, and pushing.

General guidelines for a well-planned playground include:

  • Separate areas should be available for active play, such as swinging, and for quiet play, such as digging in sandboxes.
  • Spaces for preschoolers should be located away from areas where older, more active children play.
  • A "use zone" should be established around equipment, with adequate space for entering and exiting. Open fields should be located so that children can run freely without colliding with other children or equipment.
  • Zones for popular activities should be separate to avoid overcrowding.
  • Pathways that link activity areas should provide for easy travel between areas, and unobstructed vision for a child's height.
  • Sight lines in all playground areas should be clear to allow proper adult supervision.

Equipment installation and maintenance. Schools and cities should keep playgrounds in good condition by inspecting and maintaining the equipment throughout the year. Heavy rainfall, snow, temperature extremes and high winds can damage playground equipment. So can heavy use. The most popular equipment might wear out quickly.

Manufacturers' instructions for proper installation and spacing should be followed carefully, including recommendations for maintenance. Equipment should be inspected regularly to identify any loosening, rust or corrosion, or deterioration from use, rot, insects, or weathering.

Guidelines for Safe Playground Use
  • Avoid playgrounds that have concrete, asphalt, hard-packed soil, or grass. The surface should be made of wood chips, mulch, or shredded rubber for play equipment up to seven feet high.
  • Steer children to age-appropriate playground equipment.
  • Check to see that there is enough space for kids to easily get off the slide or merry-go-round. Don't let kids crowd around the exit areas.
  • Try the handgrips to verify they are shaped and sized for easy grasp.
  • Swing seats should be made of plastic or rubber. Avoid metal or wood.
  • Avoid any equipment that has openings that could entrap a child's head.
  • Be sure you can clearly see your children on the playground. The kids should have clear, unobstructed views from their height.
  • Remove tripping hazards such as exposed concrete footings, tree stumps, or rocks.
For More Information

If you found this article helpful, you may also be interested in Playground Safety: Tips for KidsPlayground Safety: Tips for Kids (topic.cfm?topic=A00345).

Last reviewed: June 2017

Reviewed by members of the Pediatric Orthopaedic Society of North America

The Pediatric Orthopaedic Society of North America (POSNA) is a group of board eligible/board certified orthopaedic surgeons who have specialized training in the care of children's musculoskeletal health. One of our goals is to continue to be the authoritative source for patients and families on children's orthopaedic conditions. Our Public Education and Media Relations Committee works with the AAOS to develop, review, and update the pediatric topics within OrthoInfo, so we ensure that patients, families and other healthcare professionals have the latest information and practice guidelines at the click of a link.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website.
Copyright 2017 American Academy of Orthopaedic Surgeons
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