Despite safety upgrades over the past several years, the American Academy of Pediatricians continues to discourage the home use of trampolines.

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The sales of backyard trampolines peaked years ago, as well as injuries related to them, but the AAP policy statement claims severe injury is still a major concern.

In 2009, an estimated 98,000 trampoline-related injuries occurred, including more than 3,000 hospital visits.

"It's a very, very high-risk form of entertainment," said Dr. Susannah M. Briskin, co-author of the policy and Assistant Professor of Pediatric Sports Medicine. "The problem is most people don't follow the rules."

Following a recommendation from the AAP in 1999 that discouraged trampolines for recreational use, the industry issued a revision of performance and safety standards. Equipment changes included more and better padding over the springs. Warning labels were also updated, restricting multiple jumpers and advising against flips and somersaults.

The policy noted many parents and supervising adults are not aware of key components of trampoline safety.

"Even with adults supervising, one-third to one-half of injuries occur," said Briskin. "Even if adults are reading the warnings, we don't think they're actually following through."

Briskin said kids of all ages can be, and have been, victims. Three-quarters of injuries occurred when more than one jumper was on the trampoline.

She continued, "When there's more than one user at a time, the forces that are created, especially towards the smallest user, are really significant."

The policy cited a variety of injuries related to trampolines, from sprains and strains to bone fractures.

Briskin advised current and future trampoline owners to regularly check the quality of the mat, support structure, padding and netting.

According to JumpSport, based in California, currently more than 95% of all trampolines worldwide are sold with a safety net.

AAP said homeowners should verify their insurance policies cover trampoline-related claims. Some may not even allow such a structure on clients' property.

"It's not a one-size-fits-all issue," explained Marshall McKnight with the New Jersey Department of Banking and Insurance. "Insurance coverage is something homeowners should check on before they go ahead and purchase that trampoline."