As students are going back to school in Tennessee and Virginia, school staffs are looking to keep children safe.
In fact, last year in the United States, Emergency Departments treated more than 200,000 children for playground-related injuries.
Recess might be the best part of a kid's school day and the playground is all fun and games. Until someone gets hurt.
Some will even need treatment from Mountain States Medical Group orthopedic surgeon Todd Hannula.
"When they first go back to school we see quite a few children with wrist fractures, shoulder fractures, things of that sort," said Hannula.
Safety comes first at Marion Elementary School. Equipment is maintained on a regular basis and dangerous equipment is removed.
"This is a piece of equipment that we call the glider that we did remove the piece of equipment where the kids would glide from one end to the other. Because we did see several injuries resulting from this piece of equipment," said Kimberly Williams, Principal of Marion Elementary School.
Of course, kids are going to be kids and Dr. Hannula says playing on softer surfaces like mulch and grass can go a long way to preventing serious injuries.
"Most schools are much better about making sure he surface of the playground is indeed very good for the children. And that's really important," said Hannula.
Children tend to play in groups and that can be a recipe for trouble.
"If children are gathering at the bottom of the slide then people are going to back up on the slide and just place the children at increased risk that way," said Hannula.
45 percent of playground injuries are severe fractures, internal injuries, dislocations or concussions.
Children ages five to nine have higher rates of emergency department visits for playground injuries than any other age group. Most of these injuries occur at school.
Dr. Hannula also says darker colored playground equipment in hot weather can burn skin or cause abrasions as well.