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Editor’s note: Before beginning any new exercise program, consult your doctor. Stop immediately if you experience pain.

CNN  — 

While treadmills are among the most popular pieces of fitness equipment, they can be dangerous.

More people are injured by treadmills than any other piece of exercise equipment, according to the US Consumer Product Safety Commission. More than 22,000 treadmill injuries resulted in hospital emergency room visits in 2019, a spokesperson for the federal agency told CNN.

Typical injuries include slips, sprains and strains, but treadmills can also cause serious burns, concussions, broken bones and even death, although the latter is rare.

“There are all kinds of dangers with treadmills, because they’re machines,” said Clark Stevenson, owner of Treadmill Doctor, a treadmill repair company based in Memphis, Tennessee.

These dangers aren’t limited to the users, either. Children and pets are particularly susceptible to treadmill injuries during home use. Notably, CPSC issued an urgent warning to consumers in April 2021 to stop using the Peloton Tread+ machine after a young child became trapped underneath one and died.

Dana Noffsinger knows the dangers that treadmills can pose to children. A nurse practitioner at Nationwide Children’s Hospital in Columbus, Ohio, he and a colleague did a study on treadmill burns in children who were treated at the hospital. The 2017 study, published in the Journal of Burn Care & Research, found treadmill burns were more severe than burns from touching a hot stovetop.

The burns typically occurred when a child placed their hand on a moving treadmill that then got trapped near the back of the machine as it continued to run.

“What struck us most was that these treadmill burns were very deep and hard to heal,” Noffsinger said. “We’ve had patients with deep enough injuries that you can see the bone and tendons exposed, which we don’t see with other burns.”

Even after healing, treadmill burns carry a significant risk of scarring that can limit hand function for the rest of the person’s life, Noffsinger said.

Top treadmill safety measures

Fortunately, it’s relatively easy to use a treadmill safely, experts said.

First, make sure you’re wearing well-fitting exercise clothing and sturdy shoes. Before getting on the machine, warm up with stretches and range-of-motion exercises, Stevenson said. Then step onto the machine and securely attach the safety key to your shirt. If you should become at risk of falling off of the treadmill, the safety key will immediately turn off the machine.

Next, straddle the belt, then turn on the treadmill to a slow speed. Stevenson recommended 1 mile per hour (1.6 kilometers per hour). Get your bearings with the belt movement, then step on and walk slowly for a while before changing the speed or incline. When your workout is over, turn off the machine and make sure it has stopped before stepping off.

Neglecting to use the safety key is one of the top mistakes Stevenson said treadmill users make. “Walking on a treadmill without a safety key is like driving without a seat belt,” he said. “Ninety-nine percent of the time you won’t have to use it, but when you need it, you really need it.”

Certified strength and conditioning specialist Kyle Firmstone has seen many problematic treadmill activities. A master trainer at Crunch Fitness in New York City, Firmstone said you shouldn’t walk too close to the console, jump off and on while the machine is still in motion, or set the treadmill to a speed faster than you can handle.

“Talking to other people can be problematic, too,” Firmstone said. “I’ve seen people fly off the end because they were looking in a different direction than they were running, which throws off your proprioception (your body’s ability to sense motion and location).”

Safety measures for home use

When you’re using a treadmill at home, make sure there is plenty of clearance behind the machine, Stevenson said. Should you happen to fall off, you’ll need a safe spot to land. While many manufacturers say you only need 3 or 4 feet of clearance, Stevenson recommended 6 feet (1.8 meters). At his own home, he has 8 feet (2.4 meters) of clearance because he is 6’2” tall.

Maintaining the belt with a silicone lubricant according to the manufacturer’s recommendations and keeping the machine clean are also important, he said, and never use the treadmill when an unattended child or pet is in the room.

“You should never have a child in the same room as an operating treadmill,” Stevenson said. “That’s asking for trouble. All it takes is a split second for a kid to put his hand on the belt or underneath.”

While there’s no set age recommendation for treadmill usage, Noffsinger said children age 12 and older should be able to safely use a treadmill without adult supervision.

“That’s the same guideline for lawn-mowing,” he said. “The child needs to be developmentally old enough to know of the dangers and risks.”

No matter your age, don’t overdo it if you’re new to treadmill use. Your body will need time to acclimate to this new form of exercise. While similar to walking or running outside, doing the same on a treadmill is not identical, due to the moving belt.

Update: This story has been updated to replace industry data and remove use data.

Melanie Radzicki McManus is a freelance writer who specializes in hiking, travel and fitness.