More than 38 million American children participate in youth sports each year. Of those, more than 3 million will visit an emergency room each year with a sports-related injury. Some will have sprained ankles or broken bones, and others will be admitted to treat a concussion or head and neck trauma. These numbers, gathered by the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, also don’t take into account the untold thousands of injuries that are treated by athletic trainers, in clinics, or through visits to family doctors and pediatricians.

While injuries happen in all sports that children play, there are some sports that have a greater risk of injury. Numbers are skewed, of course, because of the popularity of certain sports over others. This list examines the five most dangerous sports for American children, taking into account both total injuries and individual risk of injury by sport.

5. Hockey

Total ER Visits: 21,145

Hockey has been gaining in popularity among youth athletes and has become the sixth most popular sport in the United States. Youth participation in the sport has nearly doubled, with numbers increasing from around 200,000 in 2000 to more than 350,000 in 2012, according to the American Academy of Pediatrics. Student athletes who play hockey are at a risk for concussions, torn ligaments, groin pulls and lacerations from falling on ice.

What makes this sport most controversial is the practice of “checking” – full-body defensive blocks of whoever is in control of the puck. USA Hockey allows checking with the 11-12-year-old Pee Wee League, but a recent American Academy of Pediatrics study recommended raising the age to 15. Researchers from the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus urge parents to make sure all kids wear face masks while playing.