Should I worry about the neck joint in Down syndrome before trampoline play or somersaults?

Some people with Down syndrome have increased movement at the upper neck. Current AAP guidance does not recommend routine screening X-rays for an asymptomatic child, but families should watch for warning signs such as new neck pain or head tilt, a change in walking, new weakness or changes in hand use, sensory changes, or new bladder or bowel difficulties. Seek medical assessment promptly if these occur. Discuss activities that place substantial force on the neck, as well as surgery, anesthesia, or sports participation, with the child's clinician so advice can be individualized.