(Reuters Health) - A growing number of older U.S. adults are suffering facial fractures during recreational activities like biking, gardening and playing sports, a recent study suggests.

Researchers examined data from 2011-2015 on 20,519 emergency room visits for facial fractures associated with recreational activities among adults 55 and older. During that time, the annual incidence of facial fractures rose 45 percent, from 3,174 in 2011 to 4,612 in 2015.

“The rate of facial fractures from recreational activities in the 55 and older population rose quite significantly over a relatively short period of time,” said study co-author Dr. Peter Svider of Wayne State University School of Medicine in Detroit, Michigan.

“Part of it likely has to do with our aging population, in which people are living longer and living healthier lives longer,” Svider said by email.

As the U.S. population ages, doctors have encouraged aerobic activity and muscle-strengthening exercises to help maintain mobility, flexibility and cognitive ability.

People treated for facial fractures in the current study were 67 years old, on average. Roughly 20 percent were 75 or older, researchers report in JAMA Facial Plastic Surgery.

The most common causes of facial fractures were cycling, team sports like baseball and softball, and activities such as hiking, fishing or camping and gardening. Walking and jogging also caused a small proportion of injuries.

Most facial fractures were to the nose. The next most common site was the eye socket.

Men and women injured themselves differently. About 36 percent of men sustained facial fractures from cycling, compared with 15 percent of women, for example. Gardening, however, accounted for 16 percent of facial fractures among women and just 6 percent among men.

The study only captured injuries treated in emergency departments, and not cases when people went to urgent care clinics or other places, the authors note.

The results are also difficult to interpret because researchers didn’t account for how much time people spent on various recreational activities or how often they did these things, both of which are typically included in calculating injury rates in sports, said Jean-Michel Brismee, a physical therapy researcher at Texas Tech University Health Sciences Center in Lubbock.

Even so, the findings highlight a trade-off in encouraging older adults to be more active, Brismee, who wasn’t involved in the study, said by email.

“We advise people to participate in recreational activities,” Brismee said. “If you do, you will decrease the risk of cardiovascular disease and heart attack and improve your overall health profile, but you will increase the risk of injuries including facial injuries from falls.”

Common sense can help make injuries less likely.

“Wear your helmet when you ride the bicycle, wear laced shoes when you walk the dog or garden, but for sure keep bicycling, walking the dog and gardening if you feel you are up to it,” Brismee said. “People should not just stop one activity and do nothing, otherwise their health will decline faster!”

SOURCE: bit.ly/2tJXF3x JAMA Facial Plastic Surgery, online June 15, 2017.