There’s a lot of joy in having a dog, not the least of which is heading out for a brisk walk. And therein lies a peril some dog people should pay more attention to.

Dog walking-related injuries have been on the rise in the U.S. Fractures, sprains and head trauma are among the most common.

That’s a lot of dog-tor visits. Injuries related to dog walking among American adults and children have surged a whopping 342% over the past two decades, researchers from Johns Hopkins University discovered.

From 2001 to 2020, the estimated number of adults seen at emergency departments for dog-walking injuries increased significantly, from 7,300 to 32,300 a year, Johns Hopkins University researcher Ridge Maxson told The Associated Press.