Position Statement

Injuries from Skateboarding

This Position Statement was developed as an educational tool based on the opinion of the authors. It is not a product of a systematic review. Readers are encouraged to consider the information presented and reach their own conclusions.

The American Academy of Orthopaedic Surgeons (AAOS) believes that recreational skateboarding can be an effective way for adolescents, teenagers and adults to stay fit and active but is potentially hazardous and strongly urges riders to use proper precautions and safety equipment to prevent and minimize injuries that can occur.

Skateboarding has experienced a recent surge in popularity. Approximately 8 million Americans have taken up skateboarding and the number continues to grow. Each year, more and more teenagers participate, especially males. Skateboarding involves speed, balance and coordination, and can sometimes result in serious injuries. Because it is an activity in which you move quickly over hard surfaces and sometimes utilizes ramps or rails in which higher speeds are attained, skateboarding can lead to injuries that range from minor cuts and bruises to severe fractures and catastrophic brain injury.

Each year in the U.S., skateboarding injuries cause about 50,000 visits to emergency departments and 1500 children and adolescents to be hospitalized (American Academy of Pediatrics, 2002). According to the U.S. Consumer Product Safety Commission, approximately 242,000 injuries were treated in hospitals, doctors’ offices, clinics, ambulatory surgery centers and hospital emergency rooms in 2003.

The AAOS believes that the majority of injuries are preventable if certain precautions are taken.

Sprains, fractures, contusions and abrasions are the most frequent injuries. The majority of reported injuries were of the extremities. Among these, wrist and ankle fractures are the most common and followed by head injuries. Most hospitalizations involve head injury.

Sixty percent of skateboard injuries involve children under age 15, and skateboarders who have been skating for less than a week suffer one-third of the injuries. Most of those injured are boys.

The AAOS does not recommend skateboarding for children under age 5 because they are still growing and do not yet have the physical skills and thinking ability a person needs to control a skateboard and ride it safely. Children age 6 to 10 should be supervised closely by an adult or trustworthy adolescent and wear proper safety gear, including helmets, wrist guards and knee and elbow pads.

When young children are involved in skateboarding accidents, they are often injured severely. Skateboarding is a special risk for young children because they have:

• A higher center of gravity, less development and poor balance. These factors make children more likely to fall and hurt their heads.
• Slower reactions and less coordination than adults. Children are less able to break their falls.
• Less skill and ability than they think. Children overestimate their skills and abilities and are inexperienced in judging speed, traffic and other risks.
• injuries can be reduced or prevented by following the AAOS recommendations below:

Use a quality skateboard. Skateboards have three parts—the deck (the board itself), the trucks (the mechanism to which wheels are attached) and the wheels. Shorter decks are best for beginners because they are easier to balance and handle. Skateboards have various characteristics for all types of riding including slalom, freestyle and speed. Some are rated for the user's weight.

Keep your skateboard in proper working order. You should inspect it before every ride. Look for problems that need repair. These can include loose, broken or cracked parts; sharp edges on metal boards; a slippery top surface; wheels with nicks and cracks, missing hardware, etc. Get professional help to repair serious defects and replace the skateboard regularly when it shows signs of excessive wear.

Learn the basic skills of skateboarding, especially how to stop properly. Also learn slowing and turning techniques, and how to fall safely: If you are losing your balance, crouch down on the skateboard so you won't have as far to fall. Try to land on the fleshy parts of your body rather than your arms. Relax and roll.

Wear proper protective equipment. Before getting on your skateboard, empty your pockets of all hard and sharp objects and put on your protective gear. Essential protective equipment includes a properly fitted helmet, wrist guards, elbow/knee pads and a nonskid, supportive shoe.

Learn how to fall. Even experienced skateboarders can fall. Learning how to fall safely can help reduce the risk and severity of injuries. The Consumer Product Safety Commission recommends:

• If you are losing your balance, crouch down on the skateboard so you will not have so far to fall.
• Try to land on fleshy parts of your body when falling.
• Try to roll as you fall, which prevents your hands, wrists and arms from absorbing all the force.
• Try to relax, rather than remaining stiff when falling.

Helmet: To protect your head from injury, always wear a properly fitting helmet. This is true no matter what your age, level of experience or location where you are skateboarding. Get a quality bicycle or multi-sport helmet. It should meet or exceed safety standards of the U.S Consumer Product Safety Commission (CPSC) or Snell Memorial Foundation of the American National Standards Institute (ANSI). You may need to try on several sizes and models to find a helmet that fits your head correctly and securely. A properly fitting helmet:

• Is worn flat on your head with the bottom edge parallel to the ground.
• Sits low on your forehead.
• Has side straps that form a "V" shape around each ear.
• Has a buckle that fastens tightly (there should be room to put only two fingers between the strap and your chin).
• Has pads inside that you install or remove so the helmet fits snuggly.
• Does not move in any direction when you shake your head.
• Does not interfere with your movement, vision or hearing.

Replace your helmet when it is damaged, outgrown or at least every five years. You may need to replace it sooner if the manufacturer recommends it.

Wrist guards, knee and elbow pads and other gear: Wrist guards help support the wrist and reduce the chances of breaking a bone if you fall. Knee and elbow pads reduce the severity of cuts and scrapes, and prevent gravel burns. Riders should also wear closed, slip-resistant shoes.

Skateboard only on smooth pavement away from traffic, preferably in a supervised skate park.

• Never hold onto the side or rear of a moving vehicle while riding a skateboard ("skitching"). Riders can easily fall or be thrown into oncoming traffic if the vehicle suddenly slows, stops or turns.
• Never use your skateboard in wet weather.
• Avoid skateboarding in crowded walkways or in darkness.
• Always screen the area before you skateboard, inspecting surfaces for irregularities, rocks and other debris.

Be careful with tricks and jumps. Skateboarding skill is not acquired quickly or easily. Don't take chances by skateboarding faster than your experience allows, or faster than is safe for conditions or the speed of other skateboarders. If you try tricks and jumps, practice them only in a controlled environment, such as a skate park that has adult supervision and appropriate access to emergency medical care.

Stay in shape. Prevent skateboarding injuries by keeping in top physical condition. Stretch and do conditioning exercises before and after skateboarding.

Do not use headphones while skateboarding.

Never put more than one person on a skateboard.

Be considerate of fellow skateboarders, especially those who are younger and/or less skilled.

Know what to do in an emergency. Skateboarding accidents happen, so you should always know what to do in emergency situations. Don't panic. Call 911 for medical assistance or an ambulance.

Be safe, have fun. When proper precautions are taken, the potential for injuries can be reduced and skateboarding can be a relatively safe, enjoyable activity.

References:

1. American Academy of Pediatrics, 2004.
2. Consumer Product Safety Commission, 2003.
3. Sheehan E, MulhallK J, Kearns S, O’Connor P, McManus F, Stephens M, and McCormack D, Impact of dedicated skate parks on the severity and incidence of skateboard- and rollerblade-related pediatric fractures, J Pediatr Orthop 2003 Jul-Aug;23(4):440.

© June 2005 American Academy of Orthopaedic Surgeons

This material may not be modified without the express written permission of the American Academy of Orthopaedic Surgeons®.

Position Statement 1168

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