In-line skating requires endurance, balance and strength which is developed over time. In addition, novice skaters tend to underestimate their speed while skating and can have a hard time stopping. Less experienced skaters can also lose their balance while skating due to environmental hazards such as gravel, debris, road defects and obstacles. The typical reaction of a novice skater is to fall with outstretched arms which can result in hyper-extension, and subsequent breakage, of the wrist. As children become increasingly comfortable with in-line skating, they are more likely to attempt manoeuvres that are beyond their skill level, such as stunts. Using the street environment increases children’s exposure to automobiles, bicycles and pedestrians which results in a higher risk of injury.1, 2
Fractures are the most common injuries seen in emergency departments for children as a result of in-line skating. Almost 50 per cent of injuries are fractures.3 Injuries to the upper extremities, the wrist and hand in particular, are common.2 Recent research indicates that four per cent of childhood in-line injuries result in brain injury.3
A head injury can permanently affect a child’s cognitive ability and function level. A properly fitted helmet can decrease the risk of brain injury by 80 per cent.4, 5 This means that four out of five brain injuries can be prevented if every in-line skater wears a helmet.
Bike helmets can be used for in-line skating and either CPSC, CSA, ASTM or Snell certification is important. A multisport helmet satisfies safety standards for more than one activity and is another viable option as long as the helmet labelling clearly indicates what activity it has been tested for. Contact the manufacturer for clarification.
Almost 50 per cent of in-line injuries are fractures.3 The most common type of fracture from in-line skating is forearm fractures (60 per cent), followed by ankle fractures (15 per cent) and elbow fractures (10 per cent).6 Wrist guards have been proven to provide protection against wrist fractures1 because they are designed to prevent sudden extreme hyperextension, to absorb shock and dissipate forces by allowing skaters to slide forward on a hard surface.2 Elbow pads and knee pads may also protect against injury, although there is limited scientific evidence reflecting this.
1 Schieber RA, Branche-Dorsey CM, Ryan GW, Rutherford GW, Jr., Stevens JA, O'Neil J. Risk factors for injuries from in-line skating and the effectiveness of safety gear. N Engl J Med 1996;335(22):1630-5.
2 Nguyen D, Letts M. In-line skating injuries in children: a 10-year review. J Pediatr Orthop 2001;21(5):613-8.
3 Public Health Agency of Canada. Injuries associated with wheeled, non-motorized devices. In. Ottawa: The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), All ages, 1990-2007.
4 Thompson DC, Rivara F, Thompson R. Helmets for preventing head and facial injuries in bicyclists. The Cochrane Database of Systematic Reviews 2009(1).
5 Attewell RG, Glase K, McFadden M. Bicycle helmet efficacy: a meta-analysis. Accid Anal Prev 2001;33(3):345-52.
6 Zalavras C, Nikolopoulou G, Essin D, Manjra N, Zionts LE. Pediatric fractures during skateboarding, roller skating, and scooter riding. Am J Sports Med 2005;33(4):568-73.