Kids Bikes: Are cycling and football the most dangerous sports for children?

By Nestor Lopez-Duran PhD

The journal of the American Academy of Pediatrics just published a fascinating examination of emergency room visits for concussions from 2001 to 2005 in 100 US hospitals among kids aged 8 to 19. The authors were particularly interested in examining the role of sports in concussion-related ER visits.

– Of 502,784 concussions among 8-19 years old, 50% were sports related injuries.

– Among pre-high school kids (8-13 y old), 58% of all concussions were sports related.

– Among high school kids (14-19y old), 46% of concussions were sports related.

Which sports sends the most kids to the hospital for concussions?

Here is a graph showing the % of all sports related concussions accounted by each sport/activity for8-13 year old kids:

As you can see above, for kids age 8-13, cycling accounted for the highest percentage of sports related concussions (18%), football was a close second, accounting for about 10% of all sports related brain injuries.

Now here is the same graph for older teens (14 to 19 years old):

In older teens, football is, by far, responsible for more concussions than any other activity or sport: football accounted for close to 40% of all sports related concussions. Basketball and Soccer each accounted for over 10% of sports related concussions. In contrast, cycling accounted for just over 5% of concussions among these older kids.

Whats a parent to do?

Before you put your kids bike on craigslist, there is something you need to know about these data. Cycling could be considered the most dangerous sport for young kids as so far as it is responsible for the highest percentage of sports related brain injuries. However, cycling is also extremely popular, with millions of kids riding bikes every year. This popularity could explain why cycling accounts for so many ER visits. So the data presented today doesnt help us understand the probability of injury when participating in each sport, which I would consider a better definition of dangerous. Let me give you an example with FABRICATED DATA. Imagine that cycling results in 1 brain injury for every 100,000 child bike user hours (for every 100,000 hours that a child is riding a bike, one child will have a brain injury). In contrast, snowboarding may result in 1 brain injury for every 1,000 snowboarding hours. In this scenario, the risk of experiencing a brain injury is significantly higher when snowboarding than when cycling. Specifically, you could argue that snowboarding is 100 times more dangerous than cycling. Yet, because cycling is significantly more popular (in terms of use) than snowboarding, cycling would send more people to the hospital. (Again these last statements are based on a hypothetical case with fabricated data. I dont really know if snowboarding is more dangerous than cycling.)

So the graphics presented above tell us which sports and activities are sending the most people to the hospital, but not necessarily which sport/activity is the most dangerous in terms of the probability of injury to the participants.

What would I do? I would likely minimize (but not forbid) cycling in my kids until they are 13, and I would enforce a no exceptions helmets on at all times policy when they ride their bikes. If my kid decides he wants to play football, I would enforce a 1-2 concussion limit, because the danger of a catastrophic event (e.g., second impact syndrome) increases dramatically after you experience a concussion. Here is a wonderful website about youth sports concussion by the CDC.

The reference:
Bakhos, L., Lockhart, G., Myers, R., & Linakis, J. (2010). Emergency Department Visits for Concussion in Young Child Athletes PEDIATRICS, 126 (3) DOI: 10.1542/peds.2009-3101