Biking (Care of the Young Athlete)

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Biking is a fun way for children of all ages to
get active and stay fit. Most children learn to ride a tricycle at around 3
years of age. Between 4 and 7 years of age most children learn to ride a bike.
However, remember that each child is different and will learn to ride a bike at
his or her own pace.

Biking can be an athlete’s primary sport, as
well as a way for athletes to cross-train and avoid overuse injuries. Injured
athletes often use biking to stay in shape during rehabilitation before
returning to their sport.

While not all injuries can be prevented, the risk of
injuries can be reduced. The following is information from the American Academy
of Pediatrics about how to choose a bike and prevent biking injuries. Also
included is an overview of common biking injuries.

How to choose a bike

Parents should choose a bike that allows the
child to sit on the seat and touch both feet on the ground. Also, while standing
there should only be a few inches between the top center bar of the bike and the
child’s inner groin or crotch area. Tricycles allow a child to practice
steering and pedaling. Bicycles with training wheels or bikes with no pedals can
help with balance when learning to ride. Avoid purchasing a larger bike for the
child to “grow into.”

Injury prevention and safety tips

  • Equipment. Safety gear
    should fit properly and be well maintained.

    • Helmets. Everyone
      riding a tricycle or bike should wear a helmet. Helmets are the
      most important protective gear for bikers. Parents should set a
      good example by always wearing their helmets too. Helmets should
      fit appropriately, and the straps should be fastened. Helmets
      should meet the standards set by the Consumer Product Safety

    • Clothing. When
      biking, children should wear bright-colored clothing so they are
      easily seen by other bikers, walkers, and drivers. Pant cuffs
      should be tight to avoid getting caught in the wheels or

    • Shoes. Sturdy,
      closed-toed shoes should be worn to protect the toes. Shoelaces
      should be tied securely.

    • Pads (knee, elbow,
      and wrist pads) are useful, particularly for beginners or trick

    • Reflectors should not be removed from children’s

  • Environment. When a child
    is learning to ride a bike, the area should be free of traffic and
    distractions. Parents should also choose areas without gravel, loose
    sand, or puddles. Learning to ride on a softer surface like grass will
    lower the risk of an injury from falls. It is always best to stay on a
    designated bike path. Children should not bike in the dark or twilight
    hours because it can be difficult for them to see or be seen.

  • Rules. Bikers should follow
    the rules of the road at all times, including

    • When crossing roads, get off the
      bike and walk across the road.

    • Observe stop signs.

    • Ride with traffic and stay as
      far to the right as allowed when riding on the road.

    • Do not wear headphones, text, or
      talk on a cell phone while biking.

Common injuries

Head injuries

Some of the most severe biking injuries
involve head trauma. Helmets have been shown to decrease the number and
severity of injuries. When a child has a head injury, the parent should stay
calm and assess the situation. If the child is not awake, call 911 or your
local emergency number right away. The parent should hold the head and neck
very still and avoid moving the child until help arrives. Bleeding can be
controlled with gentle pressure and a cold pack. If the child is awake but
complaining of a headache, blurry vision, ringing in the ears, nausea, or
dizziness, see a doctor right away. These can be signs of a serious head
injury (concussion).

Abdominal and groin injuries

Abdominal injuries can happen when a child
falls and the end of the handle bar hits the abdomen (stomach). Any child
with stomach pain, hematuria (blood in the urine), or vomiting should see a
doctor. Special tests will be ordered to make sure there has been no major

Groin injuries can happen when a child falls
on the center bar of the bike. Any child with bleeding, persistent pain, or
problems urinating should see a doctor. Minor injuries can be treated with
rest, pain medicine, and cold packs.

Fractures (broken bones)

Before a child stops growing, broken bones
are more common than sprains or dislocations when a child falls. This is
especially common in the wrist and ankle. If the child will not bear weight
or if you push on the bone and it hurts, the child should see a doctor for
an x-ray. Severe pain or obvious deformity is also a sign of a fracture.
Parents can immobilize the injury with a piece of cardboard and an ACE wrap.
Ice, not heat, should be applied and the arm or leg should be elevated.
Nonprescription pain medicine can be given to the child.

Soft tissue injuries

Soft tissue injuries include cuts, scrapes,
and bruises. Cuts and scrapes (“road rash”) should be cleaned
thoroughly with soap and water to remove dirt and debris. In most cases,
disinfectants such as betadine or hydrogen peroxide are not necessary. Deep
cuts or scrapes with gravel, glass, or splinters in them should be evaluated
by a doctor. The area should be dressed with a clean bandage. Ice packs can
then help to reduce pain and swelling. See a doctor if the area shows any
signs of infection (such as fever or if the skin around the wound becomes
red, warm, or swollen or drains pus).


Biking injuries can be prevented when the rules
of the road are followed. And most importantly, everyone (including parents)
should wear a properly fitted helmet when riding a bike.