Safety Gear and Injuries from In-Line Skating


Synopsis: Wrist guards and elbow pads are effective in protecting in-line skaters against injuries.

Source: Schieber RA, et al. Risk factors for injuries from in-line skating and the effectiveness of safety gear. N Engl J Med 1996;335:1630-1635.

Interviews were conducted with 161 subjects treated for injuries sustained from in-line skating in 91 hospital emergency departments participating in the National Electronic Injury Surveillance System. Wrist injuries were most common, and 25% of all injuries were wrist fractures. Forty-six percent of skaters used no safety gear; 45% wore knee pads; 33% wrist guards; 28% elbow pads; and 20% helmets. Seven percent used all four types of safety gear. Wrist injuries among skaters who did not use wrist guards were 12.9 times greater than those who wore wrist guards. Those not wearing elbow guards were 8.0 times more likely to have elbow injuries. No significant benefit was noted for use of knee pads or helmets, but the numbers were too small to make definite conclusions.


In-line skating represents a recreational activity of growing popularity, as indicated by the 22.5 million estimated participants in 1995, a 79% increase over 1993. Injuries will occur in a sport that can generate velocities of between 10-17 mph and can create falls and collisions with moveable and non-movable objects. All attempts must be made to prevent injury, including safety equipment, instruction, and appropriate skating environments. Adults must be proactive in assuring that proper choices are made by young beginners who appear to be at greatest risk.

The current study by Schieber et al demonstrates the value of elbow pads and wrist guards. Unfortunately, the severity of injury and the specific mechanism were not included; they would have been important in the determination of the need to design improved safety equipment. The authors also imply other safety and etiologic variables to consider, including instructions, stopping techniques, tricks, etc.—but as they state, using an injured population as a control group to define etiologic variables is not ideal.

The authors have demonstrated a need to inform patients of the risks, benefits, and injury prevention considerations for in-line skating because, as skaters increased 79% from 1993-1995, injuries increased 169%. It is im portant to perform future studies to obtain a clear understanding of the severity of in-line skating injuries to determine the need for improved safety equipment. (Dr. Goldberg is Clinical Professor of Pediatrics and Director of Sports Medicine at the Yale University Health Service.)