Preventing in-line skating injuries: how effective are the countermeasures?

There was a six-fold growth in participation in in-line skating in the US from 1989 to 1996 and a concomitant increase in injuries. Similar trends have been reported in Canada, the UK, Denmark and Australia. Falls, mostly from loss of balance, are a common cause of injury. Falling skaters typically put one or both hands out to break their fall and land on a hard surface with the upper limb sustaining the injury. Approximately one-quarter of all in-line skating injuries are wrist fractures. Hospital emergency department data shows that skaters aged 10 to 14 years are most at risk for injury. First-time skaters, inexperienced skaters and experienced skaters trying new tricks are also at risk for injury. In-line skating injuries can be severe, with several deaths reported. Measures to prevent in-line skating injury include: wearing personal protective equipment (wrist guards, helmets, knee and elbow pads); improving environmental conditions for skaters; providing lessons, particularly for novice skaters; certification for skating instructors; encouraging physical preparation; educating skaters about safety; improving equipment design and standards; and refining government policy and regulation in consultation with skating groups. Few of these measures have been formally proven to reduce injury. Controlled evaluations of the currently advocated methods are needed to establish their efficacy. More biomechanical and epidemiological research is needed, particularly in the area of wrist/forearm injury prevention. Given the rapid increase in popularity of in-line skating and the potential for a related epidemic of moderate to serious injuries, research into in-line skating injury prevention should be a priority.