Bikes, in-line skating, skateboarding, and scooters are very popular among children between ages 5 and 14. These activities are a great form of exercise. But without protective gear, they can be dangerous. According to the National SAFE KIDS Campaign, bike injuries accounted for more than half of the visits to the emergency room for those younger than age 19.

The most common (and often most serious) injury sustained with these activities is a head injury. Head injuries are the leading cause of death and disability in these types of crashes. Wearing a helmet can reduce the risk of death or injury. It can also reduce the severity of the injury in a crash.

Wearing a helmet whenever riding a bike, in-line skates, skateboard, or scooter should be an automatic habit. Helmets should fit correctly on your child's head and also be fastened correctly. A correctly fitting and fastened helmet does not move around on the head.

Teaching your children bike, in-line skating, skateboarding, and scooter safety could save lives. It is important for parents to model good behavior by always wearing a helmet yourself when taking part in these activities.

Biking is very popular. In fact, millions of Americans ride bikes of many different types. For safe and enjoyable biking, cyclists of all ages should follow safe riding habits. Children and adults should always wear helmets when riding bicycles. According to SAFE KIDS:

• When bike helmets fit correctly and are used, they can lower the risk for head injury by at least 45%.
• Fewer than half of children age 14 years or younger wear a helmet.

Here are suggestions for buying a helmet:

• Helmets should be approved by the Consumer Product Safety Commission, the Snell Foundation, or the American Society for Testing and Materials.
• The helmet should fit comfortably and snugly. It should sit on the head in a level position. It shouldn't rock from side to side or front to back.
• The helmet should have a chin strap and buckle to keep the helmet in place. The helmet should always be buckled when worn.
• The helmet should be made out of a hard outer shell and an absorbing liner at least ½ inch thick.

Many children (and adults) resist wearing a helmet. Point out that athletes wear helmets for their protection. Be sure to include your child when buying a helmet so they can help with the choice.

Suggestions for preventing bike injuries:

• You can't control a bike that is too large. You should be able to straddle the bike and stand with both feet flat on the ground.
• Younger children may need to ride a bike with training wheels.
• A child must be able to stop the bike by using the brakes.
• Everyone needs to learn the proper hand signals for left turns, right turns, and stopping. Make sure you understand and observe all traffic signals and signs. Children who aren't yet coordinated enough to use hand signals and still maintain control of their bike should not ride in the street.
• Children should ride on sidewalks until they are at least 10 or 11 years old.
• Anyone riding a bicycle should look left, right, and left again, before riding into traffic from a sidewalk, driveway, or parking lot.
• When riding on the street, children should be single file, in a straight line near the curb. They should be alert for car doors opening into traffic lanes. Both children and adults should ride with traffic, not against it.
• Children shouldn't ride a bike at dusk or at night. This is when most fatal accidents happen. If a child is still outside when it turns dark, the bicycle light must be turned on and the child should be wearing light or reflective clothing.
• The bike must have safety reflectors. All bikes should have reflectors on the front, rear, and wheel spokes.

In-line skating is another popular sport on wheels for many people. But even experienced in-line skaters can crash and sustain injuries. The following recommendations are from the U.S. Consumer Product Safety Commission and the American Academy of Pediatrics:

• Always wear protective gear, such as elbow and knee pads, gloves, helmets, and wrist guards.
• Buy durable skates with the correct ankle support.
• Always warm up your muscles before starting by skating slowly for 5 minutes or more.
• Skate with knees slightly bent to maintain balance.
• Practice stopping correctly without losing balance.
• Always skate on the right side of sidewalks and other paths.
• Pass on the left and warn others that you are passing.
• Don't skate in the street, especially where there is a lot of traffic.
• Look for and avoid uneven pavement or other surface problems.
• Check your skates regularly for wear and tear. Make sure the wheels are tightened.
• Obey all traffic rules.

Skateboards are very popular among children ages 5 to 14. The American Academy of Pediatrics states that children younger than age 5 should not skateboard at all. They also state that children ages 6 to 10 should skateboard only with adult supervision. Skateboards should never be used on surface streets. Even experienced skateboarders can fall, so learning how to fall safely can help reduce the risk of severe injuries. Here is some advice on how to fall correctly:

• When losing your balance, crouch down on the skateboard so you have a shorter distance to fall.
• Try to land on fleshy parts of your body when falling.
• Try to roll as you fall. This prevents your arms from absorbing all the force.
• Try to relax, rather than staying stiff when falling.

Other safety precautions to take when skateboarding include:

• Wear protective gear, such as helmets, padding for wrists, elbows, and knees, and closed-toe and slip-resistant shoes.
• Check the skateboard often for wear and tear.
• Only allow one person per skateboard.
• Don't hang onto bikes, cars, or other vehicles while skateboarding.
• Carefully practice tricks in designated skateboarding areas.
• Don't skateboard in the street.

Manual (push) scooters have been around since the 1950s. Today's scooters, including motorized or electric scooters, are often made of lightweight material. They have quickly risen in popularity. And they are the cause of more and more emergency room visits. Health officials have seen a dramatic increase in scooter-related accidents and injuries. The most common injuries are breaks (fractures) or dislocations to the arm or hand. These are followed by cuts, bruises, strains, and sprains. Almost half of all injuries tend to happen to the arm or hand. About 1 in 4 injuries occurs to the head. Another 1 in 4 happens to the leg or foot. There have also been deaths directly related to scooter accidents.

The National SAFE KIDS campaign advises the same safety measures for scooters as for biking and in-line skating. It's thought that many injuries might be prevented or not as severe if protective equipment is worn. Wrist guards are effective in preventing injuries among in-line skaters. But it's not known how much protection they provide against scooter injuries. That's because wrist guards may make it hard to grip the scooter handle and steer it.

Based on effective injury prevention for other related activities, these tips may help to prevent scooter-related injuries:

• Wear an approved helmet that meets safety standards.
• Use knee and elbow pads.
• Ride scooters on smooth, paved surfaces without traffic. Don't ride on streets and surfaces with water, sand, gravel, or dirt.
• Don't ride scooters at night.
• Don't text while riding. Don't use earbuds while riding.

Riding a scooter requires balance and coordination. Children younger than 8 years old shouldn't ride a scooter. According to the American Academy of Pediatrics, children younger than age 16 shouldn't ride motorized or electric scooters.