Safe Cycling

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Barbara K. Hecht, PhD

According to the CDC (Centers for Disease Control and Prevention), each year more than 700 people are killed and over 500,000 are treated in emergency rooms as a result of bicycling injuries in the U.S. Children between the ages of 5 and 14 are particularly prone to bicycle-related injuries and account for the majority of those treated for cycling injuries in hospital emergency rooms.

While the most common injuries from bicycle accidents involve the arms or legs, head injuries account for over 60% of the deaths. Helmets are an effective safety measure. They reduce the incidence of brain injury from bicycle crashes, but most riders do not wear helmets or use them intermittently or incorrectly. No more than 25% of all children use helmets appropriately when bicycling, and helmet use declines with age.

Statistics provide a compelling argument for bike helmets. Brain injuries are reduced by as much as 88% and head injuries by 85% through proper helmet use. Riders without a helmet are 14 times more likely to die in a bicycle crash than those wearing helmets. Twenty-two states and the District of Columbia have enacted some form of bicycle helmet legislation, and numerous local governments have established helmet laws as well.

Behavior is another major contributor to bike injuries. Boys under 14 are more likely to be killed or injured than girls, and most fatal crashes are in some way associated with the bicyclist's behavior. Disobeying stop signs, swerving into traffic, and riding against traffic flow are some of the behaviors that have been connected to cycling fatalities.

Following are some general rules and safety tips for yourself and children to a follow while riding a bike.

The five rules to avoid fatal crashes:

  1. Never ride out into a street without stopping first. Kids must learn to stop, look left, look right, look left again, and listen to be sure no cars are coming before entering a street. Look left that second time because cars coming from the left are on the child's side of the street and are closer. Use your driveway or sidewalk to demonstrate this way to enter a street. Have the child practice the entry, looking left, looking right, and looking left again. Make sure that they understand that because they see a car does not mean the driver sees them. They must always assume that the driver has not seen them.

  2. Obey stop signs. Nearly one-third of the car-bike crashes with a young child occur when a child rides through a stop sign or red light without yielding to crossing traffic. Kids must learn to stop, look left, look right, then look left again at all stop signs, stop lights, and intersections before crossing, Make sure they know the basics about stop signs and stop lights. Then take your child to a controlled intersection and practice crossing safely. Explain that when riding in a group, each bicyclist must stop and make sure it is clear before crossing. (See Rule #4 below.) Teach young children to walk their bikes through busy intersections. Remind them that it is the law to obey traffic signals even when no one appears to be coming. It's a good idea to explain one-way streets to them, too.

  3. Check behind you before swerving, turning, or changing lanes. Nearly one-third of the car-bike crashes involving children occur when a child turns suddenly into the path of faster moving traffic. Kids must learn to look behind them, signal, and look behind again before swerving, turning, or changing lanes. The best place to practice this is in a quiet parking lot or playground. Stand behind them while they ride along a straight painted line. Hold up numbered cards and have them practice looking back over their shoulder and telling you the number on the card -- without swerving off the painted line. Children should not be allowed to ride their bikes on the street alone until they have mastered this skill.

  4. Never follow another rider without applying the rules. Many fatalities occur when the first rider violates one of the three rules above and the second one just blindly follows. The statistic shows one of the three rules above caused the crash, but the real reason was following another rider. Running stop signs or red lights, riding out of driveways, or zipping across lanes all seem natural to the second child because they are more focused on following the other rider than on the rules.

  5. Before you get on your bike, put on a helmet! Every year, over 800 people die in the U.S. from bicycle crashes. Most of them die from head injuries. Many more sustain permanent damage from head injuries. Brain damage can cause learning disabilities, personality changes, and rob your child of the ability to think clearly. Hospital emergency room studies show that a helmet can prevent about 85% of head injuries. So, you don't want your child riding a bike without one, even on your block, on the sidewalk, or on a bike trail.

  6. Wear a helmet every time you ride. Parents should set an example for their children and wear helmets, too. It's hard to explain the importance of helmets to a child when you are not wearing one yourself.

Make sure that helmets have a label in them indicating that they conform to or exceed the safety standard established by the U.S. CPSC (Consumer Product Safety Commission).

Make sure bicycle helmets fit properly. Helmets should sit level on top of the head and not rock from side to side or from front to back. Helmets should not be worn at an angle on the back of the head. Straps should be buckled snugly but not too tightly. A good bicycle dealer can assist you in fitting helmets. Poorly-fitting helmets can actually increase the chances of being injured or killed should a crash occur.

Getting started, tips for beginners:

  • Be sure the bike is the proper size. The cyclist should be able to straddle the bike with both feet on the ground. Don't buy a bicycle for a child to "grow into." Take the child with you when shopping for their bicycle.

  • Gear: Start with a helmet, gloves to protect the skin on their hands, and perhaps even skaters' knee and elbow pads for the first rides. Adjust the bicycle for your child and be sure they can reach pedals, handlebars, and brakes comfortably. Wear shoes when riding a bicycle. It is not smart to go barefoot or to wear open-style shoes.

  • Brakes first! Show your kid how to stop the bike. Hold them up and gently move them forward as they use the brakes to stop until you are sure they know how.

  • Balance: Run alongside the bike, holding it up by the seat with one hand on the handlebars to show how you turn them to keep the bike upright.

  • Riding: Nobody learns without practice. Riding with your child is probably the best way to practice the rules. Go over the rules, then ride, stopping occasionally to review what they have just done and praise their good performance. As with almost any other skill, practice is required to ingrain techniques. More than one session will be needed. But the result is worth your time.

Protecting yourself while bike riding at night

Young children should never ride their bikes at night. Riding a bicycle safely after dark requires additional skills and precautions. For example, the rider should wear light-colored or reflective clothing, and their bike should be equipped with appropriate lights and reflectors.

Because of a sharp increase in the number of bicyclist fatalities resulting from car-bike collisions at night, the follow these tips when riding a bicycle at night:

  1. Use a headlight.

  2. Be sure your bike has front and rear reflectors, pedal reflectors, and side rim or wheel reflectors.

  3. Wear reflective clothing.

  4. Always wear a CPSC-approved helmet.

  5. Young children should not ride at night.

  6. Avoid riding on dark, narrow roadways.

Reference: National Highway Traffic Safety Administration (NHTSA),


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