Relevant Biomechanical Variables in Skateboarding: A Literature Review

Skateboarding, once regarded primarily as a means of transportation and entertainment for youth, has become a recognized professional sport, gaining global popularity. With its recent inclusion in the Olympics, a growing imperative exists to comprehensively understand biomechanics explaining skateboarding performance. This literature review seeks to consolidate knowledge within this domain, focusing on experimental and modeling studies about skateboard riding and tricks. The criteria for study selection encompassed content relevance and publication year, spanning from the last two decades and extending further back to 1980 following cross-referencing of seminal works. Peer-reviewed journal articles, conference proceedings, and books were considered, with comprehensive searches conducted on electronic databases, including SCOPUS, PubMed, Scielo, and Taylor & Francis. Comprehending the biomechanical facets of skateboarding is essential in promoting its use and ensuring safety among all practitioners. Insights into factors such as body kinetics, kinematics, and muscle activation represent a foundational step toward understanding the nuances of this sport with implications for both clinical and biomechanical research. Modern data collection systems such as inertial measurement units (IMU) and electromyography (EMG) offer unprecedented insights into human performance during skateboarding, such as joint range of motion, coordination, and muscle activation, whether in casual riding or executing complex tricks and maneuvers. Developing robust modeling approaches also holds promise for enhancing skateboarding training and performance. Crucially, these models can serve as the initial framework for understanding injury mechanisms and implementing strategies to improve performance and mitigate injury risks.

Epidemiology of skateboarding-related injuries sustained by children and adolescents 5-19 years of age and treated in US emergency departments: 1990 through 2008

Background

The goal was to examine the patterns and trends of skateboarding-related injuries sustained by children and adolescents in the United States.

Methods

A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System for children and adolescents 5-19 years of age treated in emergency departments for injuries associated with skateboards from 1990 through 2008.

Results

An estimated 1 226 868 children/adolescents (95 % CI: 948 733—1 505 003) were treated in emergency departments for skateboarding-related injuries from 1990 through 2008, an average of 64,572 cases per year. From 1990 through 1994, the annual rate of injuries per 10,000 children/adolescents significantly decreased overall and for males (overall: 72.9 %, P = 0.014; males: 73.9 %, P = 0.011; females: 63.6 %, P = 0.062). From 1994 to 2008, annual rates of injuries per 10,000 children/adolescents significantly increased overall and for both males and females (overall: 378.9 %, P < 0.001; males: 393.4 %, P < 0.001; females: 283.3 % P < 0.001). From 1990 to 1994 the annual rate of injuries per 10,000 children/adolescents significantly decreased for all age groups (5-10 years: 69.9 %, P = 0.043; 11-14 years: 80.6 %, P = 0.017; 15-19 years: 64.2 %, P = 0.024), and then significantly increased from 1994 to 2008 (5-10 years: 164.5 %, P < 0.001; 11-14 years: 587.0 %, P < 0.001; 15-19 years: 407.9 %, P < 0.001).

Most patients were male (89.0 %), injured at home (37.3 %) or in the street and/or highway (29.3 %), and were not hospitalized (96.9 %). Patients 11-14 years of age constituted 44.9 % of cases. The most commonly injured body regions were the upper (44.1 %) and lower (31.7 %) extremities. Fractures and dislocations were the most common diagnoses (32.1 %). Children/adolescents 11-14 years of age were hospitalized more often than younger or older children/adolescents. Lower extremity injuries increased with age, while face and head or neck injuries decreased with age.

Conclusions

Skateboarding continues to be an important source of injury for children and adolescents. Further research, using more rigorous study designs, is required develop a broad perspective of the incidence and determinants of injury, and to further identify risk factors and viable injury countermeasures while simultaneously promoting participation in skateboarding.

Head injuries in hospital-admitted adolescents and adults with skateboard-related trauma

OBJECTIVE

To provide new information on properties of skateboarders who were hospital admitted with head injuries with details of the injuries including region of head impact.

METHODS

Hospital records of patients aged 15 and older with a skateboard injury admitted to one Level II Trauma Centre during a 10-year period were reviewed. Data on demographic, exposure, severity, diagnostic and clinical factors for patients with head injury (HI) and without HI (N-HI) were compared analytically.

RESULTS

While there were no differences for patients with HI and N-HI by age, gender, mechanism of injury or alcohol use, patients with HI were more severely injured. Although significantly more head impacts occurred to the occipital region of the head, haematomas and/or contusions were much more likely to occur in the frontal region of the brain. Acute neurosurgical intervention was needed in 14% of HI skateboarders.

CONCLUSION

Skateboarding is not an innocuous recreational activity, with head injury present in 75% of patients who were hospital-admitted. Pre-hospital treatment protocols should be aware of this growing injured population. Falls while on a skateboard lead to impacts to the back of head with a contra-coup brain injury resulting in severe and sometimes fatal outcomes. The very low prevalence of helmet use among skateboarders with head injuries indicates that greater efforts should be directed toward incentives for their use.

Epidemiological and clinical features of an older high-risk population of skateboarders

BACKGROUND

Skateboard injuries have been described in the media and scientific journals as a problem prevalent among children and adolescents. Skateboarding popularity has continued to grow since the 1970s with ridership increasing to include all age groups. Recently, surgeons at one trauma centre at an urban hospital noted an increase in the number of older skateboarders with life-threatening injuries. We hypothesise that the clinical and epidemiological features of skateboard-related injuries from one trauma centre (TC) will be different from injured skateboarders identified in the U.S. National Trauma Data Bank (NTDB). We also sought to identify factors related to poor outcomes in the TC and NTDB patient groups.

METHODS

Two injured skateboarder patient groups were identified and compared using proportional morbidity odds ratios (PMORs) and multivariable methods to estimate differences among factors common to both groups of patients. Clinical and demographic features were evaluated for hospital admitted patients injured whilst riding a skateboard. Chi-square tests, PMORs and logistic regression were used to determine outcome differences between patients in both groups.

RESULTS

Patients in the TC group were on average older, with higher Injury Severity Scores (ISS), more head injuries requiring neurosurgical intervention, longer ICU and hospital stays, and injured more frequently on local streets than patients in the NTDB series. Poor outcomes in the TC group were related to moderate or severe head injuries and presence of a head/face injury. For NTDB patients, a GCS of <13, a head/face injury and an ISS of 25+ were related to poor outcomes.

CONCLUSIONS

From our Trauma Centre we describe an older injured skateboarding population, clinically and epidemiologically different from injured patients identified in the NTDB as well as those described in the literature. The greater severity of injury, including traumatic brain injury, has direct implications for preventive and educational measures and the planning of emergency surgical response.

Skateboard-related injuries: not to be taken lightly. A National Trauma Databank Analysis

BACKGROUND

With the increasing popularity of skateboarding, trauma centers are experiencing increased number of skateboard injuries. The incidence and type of injuries and the effect of age on these variables are poorly described in the literature.

METHODS

Data from National Trauma Databank during a 5-year period was used for this study. Injury Severity Score (ISS), injured body area, specific injuries, and outcomes were calculated according to age groups (younger than 10 years, 10-16 years, and older than 16 years).

RESULTS

During the study period, there were 2,270 admissions due to skateboard-related injuries (0.1% of all trauma admissions). There were 187 patients (8%) younger than 10 years, 1,314 patients (58%) 10 years to 16 years, and 769 patients (34%) older than 16 years. The overall mortality was 1.1% and ranged from 0% in the age group younger than 10 years to 0.3% in the group 10 years to 16 years and 2.6% in the group older than 16 years (p < 0.001). The incidence of severe trauma (Injury Severity Score ≥ 16) in the three age groups was 5.4%, 13.5%, and 23.7%, respectively (p < 0.001). The incidence of traumatic brain injury in the three age groups was 24.1%, 32.6%, and 45.5%, respectively (p < 0.001). The younger age group (younger than 10 years) was significantly more likely to suffer femur fractures and less likely to suffer tibia fractures than the older age groups. Helmets and use of a skateboard park were significant factors protecting against head injury.

CONCLUSION

Skateboard-related injuries are associated with a high incidence of traumatic brain injury and long bone fractures. Age plays an important role in the anatomic distribution of injuries, injury severity, and outcomes. Our findings demonstrate that helmet utilization and designated skateboard areas significantly reduce the incidence of serious head injuries.

Use of protective equipment by adolescents in inline skating, skateboarding, and snowboarding

OBJECTIVES

Determine the frequency of personal protective equipment (PPE) use in adolescent inline skaters, skateboarders, and snowboarders; explore factors influencing PPE use; identify factors that would influence use; and examine the association of high-risk behaviors and PPE use.

DESIGN

Cross-sectional survey.

SETTING

Central/southeast Wisconsin.

PARTICIPANTS

Participants 13-18 years-old.

INTERVENTIONS

None. Independent variables = age, gender, sport.

MAIN OUTCOME MEASUREMENTS

None. Dependent variables = PPE use, factors influencing use, and frequency of other high-risk behaviors.

RESULTS

The mean age of 333 participiants was 14.9 years. Adolescents wore considerably less PPE than recommended. Inline skaters wore the most; snowboarders the least. The most common reasons adolescents wore PPE were parents, peers, and rule/requirement. Younger adolescents cited parents more often than older adolescents as a factor for PPE use. Discomfort and lack of perceived need were the most common reasons for nonuse. Sustaining/witnessing an accident was the most common reason that would convince adolescents to wear PPE. Almost half of adolescents reported nothing would convince them to wear PPE. Younger adolescents wore more PPE than older adolescents. An association was seen between PPE use in all sports and bicycle helmets. An inverse relationship was found for tobacco and helmet use among skaters, as well as alcohol and helmet use in skateboarders.

CONCLUSIONS

Adolescents underuse PPE. PPE reinforcement by parents/peers, encouraging bike helmets, manufacturing more comfortable gear, educating adolescents, and instituting PPE requirements in public areas may increase compliance. This could lead to decreased injuries. Physicians should discuss PPE with their patients/families. There may be an association between PPE use in extreme sports and decreased high-risk health behaviors.

Pediatric fractures during skateboarding, roller skating, and scooter riding

BACKGROUND

Skateboarding, roller skating, and scooter riding are popular recreational and sporting activities for children and adolescents but can be associated with skeletal injury. The purpose of this study is to describe the frequency and characteristics of fractures resulting from these activities.

PURPOSE

Fractures from skateboarding, roller skating, and scooter riding compose a considerable proportion of pediatric musculoskeletal injuries.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Demographic data and injury characteristics were analyzed for all patients who presented to the pediatric fracture clinic of the level I trauma center from January 2001 to May 2002 after sustaining fractures due to skateboarding, roller skating, and scooter riding.

RESULTS

Among a total of 2371 fractures, the authors identified 325 fractures (13.7%) that occurred during one of these activities. There were 187 patients (mean age, 13 years; 95% male) who sustained 191 skateboard-related fractures, 64 patients (mean age, 10.8 years; 54% male) who sustained 65 fractures while roller skating, and 66 patients (mean age, 9.7 years; 64% male) who sustained 69 fractures while riding a scooter. The forearm was fractured most often, composing 48.2% of skate-boarding fractures, 63.1% of roller-skating fractures, and 50.7% of fractures due to scooter riding. Of the forearm fractures, 94% were located in the distal third. In the skateboarding group, 10 of 191 (5.2%) fractures were open injuries of the forearm, compared to 6 of 2046 (0.3%) fractures caused by other mechanisms of injury (significant odds ratio, 18.8).

CONCLUSIONS

Skateboarding, roller-skating, and scooter-riding accidents result in a large proportion of pediatric fractures. An open fracture, especially of the forearm, was more likely to be caused by skateboarding than by other mechanisms of injury. Use of wrist and forearm protective equipment should be considered in all children who ride a skateboard.

Skatepark injuries and the influence of skatepark design: a one year consecutive case series

Skateboarding and in-line skating are popular activities that attract millions of participants yearly and have spawned the development of skateparks (SPs). This study examined the types and distribution of injuries within a local commercial SP. Subjects were prospectively enrolled in a university Emergency Department (ED) after an injury at a local SP. One hundred subjects were enrolled over 1 year, representing 102 episodes and 106 injuries. Musculoskeletal injuries accounted for 80% of all injuries. Fractures and dislocations were the most frequent injuries (59%); six required operative management. One serious intra-abdominal injury occurred. Head and facial injuries occurred in 17% of subjects; none required operative repair. Admission rate was 9%. Safety equipment use was greater than 91%. Significantly more injuries occurred in the ramp/bars areas compared to the half-pipe and gully areas, suggesting that SP design may significantly influence injury patterns. A substantial number of injuries occurred at the SP, despite controlled conditions and equipment requirements.

Skateboard and scooter injuries

Skateboard-related injuries account for an estimated 50 000 emergency department visits and 1500 hospitalizations among children and adolescents in the United States each year. Nonpowered scooter-related injuries accounted for an estimated 9400 emergency department visits between January and August 2000, and 90% of these patients were children younger than 15 years. Many such injuries can be avoided if children and youth do not ride in traffic, if proper protective gear is worn, and if, in the absence of close adult supervision, skateboards and scooters are not used by children younger than 10 and 8 years, respectively.

Scooter injuries in children

OBJECTIVE

To describe a series of nonmotorized scooter-related injuries to children to increase public awareness and encourage prevention of such injuries.

DESIGN

A descriptive study of a consecutive series of patients.

SETTING

The pediatric emergency service of a municipal hospital.

PARTICIPANTS

All children <18 years old who presented to the Pediatric Emergency Service (PES) with a scooter-related injury from July through September 2000.

METHODS

Patients were identified by review of the PES medical records. Charts were reviewed for patient data including age, place of injury, use of protective gear, adult supervision, injury sustained, medical management, and disposition.

RESULTS

There were 15 children treated in the PES for scooter-related injuries. The mean age was 7.8 years, 73% were male. Approximately 90% of injuries occurred as a result of falling off a scooter. Irregular pavement caused 3 falls and tandem riding caused 2 falls. Inability to use the foot brake caused 1 collision, and 1 child was hit by a motor vehicle while crossing the street. Injuries occurred in a park (33%), on a sidewalk (47%), in a home (13%), and on the street (7%). Adult supervision was present in half of the cases. Only 2 children were wearing helmets at the time of injury; none wore protective padding. Five children (33%) suffered head trauma; 1 lost consciousness, and 2 suffered amnesia. Three children required a head computed tomography scan, and 1 required cervical spine radiographs. All radiographs were negative. None of these 5 children were wearing helmets. Seven children (47%) sustained facial injuries, and 4 of these children required laceration repair. Seven children (47%) sustained extremity trauma, including 1 laceration and 6 fractures (1 supracondylar, 1 distal radius, 2 radius/ulnar, 1 tibia/fibula, and 1 patella). Four fractures involved the upper extremity. Four fractures were managed by closed reduction; 2 required operative repair. One child required splinting of an avulsed tooth. Three of the children (20%) were admitted. The 5 children with head trauma were observed and released.

CONCLUSION

The use of nonmotorized scooters by children may result in serious injury, particularly in the young child. Although not life-threatening, these injuries require significant medical intervention and may result in permanent functional and cosmetic deformity. These injuries are potentially preventable with the proper use of protective gear and supervision. Public and parental awareness and education are essential to prevent additional injuries.

Surfing, Windsurfing, Snowboarding, and Skateboarding

In brief With the rise in popularity of board sports, primary care physicians need to understand the injury risks and environmental hazards faced by surfers, windsurfers, snowboarders, and skateboarders. Physicians can play an important role by telling patients about injury prevention strategies, including using proper equipment, wearing protective gear, taking lessons, and riding in terrain and weather conditions appropriate for one's skill level.

School bus related deaths and injuries in New South Wales

OBJECTIVE

To report the circumstances of paediatric bus related deaths and injuries in New South Wales (NSW) to identify preventable factors.

DESIGN

Retrospective survey using two surveillance systems-the NSW Paediatric Death Review Database and the Childsafe Injury Surveillance System.

PATIENTS

Children (0-14 years of age) who died or were injured as a result of a school bus related incident.

RESULTS

Twenty-two deaths and 58 injuries were recorded. Three of the children who died were passengers (two deaths were due to errant behaviour), two were alighting from the bus (bus door entrapment) and 17 (77%) were pedestrians crossing the road before or as the bus departed. The major causes of death were head injury and blood loss. Seventeen of the injured children were pedestrians and most (82%) of these sustained serious injury requiring admission to hospital.

CONCLUSIONS

The greatest risk to schoolchildren from bus related injuries was as pedestrians after alighting from a bus, especially when moving behind the bus. Preventable factors include slowing of traffic (40 kph) near stationary school buses, and parents waiting on the side of the road where the child alights from the bus. Continuing road safety education remains important for schoolchildren and parents as well as for drivers.

Rollerblading injuries in young people

OBJECTIVE

To study injuries in young people associated with the use of rollerblades, draw comparisons with skateboarding and rollerskating injuries, and suggest strategies for injury prevention.

METHODOLOGY

Injuries associated with the use of rollerblades, skateboards and rollerskates in young people aged < or = 14 years recorded on the Victorian Injury Surveillance System database since its inception in 1989 were examined to identify secular trends. All injuries associated with these pastimes recorded on the database by three sentinel hospitals during a 1 year period were examined in detail. Medical notes were perused to verify features of the event and obtain further information. A semi-structured telephone interview of a sample of 10-14 year old rollerbladers, the most commonly injured age-group, was carried out to obtain more specific information.

RESULTS

There has been a marked increase in the absolute numbers of injuries associated with the use of rollerblades since 1989. In 1992, they were most common in the 10-14 year age group, which sustained 59% of all injuries; 47% of injuries were fractures of the forearm and wrist. Of a sample of 33 of those injured in the 10-14 year age group, 10 (30%) had been using rollerblades for the first time. There is some evidence to suggest a concomitant fall in skateboarding injuries.

CONCLUSIONS

Injury surveillance data collected in Melbourne suggest an increasingly important contribution by rollerblading to the pattern of injury seen in young people. Preventive strategies require further evaluation but could include learning basic techniques in a controlled setting, separation from road traffic and the wearing of helmets and wrist, elbow and knee guards.