Boy crying on road after falling off of his bike

(Photo credit: Unsplash+ in collaboration with Getty Images)

PHILADELPHIA — As the old saying goes, when you fall off your bike, dust yourself off and get right back on. But it’s not that easy for many children, alarming research shows. Bicycles are responsible for over a million broken bones in children over the past two decades, reports a new study.

The 20-year review shows the most bone fractures occurred among 10- to 15-year-old boys. Despite efforts to make roads a more bike-friendly area, over 65,000 injuries occurred because of a collision with a car.

Children who typically rode bikes without a helmet were the ones most likely to have an accident. About 85.7% of children with fractured skulls were not wearing helmets.

“The results of our study suggest that continued efforts teaching road safety and promoting helmet use should be targeted towards all children, but with additional efforts being directed towards the most affected population, namely 10- to 15-year-old boys,” says Dr. J. Todd R. Lawrence, a researcher at the Children’s Hospital of Philadelphia and study co-author, in a statement. “Municipalities should continue to evaluate traffic patterns on their local roads to improve bike safety for children.”

The team collected information on adolescent bike accidents from the National Electronic Injury Surveillance System database from 2001 to 2020. These incidents involved bone fractures that required a visit to the emergency room. There were 1,019,509 fractures in the past two decades with an average of 50,975 fractures related to bicycles every year, with 71% coming from patients who are male and white. These boys were commonly between 10-12 and 13-15 years of age.

Bone fractures happened most often during spring or summer and on the lower arm, wrist, or shoulder. Children whose bones were broken from an accident with a motor vehicle were the most likely to need hospitalization than incidents without cars.

There is good news. The number of bone fractures from riding bikes has decreased over the past 20 years, with 2020 being the exception. The study authors noticed an uptick in broken bones from children riding bikes in 2020. They suggest the increase has to do with staying at home during the COVID-19 pandemic instead of going to school or summer camps.

“Given the results of our study, we recommend targeting bicycle safety efforts toward the most affected populations, largely 10- to 15-year-old boys,” says William Huffman, a medical student who contributed to the research. “Teaching road and helmet safety for bicycle riders is paramount to keeping children safe.”

The research study was published as part of the 2022 AAP National Conference & Exhibition.

About Jocelyn Solis-Moreira

Jocelyn is a New York-based science journalist whose work has appeared in Discover Magazine, Health, and Live Science, among other publications. She holds a Master's of Science in Psychology with a concentration in behavioral neuroscience and a Bachelor's of Science in integrative neuroscience from Binghamton University. Jocelyn has reported on several medical and science topics ranging from coronavirus news to the latest findings in women's health.

Our Editorial Process

StudyFinds publishes digestible, agenda-free, transparent research summaries that are intended to inform the reader as well as stir civil, educated debate. We do not agree nor disagree with any of the studies we post, rather, we encourage our readers to debate the veracity of the findings themselves. All articles published on StudyFinds are vetted by our editors prior to publication and include links back to the source or corresponding journal article, if possible.

Our Editorial Team

Steve Fink


Chris Melore


Sophia Naughton

Associate Editor


  1. Travis R says:

    This is silly. How many children didn’t break a bone while riding a bike. Helicopter parents are destroying this nation.

  2. Emory Kendrick says:

    So? How many kids have ridden and fallen on bikes in the last 20 years? Yes, kids fall off bikes, jump off of walls, beds, chairs and wagons. They play baseball without helmets, play sandlot football, get into fights, do stupid things on playground equipment, and do just about everything else they are not supposed to do…..because they are kids and take risks. Rarely, do they get more than a broken bone and usually not even that.

    Let kids be kids

  3. Richard Burton says:

    “About 85.7% of children without helmets had fractured skulls compared to the 14.2%.”

    What? That is possibly the most nonsensical sentence I’ve ever read. According to that sentence, 99.9% of children will acquire a fractured skull whilst riding a bike. Makes about as much sense as the rest of the article.