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Easy Riders

By Scott Hamilton, MD
July 8, 2022
Hamilton Blog Headshot Updated 12.21.21

In the 1970s, as bicycle popularity was soaring, so were injuries and deaths from crashes. Modern bike helmets weren’t invented until 1975, so professional racers wore old-fashioned leather football helmets instead. While form-fitting and aerodynamic, they did nothing to protect heads from impacting the ground. As one racer put it, they did keep you from “grinding your ears off while sliding along the pavement.”

Purpose-built bicycle helmets were inevitable. Post-war prosperity, population growth and the baby boom caused bicycle sales to balloon in the late 1940s. All those kids wanted bikes, and as America became more suburban, they needed child-friendly transport to farther-flung schools and friends’ houses. With more kids (and adults) on the road, accidents rose too. Many of the worst injuries were head traumas. As those bike racers first understood, helmets were a must. As states passed helmet laws and helmet use increased, head injury deaths dropped 90%!

Preventing injuries requires more than just helmets. There is a lot more of a kid’s body to protect. Thus, the need for safe places for children to ride. My parents, and myself in turn, have always lived on cul-de-sacs. The dead-end streets offer some sense of security with fewer speeding cars to worry about. Neighborhood speed bumps also make streets safer for kids. The ultimate solution, dedicated bike lanes, is fortunately becoming more popular for cities like Lafayette that want to attract young families.

Don’t let the prospect of injury keep you and your children off bikes. They are great for exercise. Cycling is comparable to running and swimming in terms of weight loss and fitness, but it is also more enjoyable, breezier and far more scenic. When traveling by bike, you’re really going somewhere. It’s also easier on your feet and joints than running. Don’t buy electric-assist bicycles (e-bikes). Louisiana doesn’t have hills, so don’t wimp out!

When I lecture residents on pediatric head injuries, I like to show them silly pictures to lighten the mood. One shows a family of four riding along, all smiles and with bike helmets on, the picture of wholesomeness. I label that picture "Maine," as most of the riders I see there are wearing them. The other picture is of a scruffy kid somersaulting off a jump with no helmet, his front wheel detaching midair and disaster seconds away. I label that one "Louisiana."

Although head traumas are the most worrisome, I see lots of other injured parts. Aside from helmets, shoes are essential biking gear. Sure, it’s summer. Shoes are hot and flip-flops are easy to slip on. But occasionally, toes and feet get caught in wheel spokes, bike chains or just scrape the ground. Ouch! Please, enforce shoe-wearing as well as helmets when your kids head out.

Less common are groin injuries. "Girl" bikes, with top bars that scoop down, were invented to protect riders from landing on the frame during sudden stops. But boys can get hurt the same way. I recently saw a 9-year-old patient who hit the bar. The impact missed his testicles but injured his urethra (the tube that drains urine from the bladder) where it runs through the bottom of his groin. The impact caused swelling so bad he couldn’t pee. Getting boys to ride "girl" bikes may be difficult; fortunately, these injuries are rare.

The last concern is the "handlebar spear injury," which occurs when riders hit solid objects, like sidewalk curbs, with the front tire. The wheel turns, and as the child flies forward, she gets speared in the abdomen by the handlebars. This can cause internal injuries to the bowels, blood vessels, and other organs. Unfortunately, the signs of serious problems are subtle-a little pain, a tiny bruise, maybe some pallor. Thus, if your child is speared and has any complaints at all, skip urgent care (they don’t have surgeons) and come to the ER!