Everyone who skates falls, and falls a lot. What changes from one slam to the next is how you meet the ground: running, sliding on your knees, rolling over a shoulder, or with a straight arm and your wrist out front. That last one is behind more ER visits than anything else, and it’s also the one you can cut down the most once you’ve practiced the alternatives.
For this guide we went through the advice from medical bodies (the American Academy of Orthopaedic Surgeons, the American Academy of Pediatrics, the CDC and the UK’s NHS), published studies on skateboarding injuries and on the biomechanics of falling, and the coaching guides skaters actually use: Braille Skateboarding, SkateIQ and Per Welinder and Peter Whitley’s book Mastering Skateboarding. We’re not doctors. Where there are red flags we send you to one, and where the sources disagree, we say so.
Is skateboarding dangerous? Injury data in context
The most quoted figure comes from the US: according to the AAOS, about 70,000 people a year end up in the emergency department with a skateboarding injury, and roughly half of them are under 15. That sounds like a lot, so it helps to compare it with other sports. A study in the Journal of Trauma in 2002 worked out ER-treated injuries per 1,000 participants in 1998: 8.9 for skateboarding, 3.9 for in-line skating and 21.2 for basketball. Only 2.9% of those skateboarding injuries led to a hospital admission, and the ones that did were 11.4 times more likely to involve a motor vehicle.
Cars show up in almost every source. A 2015 literature review puts fatal injuries at around 1.1% and notes that many come from head injuries in collisions with motor vehicles, a point the US Consumer Product Safety Commission (CPSC) also makes. The serious risk sits more with traffic and head impacts than with the skatepark.
As for what gets hurt, the pattern is fairly consistent. In US emergency data for kids and teens from 1990 to 2008 (more than 1.2 million estimated injuries), 44.1% involved the arm or hand, 31.7% the leg and 11.4% the face; 32.1% were fractures or dislocations and 24.8% sprains or strains. The 2015 review puts the upper-limb share at 55-63% depending on the study. An Australian series of 5,026 ER visits (Gold Coast, 2008-2018) found 44% fractures, 56% upper-limb injuries, and falling on an outstretched hand as the most common mechanism.
In that same series the average age was 19.4 and about 14% of patients were over 30, so this isn’t only a kids’ issue. The authors suggest that anyone over 30 thinks carefully before skating without protection.
As for the head and face, an analysis of US emergency data from 2009 to 2018 traced 76.9% of those injuries to simply falling off the board while riding, with no car involved. And in another study, riding under the influence of alcohol or drugs was linked to about four times the odds of a craniofacial injury.
Beginners and experienced skaters get hurt differently
The research isn’t fully consistent here, and the researchers say so themselves. The AAP’s 2011 skateboarding handout says a third of injuries happen in the first week of learning. It’s a figure that still gets repeated, but it goes back to a 1977 CPSC study, so treat it as a historical number rather than a current snapshot.
At the other end, a survey of 197 Spanish skaters published in 2020, with almost ten years of experience on average, found that 87.8% had been injured at some point, that the most common injury was a sprain (mostly the ankle), and that more than half of the injuries were severe, meaning more than 21 days to recover. The more experienced skaters were more likely to suffer severe injuries and head or trunk injuries.
The most likely explanation is that these sources measure different people. Emergency data mostly captures kids who lose balance and land on a hand; surveys of adult skaters capture ankles wrecked on big jumps. That’s why the answer to “what’s the most common skateboarding injury” depends on which source you read.
How to use the cards
The cards come in three sections: how to fall and how to practice it, the specific situations people ask about most, and what to do after a slam. You can search by keyword or filter by tag (“Wrist”, “Head”), and some cards include a coaching video.
How to fall, and how to practice it
Run it out
This is the most common bail when the board stops dead (a rock, a crack) or a trick throws you forward. You jump clear of the board and keep running, faster than you think you need to, staying light on your feet until you've slowed down. That's how SkateIQ's bailing guide puts it, and it's the first option in almost every coaching guide.
There's a backwards version too: if you fall backward with some momentum, you can take a few steps back. If you're going too fast for that, switch to a butt slide.
Knee slide
This is the standard bail on ramps and in bowls. In Mastering Skateboarding, Per Welinder and Peter Whitley teach it on smooth flat ground first: drop onto your knees with moderate impact, then take a few running steps and drop again, sliding about 30 cm (a foot) with the tops of your shoes sliding too. Leaning back a little spreads your weight between knees and shoes.
In the bowl, the drill is to pump halfway up the transition, roll back fakie, step off and land on your knees with your feet tucked under you, sliding down. Pads should be snug and shouldn't shift when you hit them. The same book warns that once you're used to knee sliding in pads, you may drop to your knees by reflex on a day you're not wearing them.
Shoulder roll
When you're too fast to run it out, Braille Skateboarding teaches a roll: touch your fingers to the ground, tuck your shoulders, bring your chin to your chest and take the impact on your shoulder, curling toward a fetal position to protect your head, back and hips. SkateIQ describes a similar move (get low, let your momentum roll you onto your side, then slide) and prefers it to bracing with your hands.
There's some biomechanics behind it. In a 2007 study of judokas in the Journal of Biomechanics, martial-arts sideways falls cut hip impact force by 27.5% to 30% compared with a stiff-arm block, mostly by rolling and reaching the ground more slowly. Those were lab falls onto mats, so the number doesn't carry over directly to concrete.
Fall loose, don't tense up
Braille calls it falling like a rag doll: don't tense up, and above all don't shoot your hands straight out in front. Instead, scoop your arms to the side to spread the impact and to keep your face off the ground.
The American Academy of Orthopaedic Surgeons (AAOS) sums up the same idea in three words, relax and roll, and suggests crouching as soon as you feel yourself losing balance, so you have less distance to fall.
Butt slide
For backward falls, the coaching guides agree: get low, take the impact on your backside and push forward against the ground with your hands to turn the hit into a slide. Braille stresses not landing directly on your tailbone, and compares it to a plane landing smoothly instead of nosediving.
SkateIQ adds two details. Get your feet down first and commit to getting low, and spread the impact over as much of your body as you can, because more surface area on the ground means a less concentrated hit. If you're falling forward on a ramp, the version is to drop into a deep squat and sit down; staying tall while the board shoots out usually hurts more.
The eject button
If you feel yourself leaning too far back, SkateIQ suggests hitting the eject button: keep your knees soft, jump off the back of the board and land on your feet instead of flat on your back.
The drill is simple. Roll forward slowly, lean back on purpose and jump just before the point where you'd fall. The goal is for the move to happen without thinking when it's for real.
Hands: the locked-arm problem
A fall on an outstretched hand (doctors call it FOOSH) is the classic way to fracture a wrist. An Australian study of 5,026 skateboarding emergency visits names it as the most frequent mechanism, and the AAOS says most injuries come from falling onto an outstretched arm.
The sources don't say quite the same thing here. The medical ones (AAOS, University of Utah Health, Mass General Brigham) tell you not to stick your arms out straight, and SkateIQ goes as far as never putting your hands down. Braille, on the other hand, teaches touching your fingers to the ground as you start a roll. What fits all of them is that the problem is a straight, locked arm taking the whole impact. Light contact with bent elbows, as the start of a roll, is a different thing, and the 2007 judoka study concluded that using the arm wasn't essential to reduce impact.
How to practice falling
Several guides suggest starting where the pavement meets grass: push toward the grass so the board stops, and step or fall onto something soft. The fall-training studies used mats and falls from kneeling height, so it makes sense to progress from kneeling to squatting to standing before you try it on the board. Knee slides get practiced on smooth flat ground first, then halfway up a transition.
What has been measured is that the skill fades if you don't repeat it. In a 2003 study in Clinical Biomechanics, 29 young men cut wrist impact force by 18% after a 10-minute lesson, but three weeks later much of that gain was gone. That's why it's worth working a few practice bails into normal sessions.
Kids: first falls and supervision
Age guidance varies a little between sources. The AAOS, citing the American Academy of Pediatrics (AAP), says children under 5 shouldn't ride and that kids aged 6 to 10 need close adult supervision. The US Consumer Product Safety Commission (CPSC) says children under 8 should be supervised closely.
In US emergency data from 1990 to 2008, the share of head and neck injuries was highest in the youngest riders (9.9% at ages 5 to 10), which is one more reason for a helmet from day one. The AAP also suggests beginners take a class to learn the basics, including how to fall.
Specific situations
Slipping out backward
This is the one where the wheels shoot out in front and you go down backward. What takes the hit is usually the tailbone, the wrists (from trying to catch yourself behind you) and the back of the head. Braille and SkateIQ give the same answer: get low, butt slide, use your arms to divert some of the impact rather than stop it dead, and tuck your chin.
If your tailbone takes it, the NHS says the pain may improve after a few weeks, although it can last longer, and recommends seeing a doctor if it hasn't improved by then or it's affecting daily life. If your head hit the ground, go to the head-impact card.
Primo
In a primo the board lands on its side and can throw you sideways or backward. We couldn't find any medical or coaching source dedicated to this fall, so the honest answer is to apply the general principles: get low, don't lock an arm, roll or slide onto your side or backside, and tuck your chin.
For sideways falls, the martial-arts studies are the most relevant evidence there is: rolling and hitting the ground with a less upright trunk reduced hip impact force. They're lab tests, but the principle is the same.
Hung up on coping
This is when a truck catches on the coping as you re-enter the transition. On drop-ins, the cause most often mentioned is not committing: a half-hearted lean, without pressing your front foot down as the front wheels cross the lip.
With knee pads, the standard bail is a knee slide down the ramp, which is the transition bail Welinder and Whitley teach. Without pads, you're left with running it out forward or a butt slide. To prevent it, start lower on the ramp and work your way up, commit to the drop-in, and learn knee slides before you try coping tricks.
Sliding out on a ledge, rail or stairs
For a boardslide that goes wrong, SkateIQ suggests planning in advance to run it out, and staying forward gives you more control. On stairs and gaps, get as low as you can, run it out if you're falling forward and drop into a slide if you're falling backward, without putting your hands down.
This is where the skaters in a Spanish survey published in 2020 got hurt most: 25.7% of their injuries happened on gaps and stairs. In the same survey, more experienced skaters were more likely to suffer severe injuries and head or trunk injuries.
Speed wobbles on a hill
The CPSC describes it as a board that starts to shimmy from side to side without warning and, within seconds, can rock so hard it throws you before you can react. Its advice is to crouch with your weight forward. Concrete Waves adds that leaning back is the worst thing you can do, and that carving or a powerslide helps scrub speed.
For prevention: trucks, wheels, nuts and mounting screws properly tightened, a back truck never looser than the front and, if you're choosing a board for hills, a longer wheelbase, which is more stable. And don't go faster than you can handle; the CPSC points out that you can lose control at any speed.
After the slam
Sprain or fracture? Red flags
The NHS says to go to the emergency department (and not drive yourself) if you heard a crack when you got hurt, if the area has changed shape or is pointing at an odd angle, if it's numb or tingling, or if the skin has turned blue or gray or feels cold. It also warns that it's often impossible to tell a break from a bad sprain without an X-ray.
The AAP adds two rules of thumb: if you can't walk on the ankle or the pain is severe, see a doctor as soon as possible; if the wrist is still swollen or painful the next day, the same. While you wait, the NHS suggests a towel sling, taking off rings and watches, and not eating or drinking in case you need surgery.
Pain at the base of the thumb
After a fall on your hand, pain when you press the base of your thumb can point to a scaphoid fracture, a small bone in the wrist. NHS hospital patient leaflets warn that it can look like a simple sprain.
So the sensible move is to get a wrist that keeps hurting in that spot checked by a doctor, even if it looks normal. Clinical reviews note that a missed scaphoid fracture can lead to complications, and an X-ray is how you find out.
Head impact: when to call emergency services
The CDC lists danger signs that mean calling emergency services or going to the ER: seizures, not recognizing people or places, repeated nausea or vomiting, loss of consciousness with growing drowsiness, slurred speech, weakness or poor coordination, a headache that gets worse and doesn't go away, or one pupil larger than the other. The NHS adds, among others, falling from more than 1 meter (about 3 feet) or hitting your head at high speed, and blood or clear fluid coming from the ears or nose.
Even if none of these show up, the careful choice is to end the session for the day. The NHS recommends that an adult stays with the person for at least the first 24 hours, with no alcohol and no driving until they've recovered. The AAP points out that in most concussions the person isn't knocked out, and symptoms can take hours or days to appear.
Skating again after a concussion
The CDC lays out a six-step return that only starts once a healthcare provider gives the green light: regular activities, light aerobic activity, moderate activity, heavy non-contact activity, full practice and, finally, competition. Each step typically takes at least 24 hours; if symptoms come back, you stop, check in with the provider and restart from the previous step.
The UK grassroots sport guidelines (2023, updated 2024) say no return within 24 hours and no activities with a risk of contact injury for at least 21 days after a confirmed concussion. Skateboarding has no contact, but the risk of falling and hitting your head again is similar, so our reading (not medical guidance) is that the later steps correspond to skating terrain where you could fall.
RICE or PEACE & LOVE
The NHS sprains page still uses PRICE: protection, rest, ice (up to 20 minutes every 2-3 hours), compression and elevation, while avoiding heat, alcohol and massage for the first few days. A 2019 editorial in the British Journal of Sports Medicine proposed PEACE & LOVE instead: protect for a few days without overdoing rest, elevate and compress early, then gradually load the area again with exercise and pain-free cardio. That approach questions ice and urges caution with anti-inflammatories.
Both agree on protecting and elevating early and then reloading gradually. Neither applies to a possible fracture, which needs a doctor. Any question about medication is one for your doctor or pharmacist.
The ankle sprain that keeps coming back
In a 2020 Spanish survey of 197 skaters with almost ten years of experience on average, ligament sprains were the most common injury (39.6%), with the ankle the most affected area, and also the most likely to recur: 70.1% of those sprains happened again. The AAP also notes that a previous sprain, especially a recent one, raises the risk of another, and that tape or a brace can reduce how often they happen.
The practical takeaway is to finish your rehab (balance and strength) before you go back to jumping stairs, ideally with a physio. Skateboard GB, the UK governing body, has a physiotherapy section and lists rolled ankles among the typical problems skaters bring to a physio.
Nothing matches those filters.
The principles every source agrees on
The medical guides and the coaching guides agree on a handful of ideas. Get low as soon as you feel yourself losing balance, so there’s less distance to fall (AAOS, Mass General Brigham, CPSC, SkateIQ). Land on the fleshy parts of your body, relax and roll instead of going stiff. Don’t catch yourself on a straight arm. Tuck your chin to protect your head. And bail early, when you feel the trick going wrong, instead of fighting it to the last second.
Is there science behind this, or is it skatepark folklore? There’s some, with caveats. In a 2003 study in Clinical Biomechanics, 29 young men got a 10-minute lesson on falling forward and reduced peak wrist impact force by 18%. Three weeks later they’d lost much of that gain. With martial-arts falling techniques, novices cut hip impact by 17% after 30 minutes of training, and experienced judokas by around 30%.
The caveat is that these are lab falls onto mats, and no study has measured fall training for skateboarding, at speed, on concrete. The principles (roll, slow your impact, spread the force, don’t lock the arm) are supported; how much they protect you in a real session is unknown.
How to bail on a skateboard, technique by technique
The step-by-step is in the cards; this is about when to use which. Running it out is the first option when you’re falling forward at low or medium speed: jump clear and keep running. When you’re too fast to keep up on foot, it’s time to roll over your shoulder, chin tucked, curling up. Going backward, the option is a butt slide: get low, land on your backside (not your tailbone) and turn the hit into a slide. If you catch it early enough, you can jump off the back and land on your feet. And on ramps and in bowls, with knee pads, the knee slide is the standard bail.
Terrain changes the choice. Some guides prefer sliding (on knees or backside) on smooth ramps and keep rolling for fast falls on flat ground. An easy way to remember it: on transition, slide; on flat ground with speed, run or roll. And if you skate ramps, wear knee pads every time, because the knee-slide reflex kicks in on days you’re not wearing them too.
Hands down or not? Making sense of the disagreement
This is the clearest contradiction between sources. The medical ones (AAOS, University of Utah Health, Mass General Brigham) say not to stick your arms out straight to catch yourself, and SkateIQ, talking about stairs, says never put your hands down at all. Braille, on the other hand, teaches touching your fingers to the ground to start a roll and scooping your arms to the side to spread the impact.
Read together, they don’t clash as much as it seems. The problem is a straight, locked arm absorbing the whole impact, which is exactly how wrists get broken. A light touch with bent elbows, as the start of a roll, is a different thing. And the 2007 judoka study concluded that using the arm wasn’t essential to reduce impact. If you want one rule to keep: no stiff arm, and if your hands do touch the ground, use them to start rolling.
Specific situations: primos, coping, ledges and speed wobbles
The situation cards cover slipping out backward, primos, coping hang-ups, ledges and stairs, and speed wobbles. For most of them the evidence is coaching knowledge rather than clinical trials (for primos we couldn’t find any dedicated source at all), and we flag that.
Speed wobbles are the exception, with official guidance: the CPSC recommends crouching with your weight forward, and Concrete Waves stresses that leaning back is the worst thing you can do. A lot of the prevention is mechanical, with hardware properly tightened and the back truck never looser than the front. If you want to understand what each part of a truck does, see our guide on how to choose skateboard trucks, and if you ride hills on a longer board, the longboard buying guide covers wheelbase and setup.
How to practice falling
Given the 2003 study (the skill fades if you don’t repeat it), the sensible plan is to learn it off the board and then keep it up. A progression that fits the sources: start on grass, or where the pavement meets grass, pushing toward the grass so the board stops and you fall onto something soft; practice rolls on a mat or something padded, from kneeling, then squatting, then standing; and do knee slides on smooth skatepark flat before trying them halfway up a transition. After that, throw a few deliberate bails into normal sessions every now and then.
The AAP suggests beginners take a class to learn the basics, including how to fall properly. The AAOS also recommends learning to stop, slow down and turn before trying tricks. If you’re working toward your first trick, our ollie tutorial breaks it into steps you can practice on flat ground.
Prevention: warm-up, strength and protective gear
Strength before stretching
The strongest evidence on preventing sports injuries doesn’t come from skateboarding, but it’s fairly clear. A meta-analysis of 25 trials with 26,610 participants, published in the British Journal of Sports Medicine in 2014, found that strength training brought injuries down to about a third (relative risk 0.315), that balance and proprioception training also helped (0.550), and that stretching had no meaningful effect (0.963). In the Spanish survey, 87.8% of skaters did no skate-specific physical training at all.
For warming up, Christopher Gee, a sports medicine physician at University of Utah Health, recommends 5 to 10 minutes of active warm-up before skating. The Australian clinic Physio Inq suggests dynamic movements that mirror skating: ankle rocks heel-to-toe and edge-to-edge, ankle circles, calf work, hamstrings and quads, trunk rotations, and shoulder and neck circles.
Helmets
The AAOS recommends a helmet “regardless of age, experience, or location”. It should sit flat and low on your forehead, with the side straps forming a V around each ear, two fingers of room under the chin strap, and no movement when you shake your head. Replace it at least every five years, or sooner if it’s damaged. In an analysis of 24,903 skaters admitted to US trauma centers, wearing a helmet was linked to roughly half the odds of a severe traumatic brain injury (odds ratio 0.534), and only about 5.5% were wearing one. A 2021 study also found that every helmet tested performed worse after a second impact, which supports replacing yours after a hard hit.
Are wrist guards worth it?
The AAOS and the CPSC recommend them to cut the risk of wrist fractures. The evidence is good, but it’s borrowed from other sports. In in-line skating, a 1996 study in the New England Journal of Medicine found that skating without wrist guards was linked to about ten times the odds of a wrist injury (adjusted odds ratio 10.4). In snowboarding, a 2007 systematic review found a relative risk of 0.23 for wrist injuries with guards. And a 1997 cadaver study showed that a guarded wrist needed a higher drop and more energy to fracture, with less severe fractures; its authors said clinicians should counsel skateboarders to wear them too.
The limits: there’s no skateboard-specific trial, guards protect less in very hard falls, and in snowboarding some non-experimental data hint that they might shift part of the injury load to the fingers, elbow or shoulder. Even so, for someone who’s learning and lands on their hands a lot, the available data point toward wearing them. Elbow and knee pads round out the kit, especially on ramps, and the AAOS recommends closed shoes with slip-resistant soles.
The spot and the board
The AAOS and the CPSC repeat the basics: check the surface (cracks, rocks, debris) and your board, and don’t ride on wet ground, in the dark, injured or dizzy, or after drinking. At skateparks, the 2022 trauma study found lower odds of a severe brain injury (odds ratio 0.584), although the AAP points out that many injuries happen in parks, especially around ramps and rails. For sharing the park with everyone else, there’s our guide to skatepark etiquette.
After a slam: what to watch for and when to see a doctor
What follows summarizes what the NHS, the CDC and the AAP say. It’s not a substitute for a medical assessment, and if in doubt, get seen.
Sprain or fracture. The NHS says to go to the emergency department if you heard a crack, the area has changed shape, it’s numb or tingling, or the skin is blue, gray or cold, and not to drive yourself there. It also warns that without an X-ray it’s hard to tell a break from a bad sprain. The AAP adds that an ankle you can’t walk on, or a wrist still swollen the next day, needs a doctor. Pain at the base of your thumb after a fall on your hand is worth getting checked even if it looks like a sprain, because it can be the scaphoid. According to the NHS, a broken wrist usually takes 6 to 12 weeks to heal, and stiffness can last for months.
Ice and rest, or gradual loading. This is a genuine disagreement. The NHS sprains page still uses PRICE (protection, rest, ice, compression, elevation). A 2019 editorial in the British Journal of Sports Medicine proposed PEACE & LOVE, which plays down ice and total rest, urges caution with anti-inflammatories and favors loading the injury earlier. Both agree on protecting and elevating early and then loading gradually. Neither applies to a possible fracture, and any question about medication is one for your doctor or pharmacist.
Head impact. The session is over for the day. The CDC and the NHS list signs that mean calling emergency services (911 in the US, 999 in the UK, 112 across Europe): seizures, repeated vomiting, drowsiness that gets worse, confusion, slurred speech, a worsening headache, unequal pupils, or having fallen from more than a meter or hit your head at high speed. According to the AAP, most concussions don’t involve being knocked out, and symptoms can take hours or days to show. The NHS recommends that someone stays with you for at least the first 24 hours.
Getting back on the board. The CDC sets out six steps of at least 24 hours each, always with a healthcare provider’s clearance, and the UK grassroots guidelines say to avoid activities with a risk of contact injury for at least 21 days after a confirmed concussion. Skateboarding has no contact, but the risk of falling and hitting your head again is similar, so the reasonable reading is to apply those timelines to skating terrain where you could fall. Jason Simon, an orthopaedic surgeon at Mass General Brigham, puts it this way: “If you have to think twice about how you’re feeling, go get checked.”
Keep exploring
- Skateboard helmets and pads: what to buy and what actually protects
- Skateboarding benefits: body, mind and community
- Skatepark etiquette: the unwritten rules
- How to ollie on a skateboard
- How to choose skateboard trucks
- Complete longboard buying guide
Conversation
Your name will be public. Your email stays private. Comments are reviewed before publishing.