Activity Ratings Chart

O– Originally created as a form of self-defense, Tai Chi has grown into a gentle, low-impact mind-body practice that enhances both physical and mental well-being. It combines slow, flowing movements with focused breathing to improve balance, flexibility, posture, strength, and coordination. With its emphasis on mindfulness, core stability, and controlled movement, Tai Chi promotes mental clarity, emotional resilience, and stress reduction, making it suitable for people of all ages and fitness levels.102

R– Minimal risk. Tai chi can involve standing on a partially bent knee or performing a lunge. These movements may cause muscle or joint discomfort, particularly for individuals with arthritis or a history of recurrent knee bleeds. Overuse injuries are possible if the participant does not allow enough time to rest and recover between sessions.131

S– When practicing tai chi, stand tall without locking your knees. Adjust any movement that feels uncomfortable. For example, avoid deep lunges if you have a history of knee injuries or repeated joint bleeds. Wear supportive, well-fitting shoes to maintain stability. If you experience balance issues or have other concerns, be sure to consult your instructor.

O– Martial arts is a broad term that includes various styles of both contact and non-contact combat sports. Non-contact forms emphasize form, technique, meditation, and self-discipline, while contact styles also add sparring, which involves grappling and/or striking for training and competition. Martial arts training also builds strength, balance, and flexibility, while supporting mental and emotional well-being through mindfulness, self-control, and stress reduction. Studying low-contact martial arts under the guidance of a qualified instructor can offer excellent physical conditioning.

R– Traditional and mixed martial arts practices differ in technique, regulations, equipment and intensity. As a result, participation may result in a wide range of injuries from mild to severe. The most common martial arts injuries are sprains, strains, cuts, bruises and broken bones. These injuries often affect the knee, ankle, shoulder and elbow. Striking techniques may result in injuries to the face, nose, mouth and hands. They can also cause concussions and traumatic brain injuries in people with bleeding disorders. Any martial art using kicks, punches and falls onto the opponent can result in rib fracture or injury to the chest.101

S– Injury prevention in martial arts depends on a combination of protective gear, strength training, proper technique, rule enforcement, and progressive skill development. To improve safety, consider the following recommendations: always wear appropriate protective equipment—such as headgear, mouthguards, protective cups, and proper footwear—especially during sparring. Wrap hands correctly using well-fitted wraps, and if you wear glasses, opt for safety-rated eyewear. Practice should take place in a well-padded area under the supervision of a coach or trained spotter. Learning how to fall safely is one of the most important foundational skills. New techniques should be introduced at half speed, with a focus on precision and control in all movements, including strikes, blocks, punches, and kicks. Even with protective equipment, striking martial arts as well as fighting throws and submission holds are not recommended for people with bleeding disorders.

O - Micromobility means using small vehicles like scooters and bicycles to get around. Many people now use them not just for fun, but also to travel to work or school. These vehicles can be good for your health, help the environment, and reduce traffic. However, there are also safety concerns. Riders can get hurt if they fall or crash, so it’s important to use micromobility devices carefully and follow safety rules.

R - A new report from the U.S. Consumer Product Safety Commission (CPSC) shows that injuries from micromobility devices—like e-scooters, e-bikes, and hoverboards—are going up. In 2022, injuries increased by nearly 21% compared to 2021. Since 2017, these injuries have gone up by about 23% each year. E-scooter injuries rose 22% in 2022 alone. E-bike injuries also jumped, with almost half of all reported injuries from 2017 to 2022 happening in 2022. Hoverboard injuries, however, went down by 26% from 2021 to 2022. Children 14 and younger made up about 36% of all micromobility injuries, even though they are only 18% of the U.S. population. The most common injuries were broken bones and scrapes or bruises. Arms, legs, heads, and necks were most often hurt. Fires are also a danger. From January 2021 to November 2022, there were 19 deaths linked to fires caused by micromobility devices.153

S - To stay safe while riding scooters, e-bikes, or other small electric rides, it’s important to follow some simple rules. Always wear a helmet to protect your head in case you fall. Before you ride, check that everything works, like the brakes, tires, lights, and handlebars. Because these rides are small and quiet, people might not see or hear you, so stay alert and act like no one can see you. Use your bell or horn to let others know you’re nearby, and ride smoothly without making quick or surprising moves. Watch out for bumps or cracks in the road and keep both hands on the handlebars—don’t hang bags from them. When you go over a bump, slow down and lean back a little to stay balanced. Never ride if you’ve had alcohol or drugs, and only one person should ride at a time. Always follow the rules from the company that made your scooter or e-bike, including age and weight limits. Finally, ensure you check and follow local laws that might restrict where you can ride them, as well as the speed limits.

O– Riding a motorcycle can be either a mode of transportation or recreational activity. Motocross is an off-road motorcycle race on a closed circuit. Movements involved in steering a bike strengthen abdominal muscles.

R– Both motorcycling, motocross, and ATV riding have the potential for serious, life-threatening injury. Possible injuries include traumatic brain injury, concussions, spinal cord injuries, fractures and dislocations, in addition to chest and abdominal injuries. These activities are extremely dangerous for anyone.

S– Motorcycle and ATV riding are extremely dangerous activities. If you choose to ride a motorcycle or operate an ATV, always wear a helmet and protective gear. Current data show that approved motorcycle helmets reduce the risk of fatal injury by 37% for operators and 41% for passengers. Never ride under the influence of alcohol. Avoid excessive speeds to help prevent serious injury or death.181

O– Mountain biking is a type of bike riding that takes place on trails instead of smooth roads. People do it for fun or in races. It’s a great way to exercise because it helps your heart stay healthy and makes your muscles stronger. Mountain biking usually happens on bumpy paths with hills and turns. This makes it more challenging, but it also helps riders improve their balance, coordination, and problem-solving skills as they learn to handle different trail conditions.

R - Mountain biking can be risky because riders might fall or crash into things like rocks or trees. In one study of student athletes, researchers found that about half of all injuries happened while riding downhill. Almost 50% of the crashes were serious enough that the rider had to go to the emergency room. In 2021, a report from NICA (the National Interscholastic Cycling Association) looked at injuries in student mountain bikers across the U.S. The report showed that the most common injuries were broken bones, and concussions. Less common injuries included sprains, strains, bruises, cuts, and scrapes. 103

S– Just like with regular biking, wearing a helmet is very important when mountain biking. Helmets help protect your head if you fall. Other safety gear, like elbow pads, shin guards, gloves, and goggles, can also help keep you safe. It’s also important to ride a bike that fits your body and is in good working condition. Before you go out, make sure your bike is checked and ready. Always carry a repair kit in case you need to fix a flat tire or something else on the trail.

O- Pickleball is a sport that uses a paddle and a racket, and it’s becoming popular with people of all ages. It’s played on a smaller court than tennis, and the paddle is lighter. The rules are a lot like tennis.

R - The most common injuries in pickleball that send people to the emergency room are muscle strains, joint sprains, fractures.144

S – Make sure to wear the right shoes—ones that support your feet and are made for court sports. Look around the area before you play to make sure there’s nothing you could trip over, like benches or gym equipment. Never play on a wet court. Wet surfaces are very slippery and can be dangerous. And always wear eye protection to help keep your eyes safe while playing.115

O– Joseph Pilates made the Pilates method popular in the 1930s to help athletes train and heal from injuries. Pilates includes special movements that make your core muscles stronger and uses special breathing patterns. It is a mind-body exercise, which means it helps both your body and your focus. Pilates helps improve core strength, posture, flexibility, breathing, and how well you control your movements. You can do Pilates on a mat or with special equipment. Using equipment can make the exercises easier to learn and may help build core strength more safely.

R– To get the most benefit and stay safe, Pilates exercises should be done the right way. Good Pilates form needs strong and steady joints in the shoulders, hips, spine, and neck. If someone has a problem with one of these joints—like an injury or a target joint—they should work with a certified instructor. The instructor can help change the exercises to fit their needs and protect those areas from getting worse.110

S - If you’re new to Pilates, it’s best to start with a class led by an instructor. You can try a mat or chair class. These use your body weight to build strength, and may also include small tools like hand weights, bands, or balls. If an exercise hurts or feels too hard because of strength or movement limits, ask your instructor for a different version, called a modification. This helps you stay safe and still get the benefits of the workout.

O– Both weightlifting and powerlifting are competitive sports where people try to lift the most weight in one try. In weightlifting, there are two events: the snatch and the clean and jerk. In powerlifting, there are three events: the squat, bench press, and deadlift. Powerlifting uses heavier weights and focuses on strength. Weightlifting movements are faster and need more flexibility. Weightlifting also focuses on power and how quickly you can move the weight.

R– Both weightlifting and powerlifting by comparison have a lower risk of injury. In weightlifting, there are about 2 to 3 injuries for every 1,000 hours of training. In powerlifting, it’s about 1 to 4 injuries for every 1,000 hours. But lifting very heavy weights through big movements can put a lot of stress on the joints. This can lead to muscle and joint bleeds, especially for people with bleeding disorders. Because of this, the risks of these sports may be greater than the benefits for some people.111

S – As with all riskier activities, get advice from your medical provider, use all recommended protective gear and use proper techniques.

O– Racquetball is a fast-paced racket sport played in an enclosed court with two or four players. Playing racquetball can improve reflexes and hand-eye coordination.

R– Because the ball moves fast and players swing rackets; there is a high risk of eye injuries in this sport. These injuries can be serious and may even affect vision. That’s why wearing eye protection is very important. Just like in other racket sports, swinging over and over can cause overuse injuries in the arm muscles and joints. Even though the court is smaller than a tennis court, players still run, lunge, and make quick moves. These actions can lead to ankle sprains or other injuries in the legs.

S– Wearing shoes that support your feet and are made for court sports is important. Because racket sports are one of the sports that report the most eye injuries, protective eyewear is recommended. Only eyewear compliant with updated ASTM (or similar) standards was associated with no eye injuries. 116

O– River rafting can be done in calm water or in fast-moving water. It is usually done with a group of people working together in the same raft.

R– Rafting in fast-moving water is riskier than rafting in calm water. People can get hurt both inside the raft and after falling out, which is called capsizing. When this happens, they may have to swim in the river. In whitewater rafting, injuries often happen when someone gets hit by a paddle, another person, or equipment inside the raft. Blunt trauma injuries can also happen if someone falls out of the raft and hits rocks or other objects under the water.107

S– If you go on a guided rafting trip, choose a company with trained guides who know the river and the rapids. Always wear a U.S. Coast Guard-approved life vest. If you're rafting in white water, you must also wear a helmet. Watch the water currents so you don’t float farther than you planned. If the current gets too strong, or if you see rocks or fallen trees ahead, paddle away from them. Since surprises can happen on the water, it’s important to learn basic rescue skills. Taking a paddler safety course is a smart way to stay safe.

O– Rock climbing is an activity that can be done in different ways. Some people use ropes and harnesses, while others enjoy bouldering, which means climbing shorter walls without ropes. To climb, you need strength and good movement, but there are ways to make it easier for different people. Indoor climbing walls and challenge courses are great places to learn. With the right teacher and safety rules, climbing can be a safe and exciting way to stay active. Strength and range of motion are important components of rock climbing, but the activity can be done with adjustments. Climbing on indoor walls and challenge courses with proper instruction and supervision can provide a safer environment.

R– The biggest risk in rock climbing is falling. This is especially true in indoor bouldering, where climbers don’t use ropes. Most injuries happen to the lower body, like legs or feet. These injuries often occur when someone falls or jumps down from the climbing wall.120

S– Climbing safely is very important. Always make sure trained staff are watching and helping during climbing activities. All the gear you use, like ropes, harnesses, and helmets, should meet special safety rules from a group called the International Climbing and Mountaineering Federation (UIAA). Never try to fix broken gear yourself. Instead, make sure everything is checked and in good shape before you climb. Before you start climbing or helping someone else climb (called belaying), learn how to do it the right way. Wear special climbing shoes to help you grip better. Don’t climb higher than the safe area marked at the site. Keep practicing to get better and take breaks when you feel tired or need to catch your breath.

O– Just like indoor climbing, outdoor rock climbing also needs strength and good movement. These help climbers reach and hold onto rocks safely. But if someone has trouble with certain movements, there are ways to change the activity to make it work better for them.

R– Climbing outside on real rocks can be more dangerous than climbing indoors. Even though serious injuries are rare, falling can sometimes cause very bad injuries. The most common problems are cuts, bruises, sprains, and broken bones. Fingers and shoulders are injured most often. For teens, there’s a special risk of hurting the growth plates in their bones, which can affect how they grow. In a type of climbing called lead climbing, climbers may get different kinds of injuries. These can include head injuries, shoulder or collarbone injuries, and foot problems. Some of these are caused by the tight shoes climbers wear to help them grip the rock.150

Bouldering outside can lead to more finger and hand injuries, especially to the ligaments. These are the stretchy parts that help your fingers move. Climbing without ropes or harnesses, like in bouldering, is riskier—especially for people with bleeding disorders, because even small injuries can be more serious for them. There are also extra risks when climbers go rappelling, which means using a rope to slide down a rock. If it’s not done carefully, accidents can happen.

S– See Indoor Rock Climbing for safety tips. In addition to those safety measures before climbing outside, it’s important to learn how to do it safely. Start by taking a class or practicing at an indoor climbing gym. There, you can learn the right way to climb and how to belay, which means helping to keep another climber safe with a rope. You’ll also learn the special words and commands climbers use to talk to each other clearly. When climbing outdoors, always use strong and safe anchors to hold your ropes. Wear clothes that match the weather and shoes that work well on rocky ground. Watch out for falling rocks and always check the weather before you climb. In the mountains, the weather can change quickly and without warning.

O– Rodeo is a sport that includes different events, like riding wild horses (called broncos) and catching calves with a rope. Each event needs its own special skills.

R -Rodeo is a rough and risky sport with a lot of hard contact and crashes. Because of this, many different kinds of injuries can happen. Some of the most serious injuries affect the head, neck, spine, arms, and legs. The most common injuries are sprains and strains, but concussions also happen often. Out of all the rodeo events, bull riding causes the most injuries, and bareback riding has the second highest injury rate.121

S - As with all high risk activities, get advice from your medical provider, use all recommended protective gear and use proper techniques.

O– Rowing is a great way to get strong and stay healthy. It gives you a tough aerobic workout and uses your whole body. In rowing, people sit in a boat and face backward. They use one or two oars to move the boat through the water. Their feet are strapped into a footboard to help them push. Rowing can be done alone or as part of a team. Some people row just for fun, while others do it in races and competitions.

R– Rowing uses many muscles, especially in the legs, back, and arms, to move the boat. It gives your body a strong workout. However, using the same muscles over and over can lead to overuse injuries. Some common rowing injuries include low back pain, rib stress injuries, shoulder pain and instability, knee, wrist or forearm pain. A more serious condition called exertional compartment syndrome can happen in the forearm. This injury can be more complicated for someone with a bleeding disorder.108

S– Always wear a U.S. Coast Guard-approved life vest or personal flotation device. Since accidents can happen, it’s important to learn basic rescue skills. If you start to feel tired, take a break and rest.

O–A rowing machine is a piece of exercise equipment that mimics the action of rowing a boat. It gives a full-body workout by using your legs, arms, and core. You sit on a sliding seat, pull a handle, and push with your legs to create a smooth rowing motion. The machine uses resistance—like air, water, or magnets—to make the workout more challenging. Rowing machines are great for building strength, improving heart health, and offering a low-impact way to stay fit. 28

R–Users should be aware of possible strain of the shoulders, knees and lower back. Rowing requires lower back and hip mobility. Overuse injuries are possible.

S– Proper use requires some degree of coordination and practice. Proper form is key. Reduce risk by getting instruction and performing a proper stroke. Listen to your body and pace yourself.

O– Rugby is a team sport that includes a lot of running, passing, kicking, and tackling. Players try to move the ball down the field while stopping the other team from scoring. Rugby is a high-contact sport, which means players often bump into each other and fall during the game. One great benefit of playing rugby is that it helps build endurance, which means you can stay active and strong for longer periods of time. Tackling and hard hits are a regular part of the game, so learning how to play safely is very important.

R– Rugby players can get hurt in ways that are similar to American football players. Serious injuries can happen to the head, neck, spine, arms, and legs. Concussions, injuries to the brain caused by a hard hit, are also a risk. Most injuries in rugby happen during tackles, which are when one player tries to stop another by bringing them to the ground. Because tackling is such a big part of the game, learning how to do it safely is very important.122

S– If you decide to play rugby, it’s important to stay safe. Learn the right way to move and position your body during the game to avoid risky plays. Always wear a mouth guard that fits well to protect your teeth and jaw. And make sure you’re playing at a level that matches your skills and experience.

O– Running is a great activity you can do on your own or with others. You can choose to run just for fun, or take part in races or fun runs, either by yourself or as part of a team. Since running is an individual sport, you get to decide how often you run, how hard you run, and where you run. Running has many benefits. It helps your heart stay healthy and can also help tone your muscles. Plus, it’s a great way to enjoy the outdoors and stay active.

R– Running and jogging are harder on the body than walking because they involve more impact. This means your legs, hips, and spine take more pressure with each step. Because of this, runners have a higher chance of getting hurt. Common injuries include sprains, strains, stress fractures, irritation of the bands that connect the muscles to the bones, and nerve problems. For people with bleeding disorders, this extra impact can lead to more bleeds and may make joint problems worse over time. That’s why it’s important to listen to your body and take care of your joints when running.123

S– To stay safe while running, it’s important to start slowly and learn the right way to do things. Get help from a coach or instructor if you can. Go at your own pace, especially during the first 4 to 6 months, when your body is still getting used to running and injuries are more likely. Wear proper running shoes that fit well—it's best to have them fitted by a professional. Pick a safe place to run, like a track or a path away from traffic. Be extra careful when coming back from a bleed, an injury or when changing how far or how fast you run, because these times can lead to more injuries.

When running near roads, it’s important to stay safe. Use sidewalks whenever you can. If there isn’t one, run facing traffic so you can see the cars coming. Stay alert and don’t wear headphones or use your phone while running. Cross streets at crosswalks or in bright, well-lit areas. Try not to run when it’s dark, but if you do, wear bright or reflective clothes and carry a flashlight or headlamp. Always follow traffic rules and never run through red lights. Avoid roads with fast-moving cars, and don’t run toward the rising or setting sun, because drivers might not see you well. If you’re new to running, get a safety talk first, and try to run with a buddy or a group.124

O - Micromobility means using small vehicles like scooters and bicycles to get around. Many people now use them not just for fun, but also to travel to work or school. These vehicles can be good for your health, help the environment, and reduce traffic. However, there are also safety concerns. Riders can get hurt if they fall or crash, so it’s important to use micromobility devices carefully and follow safety rules.

R - A new report from the U.S. Consumer Product Safety Commission (CPSC) shows that injuries from micromobility devices—like e-scooters, e-bikes, and hoverboards—are going up. In 2022, injuries increased by nearly 21% compared to 2021. Since 2017, these injuries have gone up by about 23% each year. E-scooter injuries rose 22% in 2022 alone. E-bike injuries also jumped, with almost half of all reported injuries from 2017 to 2022 happening in 2022. Hoverboard injuries, however, went down by 26% from 2021 to 2022. Children 14 and younger made up about 36% of all micromobility injuries, even though they are only 18% of the U.S. population. The most common injuries were broken bones and scrapes or bruises. Arms, legs, heads, and necks were most often hurt. Fires are also a danger. From January 2021 to November 2022, there were 19 deaths linked to fires caused by micromobility devices.153

A new study looked at nearly 2 million injuries from micromobility devices between 2019 and 2022. These devices include e-bikes, powered scooters, hoverboards, and bicycles. The study found that injuries from e-bikes went up by 293%, and injuries from powered scooters rose by 88%. Powered scooters had the highest number of injuries involving alcohol use (9%), E-bikes had the most injuries involving cars (35.4%). Hoverboard riders were more likely to have broken bones and concussions. Helmet use was highest among bicycle riders (48.7%), followed by e-bike riders (43.8%), scooter riders (34.8%), and hoverboard riders (30.3%). The study shows that serious injuries from e-bikes and scooters are rising. Experts say we need better ways to track and prevent these injuries to keep people safe.154

S - To stay safe while riding scooters, e-bikes, or other small electric rides, it’s important to follow some simple rules. Always wear a helmet to protect your head in case you fall. Before you ride, check that everything works, like the brakes, tires, lights, and handlebars. Because these rides are small and quiet, people might not see or hear you, so stay alert and act like no one can see you. Use your bell or horn to let others know you’re nearby, and ride smoothly without making quick or surprising moves. Watch out for bumps or cracks in the road and keep both hands on the handlebars—don’t hang bags from them. When you go over a bump, slow down and lean back a little to stay balanced. Never ride if you’ve had alcohol or drugs, and only one person should ride at a time. Always follow the rules from the company that made your scooter or e-bike, including age and weight limits. Finally, ensure you check and follow local laws that might restrict where you can ride them, as well as the speed limits.

O - Nonmotorized or “kick” scooters are a fun and healthy way to move around. Riding one gives you a great workout that’s easy on your joints. It helps your heart, strengthens your whole body, and improves your balance and coordination. You can use a scooter just for fun or as a way to travel short distances, like to school or around your neighborhood.

R - A study found that most scooter injuries in children were minor, like cuts, bruises, and sprains. Out of 983 patients, over half had these types of injuries. Some children had more serious problems, like head injuries (25%), broken bones (17%), or injuries to the chest or stomach (5%). A few children had very serious injuries, such as skull fractures, bleeding in the brain, or damage to organs in the belly. Most of the injuries happened to kids under 15 years old. Even though most injuries were not severe, the serious ones show why safety is so important.125

There are some important things to know about staying safe while riding a scooter. One big risk is not wearing safety gear, especially helmets and wrist guards. Riding on bumpy or busy roads can also be dangerous because it’s harder to stay balanced and avoid traffic. Most injuries happen to kids around age 11, especially if they’re new to riding. Going downhill or riding too fast can make it hard to stop or stay in control, which can lead to accidents.

S - Wearing safety gear—like helmets, wrist guards, and knee pads—can help prevent injuries. Helmets, have been shown to reduce the risk of concussions and other head injuries. Parents and children should be aware of the risks and always use safety gear when riding scooters

O– Scuba diving is an underwater activity that lets you breathe using special equipment. SCUBA stands for Self-Contained Underwater Breathing Apparatus. To dive safely, you need the right gear and proper training, including a certification course. Scuba diving is good for your health, just like swimming. It helps your heart, builds strength, and improves flexibility. When you move through water, your muscles work harder because of the water’s resistance, giving you a full-body workout.

R– Scuba diving can be fun and healthy, but it also requires your body to be in good shape. Serious injuries or even death can happen if a diver isn’t physically ready. That’s why it’s important to do regular exercise, especially activities that help your heart and build strength, before going for your dive check-up. People with health risks like diabetes, high blood pressure, heart problems in the family, high cholesterol, smoking history, or signs of frailty should get a physical exam before starting or continuing scuba diving. This helps make sure their heart and body are strong enough for diving.

The most common injury is called “ear squeeze,” which happens when a diver doesn’t balance the pressure in their ears while going deeper underwater. This can hurt or damage the eardrum. Lung injuries can happen if a diver holds their breath or swims up too fast, so it’s important to breathe normally and rise slowly. Another serious problem is decompression illness, which includes two types: one where bubbles block blood flow (called arterial gas embolism), and another where nitrogen bubbles form in the body (called “the bends”).126 Drowning can happen if equipment breaks or a diver gets scared underwater. Some sea animals can sting, bite, or cause allergic reactions, so divers should be careful and avoid touching marine life.

S– Before going scuba diving, it’s important to plan ahead for safety, and have a plan in case something goes wrong. Divers should look at things like the weather, water conditions, and how deep they plan to go. This helps them decide if it’s safe to dive.127 Bring first aid supplies, like bandages and extra oxygen. Make sure you have a way of calling for help, such as a phone or walkie-talkie. Always wear the right gear and check that it works before you dive. Never dive alone—go with a buddy or someone who can watch you. It’s also smart to dive in places that are easy to get to, like shallow water, and make sure help is nearby if there’s an emergency.