Activity Ratings Chart

O– Roller skating is an activity and sport where shoes have 4 wheels attached to glide on, two in front and two in back. Inline skating is a mix of roller skating and ice skating. The wheels are in a straight line, which makes the skates less stable. That means it can be harder to learn at first and takes more balance. Just like ice skating, all of these types of skating give your heart a good workout and help make your leg muscles stronger. Skateboarding involves standing on or doing tricks on a board with 4 wheels.

R– The most common way people get hurt while skating is by falling. Most of the time, this causes small injuries like cuts, scrapes, or bruises. But sometimes, a fall can lead to a broken bone or even a head injury.

S– To stay safe while skating, it’s important to take care of your skates and wear the right protective gear. Always wear a helmet to protect your head, use wrist guards, knee and elbow pads.129 Check your skates/wheels to make sure they’re in good shape and working well. Get instructed in the basic skills like learning how to stop and fall.

O– Ice skating as exercise helps your heart and lungs stay healthy, and it makes your leg muscles stronger.

R– Skaters can get hurt in two main ways: Over time from doing the same moves again and again and all of a sudden, falling on the ice.

The biggest danger is falling. Skaters can hit their heads or break bones. Most injuries happen to the legs and lower back. Doing jumps and spins, especially in competitions, makes injuries more likely. A study found that the most common injury for skaters was broken bones, typically in arms or hands. Other injuries included cuts and scrapes, muscle or ligament injuries, and head injuries. The main reason people got hurt was from falling, which caused 85.4% of the injuries. Some skaters also got hurt by hitting something or landing badly after doing a jump, axel, or twist.128

S– To stay safe while ice skating, it’s important to take care of your body and your gear. Exercise off the ice to build strong muscles, stay flexible, and keep your balance. Make sure your skates fit well and are already broken in, because stiff boots can hurt your legs and back. Keep your skate blades sharp, but not too sharp. Always check the ice for cracks or bumps that could make you fall. Limit the number of repetitions of any skill performed in one session to prevent overuse. Wear the right clothes and safety gear and make sure everything you use is in good condition.

O– Roller skating is an activity and sport where shoes have 4 wheels attached to glide on, two in front and two in back. Inline skating is a mix of roller skating and ice skating. The wheels are in a straight line, which makes the skates less stable. That means it can be harder to learn at first and takes more balance. Just like ice skating, all of these types of skating give your heart a good workout and help make your leg muscles stronger. Skateboarding involves standing on or doing tricks on a board with 4 wheels.

R– The most common way people get hurt while skating is by falling. Most of the time, this causes small injuries like cuts, scrapes, or bruises. But sometimes, a fall can lead to a broken bone or even a head injury.

S– To stay safe while skating, it’s important to take care of your skates and wear the right protective gear. Always wear a helmet to protect your head, use wrist guards, knee and elbow pads.129 Check your skates/wheels to make sure they’re in good shape and working well. Get instructed in the basic skills like learning how to stop and fall.

O– Ski machines copy the movements of cross-country skiing. Instead of real skis, they have long foot pads that slide back and forth. They give your whole body a workout, including arms, legs, back, and tummy. They also help keep your heart and lungs healthy.29

R– Minimal to Moderate risk, based upon the type of machine. A SkiErg, a newer type of ski exercise machine, is like a vertical rower. It requires more coordination and uses more free movement of the trunk and shoulders than prior models. A SkiErg may not be a great choice for individuals with problems in those areas.30

S– Use proper form to exercise safely. If you choose to use a SkiErg, please learn proper form from a coach, trainer, or therapist familiar prior to use.

O– Cross-country skiing works both your arms and legs and helps your heart stay strong. It’s one of the best sports for building endurance. People usually do cross-country skiing on flat or gently sloping land. The skis are long and narrow, and the boots let your heels lift up so you can glide forward more easily. You can ski just for fun or in races. You can also use different styles and go at your own speed. If it’s too cold or snowy outside, you can even try it indoors on a cross-country ski machine.

R– Because cross-country skiing uses the same movements over and over, it can sometimes cause injuries. Most injuries happen in the lower body, especially the knees. The most common types of injuries are sprains or torn ligaments and bruises from falling or bumping into something.130

S– Use the right technique and make sure your skis and boots fit well and are in good shape. Pay attention to the weather and what’s around you. Stay on marked trails that match your skill level.

O– Downhill skiing helps make your leg muscles stronger and uses your core muscles to help you stay balanced while you ski.

R– Downhill skiing is exciting, but it can also be risky. Most injuries happen when someone falls or crashes. The most common injuries are in the knees, head, and face and include fractures (about 39%), bruises and soft tissue injuries (17.2%), sprains and strains (14.5%), and head injuries (14%).131 Head injuries can be very serious and are the leading cause of death in skiing accidents. Most broken bones happen when skiers fall, try to do jumps or tricks or collide with something, like a tree, rock, or ski lift pole.

S– To stay safe while skiing downhill, it’s important to learn the proper techniques by taking a lesson. Skiers should always wear a helmet and goggles to protect their head and eyes. Boots should fit well and be in good condition to help with control and comfort. It’s important to follow all trail signs and rules to avoid accidents. Skiers should choose trails that match their skill level and avoid slopes that are icy or very steep. To stay safe while alpine skiing, always ski with a buddy and never go alone. Dress warmly in layers to protect yourself from cold weather. Wear safety gear like a helmet and goggles to keep your head and eyes safe. Stick to marked trails and follow all the rules on the mountain. Be careful with high speeds, jumps, and tricks, because they can cause injuries. Choose trails that match your skill level and avoid ones that are too hard. Watch out for trees, rocks, and ski lift poles. Make sure your ski equipment is in good condition before you start. Keep a safe distance from other skiers to avoid crashes. If you’re new to skiing, take lessons from a trained instructor.

O– Physical benefits include building strong muscles and improving your balance.

R– Water skiing can lead to injuries if you're not careful. The most common way people get hurt is by hitting the water hard. This can cause sprains and strains, especially in the legs; bruises; injuries to elbows and shoulders. Sometimes, people crash into things like docks or other solid objects, which can cause more serious injuries. Water skiing can also be tough on your joints and muscles. If you’ve had problems with your elbows or shoulders before, water skiing might be harder or riskier for you. 132

S– When water skiing, always have a spotter sitting in the back of the boat to watch the skier and talk to the driver. It’s important for the skier and spotter to learn hand signals so they can communicate clearly. The boat driver should be experienced and know the water well. Skiers must wear a life jacket that is approved by the U.S. Coast Guard. They should also learn how to safely use the rope and to protect their joints while getting up on the skis. Skiing should never be done in shallow water or near docks, boats, or swimmers. Skiers should always look ahead, be aware of where they’re going, and watch out for obstacles in the water.

O– Snorkeling is a fun and easy water activity. You can swim on the surface of the water or dive, while wearing a mask to see underwater, a snorkel (a breathing tube), and swim fins to help you move. Snorkeling lets you look at fish, plants, and other sea life without needing scuba gear or special training. Because the water helps support your body, snorkeling is gentle on your joints. This makes it a good activity for people with bleeding disorders or joint problems.

R– While snorkeling is usually safe, injuries can still happen. These may include drowning, sunburn, dehydration, or stings from sea animals. But with good planning and safety steps, these risks can be managed.

S– To stay safe while snorkeling in oceans, lakes, or rivers, it’s important to be prepared. Always check the weather forecast, know your surroundings, and be aware of tides and water temperature before you go. Follow basic water safety rules, like using the buddy system—never snorkel alone. Make sure all your equipment is in good shape and fits well. Wear a U.S. Coast Guard-approved life jacket if you need extra support in the water.

O– Snowboarding helps make your leg muscles stronger and uses your core muscles to help you stay balanced while riding down the slopes.

R– Most injuries in snow sports happen suddenly. They are often caused by dangerous terrain, accidents on ski lifts, falls, or crashing into other people or objects. In snowboarding, common injuries include: dislocations, fractures, torn ligaments, spinal and head injuries.

S– Before you hit the slopes, it’s a good idea to take a lesson to learn how to snowboard safely. Wearing the right safety gear is very important. A helmet can help protect your head and may even save your life. Even though not all ski resorts require helmets, about 48% of skiers and snowboarders in the U.S. wear them regularly. In terrain parks, it’s also smart to wear wrist guards, elbow pads, and knee pads. These can help protect you if you fall. Using safety gear has been shown to lower the number of head, neck, and face injuries by 43%.133

O– Snow mobiles can be used for recreation or for transportation.

R– Snowmobiling is a high-collision activity with potential for serious traumatic injury. The American Academy of Pediatrics states that head injuries remain the leading cause of mortality and serious morbidity, due to collisions, falls or overturning during operation. Due to risk of serious injury, snowmobiling is high risk for people with bleeding disorders.

S– When snowmobiling, always wear a helmet, drive carefully at safe speeds and be aware of your surroundings.

O– Soccer is a popular sport played all around the world. It’s a great way to get exercise and stay healthy. Playing soccer helps your heart and lungs, and it also makes your muscles stronger. It improves your balance, coordination, and agility. Plus, it teaches you how to work as a team with others.

R– As kids get older, soccer games can become more competitive. This means there may be more contact between players, which can lead to more injuries. The most common injuries in soccer are sprains, strains, broken bones, dislocations, and concussions. One move that can be risky is heading the ball. It can cause neck injuries or concussions. But concussions can also happen if a player hits another person, the goalpost, or the ground. The four most common places players get hurt are the knees, shoulders, head, and neck.134

S– To stay safe while playing soccer, always wear the right protective gear, like shin guards and a mouth guard to protect your legs and teeth during the game. U.S. Youth Soccer has a rule to help prevent head and neck injuries in younger players. Kids 10 and under are not allowed to head the ball in games or practice. Players who are 11 or 12 years old can head the ball, but only up to 25 times per week. Once players turn 13, there are no limits on heading. When heading is first taught, coaches should show players the right way to do it and how to stay safe when going for the ball in the air.135

O– Baseball and softball are fun team sports that are usually well-organized and have adult supervision. Playing these sports is good for your heart and helps you stay healthy. They also help you get better at using your eyes and hands together, which is called hand-eye coordination. Plus, you learn how to work well with others on a team. Tee-ball is a version of baseball for younger kids. Instead of hitting a ball that’s thrown, players hit a ball that sits still on a tee. It’s a great way for children to start learning the game.

R– Baseball and softball are generally safe sports. However, serious injuries can still happen, for example bleeding if a player is hit in the head, by a ball, bat, or another player. Joint injuries are also possible, especially from sliding into bases or colliding with other players. The position you play can affect your risks. For example, pitchers may suffer from joint overuse in the shoulder or elbow, and catchers face added risk of joint strain due to squatting. Tee-ball has a lower injury since players never pitch.7

S– Fatigue and overuse are the most common causes of injury in young baseball players, so it's important to take steps to stay safe. One way to help prevent injuries is to avoid specializing in just one position until high school, giving your body time to develop in different ways.8 Choose a position that matches your physical abilities and always wear the right protective gear. Pitchers should follow pitching rules and pitch count limits to avoid throwing too much, which can lead to serious arm injuries.9 Using “breakaway bases” instead of fixed ones can reduce the risk of injury when sliding. Batters should wear helmets that cover both ears, and for extra protection, consider helmets with a face guard, chin strap, and eye protection. Catchers need to wear full safety gear, including a helmet, face mask, and padding. Always be alert for early signs of a bleed or injury, and make sure to stay hydrated, especially during hot weather or long practices.

O –This activity started in the ocean and was related to surfing, but now people also do it on lakes and calm rivers. It’s kind of like a mix of surfing and paddling. The person stands on a big, floating surfboard and uses a long paddle with one blade to move through the water.

R- There is a higher chance of getting hurt when paddling in rough water, like in surf or waves. Most injuries happen in the shoulder, upper arm, elbow, forearm, or wrist. Low back pain is also a common problem. It makes up about 15 out of every 100 injuries in this sport.109

S – For safety, just like in other paddling sports, you should always wear a U.S. Coast Guard-approved life vest or personal flotation device.

O– Stationary bikes are exercise bikes that don’t move. There are two kinds: upright bikes, which look like regular bikes, and recumbent bikes, where you sit back in a comfy seat with your legs out in front. Both types are great for getting your heart pumping and staying healthy.31

R– Minimal risk. The most likely risks associated with riding a stationary bike are knee pain (related to incorrect seat height or pushing against too much resistance), or back/shoulder/wrist discomfort (related to handlebar position). If a rider has a history of recurrent knee bleeds, a physical therapist may be able to recommend modifications to improve comfort. Stationary bike injuries in children are a significant concern, especially when the bikes are used for play instead of exercise. The type and cause of injuries vary by age and gender. Children under 5 being more likely to experience head, neck, and upper body injuries serious enough to need emergency care.32 33 34

S– People with mobility issues, balance concerns or low back pain may find the recumbent bike more comfortable. Some upright bikes have more possible adjustments than others, which allows for a more customized fit and less stress on your body. To minimize risk, adjust the seat and handlebar heights to your comfort, make sure pedal straps are snug but not tight and be cautious when dismounting. Listen to your body and progress gradually. Finally, please take care to discourage young children from playing on stationary bikes.

O– Steppers are exercise machines that are great for working the big muscles in your legs. They also give your heart a good workout. The best steppers keep your feet in contact with the surface and moving naturally, which makes them easier and safer to use.35 36 37

R– Minimal risk. Risks include injury when getting on and off the machine as well as overuse injuries, especially at the knees. May not be the best choice for individuals with knee problems. Poor posture or leaning too much weight on the bars can cause back pain.

S– To keep risk low, use proper form to bend the knee while maintaining good posture: shoulders back, head up, chin straight, abdominals tight and arms relaxed. Rest hands lightly on the handrails to help with balance (or use the workout bars if available). Try not to lean forward or grip the bars tightly. If needed, lower the resistance level. Exercising on steppers can be an intense cardio workout. Listen to your body and pace yourself.

O– Strength training means using weights or resistance to make your muscles stronger. It’s a safe activity for people of all ages and fitness levels. One great thing about it is that you can go at your own pace. You can make your workout easier or harder depending on what you need or want to achieve. There are many tools you can use, like dumbbells, long bars, kettlebells, medicine balls, stretchy bands, cables, or machines at the gym. Strength training has lots of benefits! It can help your heart stay healthy, keep your bones strong, improve your mood, and help you stay at a healthy weight.

R– Sometimes, people can get hurt while doing strength training. These injuries might include back pain, pulled muscles, broken bones, or damage to the soft parts in your joints, like cartilage.

S– To stay safe while doing strength training, it’s important to learn the right way to do each exercise. You should get help from a coach or teacher and go at your own pace. It’s best to train in a place where an adult can watch and help if needed. Kids and teens should do strength activities at least 3 times a week. These can include exercises that use your own body weight (like push-ups), stretchy bands, weight machines, or small hand-held weights.136

O– Surfing is a sport that’s also great for your body. It helps your heart stay strong, and it builds balance, coordination, and muscle strength.

R– Surfing is fun, but like any sport, it can sometimes lead to injuries. A surfer might get hurt during a wipeout, which is when they fall off the board and hit the ocean floor, sand, or a reef. Doing the same movements too often can also cause overuse injuries. The most common injuries happen in the lower body, face, head, and neck. Cuts are the most common type of injury in surfing.137

S– To stay safe while surfing, pick a place that matches your skill level. Surfing in a man-made wave pool is often safer because the waves are more predictable. In the ocean, waves and conditions can change quickly. You can also wear safety gear like a life vest, a personal flotation device, or even a helmet if needed. These can help protect you while you’re having fun in the water.

O– Swimming is a low-impact sport that helps make your muscles stronger and keeps your heart healthy. Using the right swimming technique can help prevent injuries from doing the same movements over and over. Swimming is also a great activity you can enjoy at any age, even as you get older.

R– Most swimming injuries happen in the shoulders, knees, hips, or back. The type of stroke you use can affect where you might get hurt. These injuries usually happen from doing the same movement too much or using the wrong technique, especially when you're tired. Swimmers can also become too flexible, especially in their shoulders. Sometimes, swimmers who do the breaststroke may have problems with their hips or knees because of the way they kick.138

S– You can lower your risk of getting hurt while swimming by using the correct strokes and taking breaks when you feel tired. Try not to repeat the same movement too much, especially if it starts to hurt. Doing other exercises on land—like ones that build core strength and balance—can also help your body stay strong and healthy. If you’re worried about an injury or want to learn how to stay safe, talk to a sports doctor or athletic trainer. They can give you helpful tips and make sure you’re training the right way.

O - Table tennis, also called ping-pong, can be a recreational game or competitive sport played with rackets. People of all ages enjoy it. The game is fast and needs quick reflexes and fast thinking. Players use their wrists, elbows, and shoulders to hit the ball. They also twist their upper body and move their legs to stay in position and return the ball.

R – The most common injuries in table tennis are irritation of the tendon which connects the muscle to the bone, muscle injuries, and strains or sprains. These can happen in many parts of the body, including the legs, shoulders, spine, knees, arms, and the middle of the body.117

S - Wear protective eyewear, especially if you wear glasses or contact lenses.

O– Tennis can be played on different surfaces like grass, clay, or pavement. Playing tennis helps improve coordination, build muscle strength, and increase endurance.

R– Because tennis involves a lot of swinging, players can get overuse injuries in the shoulder, elbow, and wrist. The game also includes quick and repeated movements in different directions. This can lead to muscle strains, ligament sprains, and stress fractures.118 The risk of eye injury is common in tennis.119

S– To stay safe while playing tennis, use the right equipment, including good shoes made for court sports. It’s also important to learn the correct way to hold the racket and use proper form. Because the ball moves fast, there’s a risk of eye injury—especially for people with bleeding disorders. To protect your eyes, wear safety glasses that meet the standards of the American Society for Testing and Materials (ASTM) for racket sports.