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Encouraging Families to Safely Wear Bike Helmets is a No-Brainer

Dipesh Navsaria, MD, FAAP
July, 2018

On a rainy September morning 10 years ago, my world stopped, for a brief, terrible instant.

I was at work, seeing patients at the hospital, when I received an unexpected page. An ER nurse at another medical center across town came on the line. A few confused seconds passed before I realized that they were telling me my wife was in a bicycle accident. This wasn't was personal.

All I knew was that she was conscious but not making sense. I quickly excused myself from rounds and got on my own bike to make my way over to the University of Wisconsin Hospitals & Clinics. I rode through downtown Madison as visions of brain trauma, surgery, and long-term disability ran through my mind. It is one of those unique curses those who work in health care suffer from, the acute knowledge not only of precisely what may be going on, but all the terrible possibilities that could become very real.

I arrived and even before a hello, the ER nurse (who recognized me from when I've worked there) told me the just-performed head CT was negative. Immense relief flooded through me. I then saw my wife, who had what turned out to be a moderate concussion and a fractured arm. Thankfully, neither injury required surgery or extensive therapy. She stayed overnight for observation but was able to go home the next day. Her concussion resolved quickly, and her arm has long since healed.

What happened that day wasn’t clear, but there was no car involved in my wife’s bicycle accident. She probably lost balance on a wet road. Her injuries and the pattern of bruises made painfully clear the force with which she had hit the ground. The bike was surprisingly intact, but the plastic shell of her helmet cracked off. It had done its job well, spreading and absorbing the force of the impact while protecting her from what may otherwise have been a devastating and possible fatal head injury.

With 26,000 bike-related pediatric brain injuries each year, many children (& adults) still wear helmets incorrectly–if at all. In #AAPvoices, @navsaria on why he’s so thankful his wife wears hers, and why he always urges patients & families to do the same.

As a pediatric physician and an avid cyclist, I tend to notice other people's habits when it comes to bicycles.  Sadly, I have long since ceased to be surprised when I see students riding around campus without helmets, but I'm still astonished to see so many others riding with unprotected heads.  I hear odd arguments from people justifying why they ride without helmets: how they won't protect your limbs, for example, or won’t make much difference if you’re run over by a bus. But the fact is, wearing a helmet can prevent up to 88 percent of cyclists' head injuries.

What's even more concerning are the large numbers of children who are wearing helmets but do not have them adjusted correctly. Time and time again I see loose straps dangling well below their chins, or helmets tipped back so far that their foreheads are exposed to injury.  A common excuse I've heard is that kids "don't like it strapped on so tight."


As a parent, I get it. But it all depends on what they're used to.  My own children know that unless their helmets are adjusted the right way, the bikes have to stay in the garage. They know the rule, and they don’t question it.

 “As pediatricians, we should make sure families know how important it is to wear bicycle helmets and to make sure they fit correctly—starting with a child’s first tricycle and continuing into adulthood.”


Bike helmets should be strapped snugly enough so that you can only just slip a finger or two underneath.  Likewise, the helmet should sit no more than one or two finger-breadths above the wearer's eyebrow.

Bike riding is fun, great exercise and an environmentally friendly way to get where you need to go.  But as with any activity, accidents do happen.  Each year, according to the Centers for Disease Control and Prevention, 26,000 of these bicycle-related injuries to children and adolescents are traumatic brain injuries treated in emergency departments.

As pediatricians, we should make sure families know how important it is to wear bicycle helmets and to make sure they fit correctly—starting with a child’s first tricycle and continuing into adulthood.We can also remind them at well-child visits to check the fit regularly for growing children and replace helmets if they’ve been hit hard. Once the foam padding inside a helmet has absorbed the force of a crash, it’s no longer as protective as it should be. Yes, my wife’s helmet has long been replaced.


When I think back to that rainy morning, I am unspeakably grateful to the passers-by who stopped to help my wife, and to paramedics and emergency room staff for their prompt and expert care.


Most of all, I am thankful my wife wore her helmet.

* The views expressed in this article are those of the authors, and not necessarily those of the American Academy of Pediatrics.

About the Author

Dipesh Navsaria, MD, FAAP, is vice-president of the Wisconsin Chapter of the American Academy of Pediatrics. He also serves on the Executive Committee of the Council on Early Childhood and has been on numerous other AAP task forces and working groups.  An associate Professor of Pediatrics at the University of Wisconsin School of Medicine and Public Health, Dr. Navsaria directs the MD-MPH Dual-Degree Program there.