A cycle of danger

One of the first hazards presents itself before a child even gets on the bike. That occurs when parents either buy a bike a few sizes too big, hoping to extend the life of their investment, or they pass on an older sibling's bike to a younger child.

"It's logical that parents try to buy a bike that's going to last a few years as the child grows. But, it's also very dangerous for a child to be riding a bike that's too big for them," says Dr. Niel Miele, assistant professor of paediatrics at the Temple University Children's Medical Center in Philadelphia.

Many kids' bikes offer some leeway with adjustable seats and handlebars, so parents should look for those features, Miele adds.

But how do you determine the correct size?

"When a child is sitting on a seat, their feet should be touching the ground on both sides," says Miele. "And when buying boys' bikes, which have the crossbar, make sure that when the child is off the seat, that they stand above the bar by at least an inch."

Then there's the crucial issue of wearing a helmet. Dr. David H. Janda, director of the Institute for Preventative Sports Medicine in Ann Arbor, Mich., says you can't overestimate the need for head protection.

"The key to safe bicycle-riding is the following: helmet, helmet, helmet," Janda, an orthopedic surgeon, says. "And helmets should be mandatory for every family member - not just with biking, but for anyone who is roller skating, ice skating, rollerblading, skiing, skateboarding and sledding."

"That might sound a bit protectionist," he adds. "But all you have to do is see one child with a severe, closed-head injury from biking or rollerblading and you say, 'My gosh, how preventable was this?' "

"Yet it happens on a daily basis, and there are completely long-term ramifications - in terms of both disability and financial consequences," Janda says.

Miele agrees.

"You simply can't stress the need for helmets enough. But it's not enough to just go out and buy one - you have to also make sure that it fits properly, too. Otherwise, it can be almost useless in some instances."

After broken arms, head injuries are the most common injuries sustained on bicycles, he says.