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Playing It Safe: Activity Ratings Chart

On this page, you can access an interactive chart of activity safety ratings with descriptions, and a downloadable PDF of the full Playing It Safe booklet.”

Before You Start
Once you’ve selected activities that best suit you, meet with your healthcare provider for an evaluation.

About the Ratings
With the color-coded chart, you can see the level of risk involved in the particular activity you are considering. The risk of participation in a specific activity will vary, depending on how you choose to play.

Activities are rated on a scale from 1 to 3. Descriptions of each activity consist of an Overview (O), Risks (R), and Safety Measures (S).

Activitysort descending Range


O– Aquatics here refers to exercise activity that takes place in the water.
Water can provide excellent exercise conditions for people of all ages
and levels of fitness. The buoyancy of water allows people with weak arms
or legs and joint issues to move less painfully. Chest-high water provides
support, allowing people to perform exercises more easily than on land.
Water resistance can also be used to strengthen muscles. Water exercise
has been shown to improve muscular endurance, flexibility and aerobic
fitness. It can also decrease body fat percentage10, while minimizing
stress to joints. Adding props can increase water resistance for a more
challenging workout.
R– Minimal risk.
S– Flotation devices can be used as needed.


O– Shooting with a bow and arrow can be done individually or as part
of a team, and either recreationally or competitively.
R– The overall injury rate is low, 4.4 per 10,000 participants age 6 and over.11
Archery may cause stress to the back, shoulder or elbow, resulting in
possible joint bleeds.
S– Properly fitted and maintained equipment is required, and safety
precautions should be followed to reduce risk of injury. Beginner archers
should wear long armguards to protect from string rebound. You can
minimize risk by building strength in the back, shoulder and elbow,
as well as by using proper technique.11


O– Both recreational and competitive baseball and softball teams are usually
well organized and supervised. Playing baseball and softball provide a
good cardiovascular workout. In addition, they help improve hand-eye
coordination. Further, players develop skills in team play. Tee-ball is a team
sport that is used as an introduction to baseball and softball, as the ball is
hit from a stationary tee. It is popular among young children.
R– Overall, baseball and softball are relatively safe sports. Only 2%-8%
of players report injuries. However, serious impact injuries, such as
intracranial hemorrhage, can occur if there is contact from a ball or
bat to the head, eye area or chest. Additionally, joint trauma can occur
from sliding into bases or colliding with other players.12 The position you
play can affect your joints. For example, joint overuse can occur due to
pitching, and playing catcher presents additional risks of joint injury or
trauma. The injury risk of tee-ball is similar, but is decreased since there
is no pitching in this sport.
S– Use of “breakaway bases” instead of stationary bases minimizes injury
risk from sliding. To maximize safety, players at bat should use certified
helmets with ear flaps on both sides, and possibly face guards, a chin
strap and eye protection. If you choose to play catcher, wear protective
safety gear, including a helmet, facemask and padding. Play safely by
choosing a positio


O – Basketball provides a good cardiovascular workout with a focus on agility.
Intensity of play can vary. Players can choose to participate in casual
games with limited physical contact or more intense, competitive games.
R– During competitive games, players are jumping, landing, pivoting, cutting,
running forward and backward, changing directions and making physical
contact with other players, all of which could lead to musculoskeletal
injury. Sprained ankles and knee ligament tears can occur, and may be
more serious in a player with a bleeding disorder.
S– Injury risk can be minimized by using eye protection, elbow and knee
pads, mouth guards, athletic supporters (males) and proper footwear.


O– From tricycles to multispeed bicycles, bicycle riding is a good nonimpact sport. Children usually have the skills required to ride a tricycle around 3-4 years of age, a bicycle with training wheels around 4-5 years of age and two -wheeled bicycle around 5-6 years of age. Learning to ride a bicycle safely requires simultaneously using motor and thinking (cognitive) skills, which is challenging for most kids.
R– Many of the bicycle-related crashes resulting in serious injury or death occur because of the rider’s poor judgment or not following the rules of the road. Riding a bicycle on very busy roads can bring additional risk. While recreational bicycle riding can be lower risk when safety rules are followed, distance riding and bicycle racing are higher risk. Bicycle racing has the highest risk due to the possibility of high-speed collisions and falls.
S– Riders need to remember basic safety rules. Riders of all ages should wear bicycle helmets that meet or exceed standards set by the American Society for Testing Materials (ASTM), the US Consumer Product Safety Commission (CPSC) and/or the Snell Memorial Foundation.
While there is no federal law requiring the use of helmets, many states and local municipalities do have regulations. It is also important to have a properly fitting bicycle that is well maintained. Avoid risky situations such as riding in the dark, and near heavy traffic or road hazards. Consider bike accessories such as flashing lights, reflector strips
and wearing a reflective vest to be more visible to cars. Riders less than 10 years old may be safer riding on sidewalks or bike paths rather than streets.
Young bicycle or tricycle riders should be closely supervised at all times. If completing a long-distance ride, be sure to train for the event. Make sure you have a bicycle repair kit for breakdowns.

BMX Racing

O– Bicycle motocross, or BMX, is a form of off road cycling on specialized
bikes. Participants either do sprint races on off-road single-lap racetracks,
or focus on jumps and tricks on off-road trails.
R– This is a high-collision, competitive sport with the potential for serious
traumatic injury. BMX racing is dangerous for all people who participate.
S– If you choose to participate, use appropriate safety equipment including
a helmet, goggles, padding and gloves.
Activities with a rating of 2.5 or

Body Sculpting Class

O– These are muscle-toning classes that often include core strengthening. Some have a cardiovascular component. A variety of exercises may be done using equipment, such as small handheld weights or resistance bands.
R– Minimal risk.
S– There are usually beginner to advanced level classes. Participants can work out at their own pace.

Boot Camp Workout Class

O– These classes are a mix of strength training and aerobic conditioning, and contain a variety of exercises offered in intervals. In general, body weight exercises, such as calisthenics, are used along with drills and sprints. The high-intensity intervals of activities are generally alternated with lighter activity.
R– Rapid movements that are often included in these workouts carry more risk.
S– Maximize safety with proper technique, and working at your own level and pace.

Bounce Houses

O– Inflatable bounce houses are popular at children’s birthday parties and
carnivals, and can be a fun, social activity for kids.
R– Bounce houses are similar to trampolines and can also lead to injuries
ranging from sprains/strains to broken bones and concussions. Children
can easily collide with each other in a bounce house that is too crowded,
or can land incorrectly after a jump.
S– To maximize safety, remove footwear, eyeglasses and jewelry. Group
children together by size and do not allow use by those who may exceed
the height/weight warning on the equipment. Proper adult supervision
is recommended.15


O– Boxing provides benefits for participants, including exercise, self-discipline
and self-confidence.
R– Boxing is a high-contact, high-collision sport with high risk for injuries.
The sport encourages deliberate blows to the head and face, which can
result in risk of head injuries (concussions and traumatic brain injury),
facial injuries and neck injuries, including chronic and potentially fatal
neurologic injuries. The American Academy of Pediatrics opposes boxing
as a sport for children and adolescents.16
S– Boxers should always wear a helmet and protective gear. Even with safety
gear, there is high potential for injury.
Activities with a rating of 2.5


See Paddling Sports

Cardio Kickboxing Class

O– Classes combine cardiovascular exercise with the agility, strength,
balance and coordination that can be achieved through martial
arts training. Techniques range from easy to hard, with low-impact
movements (where at least one foot remains on the ground) to
high-impact movements (where both feet leave the ground at
the same time), and no contact to full contact.
R– Full-contact, high-impact cardio kickboxing carries greater risk
of injury through contact and overuse.
S– Full-contact, high-impact cardio kickboxing is more demanding
on the body. To participate safely, make choices to minimize impact
to your body, such as wearing proper footwear.


O– Cheerleading provides the opportunity to work on a team, and participate
in high-energy exercise.
R– Basic cheers and jumps present minimal risk. The risk for injury increases
with pyramids, lifts and throws, especially in competitive squads. The
most common injuries are sprains/strains, usually occurring during
stunts. However, cheerleaders do have a small risk of catastrophic
injuries, such as head and spine injuries.
S– Proper spotting is essential to minimize risk. Aerial moves are not
recommended. Safety precautions that include technical skills, such as
pyramids, mounts, tosses and tumbling, should not be performed on hard,
wet, uneven surfaces or on obstructed surfaces. No cheer events should
take place on dirt, vinyl floors, concrete or asphalt. Pyramids and partner
stunts should only be performed with spotters on a spring floor or with
a landing mat, on either a traditional foam floor or grass/turf. Pyramids
should not be more than two people high.

Circuit Training

See Strength Training


O– Dance may involve participation in a structured class with an instructor
or can be done individually. There are a wide range of dance styles that
can be done for exercise, recreation and/or performance.
R– Injury risk varies greatly from very minimal risk in ballroom dancing or
beginner ballet all the way to very high risk associated with head-spinning
during breakdancing. Injuries tend to be the result of overuse, rather than
trauma, and can include stress fractures, tendon injuries, sprains
and strains.
S– To improve safety, get instruction and follow proper technique.