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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


See Paddling Sports

Martial Arts, Tai Chi

O– Tai chi is a mind-body exercise focusing on core stability, posture,
flexibility, strength, breathing and movement control. The emphasis
on slower movements, breathing and meditation makes this activity
appropriate for most people.
R– Minimal risk. Tai chi practice can involve standing on a partially
bent knee.
S– People with a history of knee injury or repeated joint bleeds may
need to modify some techniques in this form of martial arts.

Martial Arts, Traditional and Mixed

O– Studying low-contact forms of martial arts under the supervision of a qualified instructor can provide good 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 arts 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.
S– To maximize safety, consider the following recommendations. Using proper safety equipment, such as headgear, protective cups, mouth guard and footwear, is essential when sparring. Wrap hands using proper technique with appropriately sized wraps. If you wear glasses, use safety glasses for proper eye protection. Always practice in a well-padded area. A coach or supervisor should spot participants at all times. Protecting oneself during a fall should be one of the first techniques learned and perfected. New techniques should initially be practiced at half speed. Practice precise movements, including strikes, punches, blocks and kicks, in a disciplined manner.

Motorcycle/Motocross (ATV, Dirt Bikes)

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 and motocross 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– If you decide to ride a motorcycle, always wear a helmet and
protective gear.

Mountain Biking

O– Mountain biking provides excellent cardiovascular exercise and builds
muscle strength. Because mountain biking is done off-road, the terrain
can be rough. However, there can be variety in incline and path
conditions, making it a fun challenge to negotiate the trails.
R– Risk involves falls and collisions with obstacles due to the rough,
uneven terrain. In a study of injuries in downhill mountain bikers,
the most common areas injured were the lower leg and forearms.
The most common injury types were cuts and bruising.
S– As with regular bicycling, helmets are essential. Additional safety
equipment may include elbow pads, shin guards, gloves and eye
protection. Maximize safety by riding a bike that fits you and that
is well maintained. Always carry a bike/tire repair kit.

Power Lifting

O– Power lifting is a discipline of competitive weight lifting in which
athletes demonstrate maximum lifting ability through sudden moves.
Power lifting builds strength.
R– Lifting maximal weight can cause micro-tearing of the muscles, which
is accompanied by bleeding. This could lead to serious complications
in a person with a bleeding disorder.


O– Playing racquetball can improve reflexes and hand-eye coordination.
R– Because of the speed of the ball, as well as racquet-induced injury,
there is a high risk for internal and external eye injury, with the potential
for vision-threatening consequences. Similar to other racquet sports,
the muscles and joints of the arm are susceptible to overuse injuries due
to repeated swinging. Although the court is not as large as a tennis court,
there are still running, lunging and cutting moves that can lead to ankle
sprains or other injury to the joints and muscles of the leg.
S– Because racquet sports are one of the sports reporting the most eye
injuries, protective eyewear is recommended.

River Rafting

See Paddling Sports

Rock Climbing, Indoor or Challenge/Ropes Course

O– Rock climbing uses ropes and harnesses. Strength and range
of motion are important components of rock climbing, but the
activity can be done with modifications. Climbing on indoor walls
and challenge courses with proper instruction and supervision
can provide a safe environment.
R– The primary risk of this sport is falling. The most common causes
of injury are human error and equipment malfunction.
S– Climbing activities should be supervised by trained staff at
all times. All equipment must meet the International Climbing
and Mountaineering Federation (UIAA) guidelines and standards.
Never attempt to repair damaged or malfunctioning equipment.
Ensure all equipment has been well maintained and safety checked.
Learn correct climbing and belaying before climbing or belaying
someone else, and ensure your partner has done the same. Wear
specialized shoes for climbing. Don’t climb above the site’s safe
boundary zone. Practice to improve your skills. Rest when you’re
tired or need a break to catch your breath.

Rock Climbing, Outdoor

O– Like indoor rock climbing, strength and range of motion are
important for outdoor climbing. Some modifications may be possible.
R– Rock climbing in natural settings increases the risk because, though
rare, the potential exists for falls resulting in serious trauma and lifethreatening
injury. The most common injuries range from cuts and
bruises to sprains/strains and fractures. Injuries tend to occur in the
fingers and shoulders. Teen injuries carry the risk of growth plate
fractures. Bouldering or any other climbing without harnesses
or ropes is high risk for people with bleeding disorders.
S– See Indoor Rock Climbing for safety considerations. In addition
to those safety measures, learn correct climbing and belaying
techniques through a formal class and/or in indoor climbing gym
before heading outside to scale real rocks. Learn the language
involved, and use proper communication terms and commands.
Always use safe anchors. Wear appropriate clothing for the climate
and proper shoes for the terrain. Watch for falling rocks. Keep an eye
on the weather. At certain altitudes, it can change dramatically, often
without warning.


See Paddling Sports

Rowing Machine (Training Equipment) .

O– Rowing machines offer the benefit of a total body workout with
little impact on the joints. In addition to the aerobic benefits, rowing
machines can strengthen arm, back, shoulder and abdominal muscles.
R– Users should be aware of possible strain to the knees and lower back.
S– Proper use requires some degree of coordination and practice.
Proper form is key. Reduce risk by getting instruction and performing
a proper stroke.


O– You can choose to run recreationally and/or to participate in fun runs or races, individually or as part of a team. Since running is an individual sport, you can control the intensity of participation and where you run. Benefits of running include improved cardiovascular health and toning.
R– Running and jogging are higher impact than walking, and therefore pose a great risk of injury to the weightbearing joints of the lower body. Injuries include sprains, strains and stress fractures. This impact and wear and tear may increase the number of bleeds and contribute to severity of joint disease.
S– To maximize safety, get instruction, start at your own level and progress at your own pace. Wear proper footwear, fitted by a professional. Choose a safe area for the activity.

Scooters, Motorized

O– Gas- and electric-powered scooters can be used for recreation
or as a way to get around.
R– Riding a motorized scooter carries the risk for serious traumatic
injury. The most common injuries are cuts, bruises and fractures.
Most injuries are due to rider error or the terrain.
S– The risk of injury can be minimized by wearing a helmet and
protective pads for elbows, knees and wrists. Ride only on smooth
surfaces free of dirt, sand, gravel and water. Avoid riding at night or
in bad weather. Owners of power scooters should check with local
laws, as many jurisdictions prohibit the use of powered scooters on
roadways and sidewalks. The Consumer Product Safety Commission
strongly discourages children younger than 13 from riding high-speed
motorized scooters.

Scooters, Nonmotorized

O– Nonmotorized scooters can provide an excellent aerobic workout.
They can be used for recreation or as a way to get around.
R– Falls and crashes are possible on a scooter. The most common
injuries occur in the wrist, followed by the face and head.
S– Practice slowing, stopping and balancing before venturing out.
Novices should stay in safer environments without traffic, hills,
obstacles and uneven surfaces. Riders should wear a helmet and
protective pads for elbows, knees and wrists. Wearing wrist guards
can decrease the number of wrist injuries by 87%; elbow pads can
decrease the number of elbow injuries by 82%; kneepads can decrease
the number of knee injuries by 32%. Further, helmets can decrease
head injuries by 85%. Follow traffic rules. Children under 8 should
ride with adult supervision at all times.