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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

Scuba Diving

O– Scuba (self-contained underwater breathing apparatus) diving is an
underwater activity that requires the proper equipment and training,
including dive certification. Scuba diving develops flexibility and strength,
as you move your muscles to propel yourself through water, which
provides resistance.
R– This activity carries inherent risks related to the depth of the water and
the need for proper maintenance of equipment and oxygen supply. There
is also the potential for encountering hazardous marine life. According to
the CDC, injury to the ear due to failure to equalize pressure is the most
common injury. More serious injury can occur during improper ascending,
which can cause lung collapse and decompression sickness.43
S– Minimize risk by scuba diving in a more controlled setting in
shallow depths.

Skateboarding

O– Similar to ice skating, inline skating, roller skating and
skateboarding all provide an excellent aerobic workout.
They also strengthen leg muscles.
R– 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. Always follow traffic rules. While
head injuries are fairly uncommon, participants should wear
helmets to prevent these serious injuries. Protective pads for
elbows, knees and wrists should also be worn. The risk of injury
increases with aerial skills and competitive participation.

Skating, Ice

O– Ice skating provides a solid aerobic workout, and is good exercise
for leg muscles.
R– Figure skaters are at risk for both overuse and traumatic injuries.
The greatest risk is falling on the ice, hitting the head or breaking
a bone. The most common injuries are injuries to the legs and
low back. The risk of injury increases with jumps, aerial skills and
competitive participation.
S– To minimize the risk of injury, participate in off-ice workouts that
develop flexibility, strength and core stability. Make sure your skates
fit well and are broken in. Stiff boots limit ankle and foot range of
motion, which stresses your legs and back. Skates should be sharp,
but not too sharp. Check the ice for chips and bumps that can lead
to falls. Limit the number of repetitions of any skill performed in
one session to prevent overuse.

Skating, Inline and Roller

O– Similar to ice skating, inline skating, roller skating and
skateboarding all provide an excellent aerobic workout.
They also strengthen leg muscles.
R– 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. Always follow traffic rules. While
head injuries are fairly uncommon, participants should wear
helmets to prevent these serious injuries. Protective pads for
elbows, knees and wrists should also be worn. The risk of injury
increases with aerial skills and competitive participation.

Ski Machine (Training Equipment)

O– Ski machines mimic the movement of traditional ski poles in crosscountry skiing. Instead of skis, they have long, narrow boards or foot pads that glide on rollers. Without impact on the joints, they provide a total body workout to the arms, legs, back and abdomen, in addition to the cardiovascular benefits.
R– Minimal risk.
S– Use proper form to exercise safely.

Skiing, Cross-Country

O– Cross-country skiing is a recreational or competitive sport usually
performed on relatively flat terrain, using narrow cross-country skis
with boots that allow you to lift your heel, so you can glide more
easily. It is an excellent aerobic lifetime activity that may be done
using a variety of techniques and at different intensity levels.
This activity may also be performed on an indoor cross-country
ski machine.
R– Due to the repetitive nature of the sport, overuse injuries can occur.
Soft tissue and ligament injuries can result from falls.45
S– Warm up properly before beginning activity, and stop activity when
tired to avoid overuse.

Skiing, Downhill

O– Downhill skiing exercises leg muscles, and also uses core muscles
for balance.
R– Common skiing injuries occur in the knee, head or face, and
include bruises, ligament injuries and fractures. Most injuries
occur during a fall or crash. Traumatic brain injury is the leading
cause of serious injury and death. Moguls, aerial skills and
jumps carry increased risk.
S– Maximize safety by getting instruction, using a specialized skiing
helmet, goggles and properly fitted boots. Make sure to follow all trail
rules, and choose trails that match your skill level. Avoid icy conditions
and steep elevations.

Skiing, Water

O– Physical benefits include balance and strengthening.
R– The most common water skiing injuries are sprains/strains, most
often in the legs. Many water ski injuries result from collisions with
docks or other solid objects. Water skiing can be stressful to the
muscles and joints of the lower extremities, and to the elbows and
shoulders. You may have difficulty water skiing if you have a history
of elbow and shoulder bleeding or injury.
S– Always have a spotter sitting at the back of the boat to watch the
skier and communicate with the driver. Review basic hand signals
with a spotter. Make sure the boat driver is experienced with both the
boat and the body of water. Always wear a US Coast Guard-approved
protective flotation device (PFD, life jacket). Learn how to get out
of the water and use a tow rope safely. Do not ski in shallow water,
near docks or other areas that may have obstacles around the water
level, other boats or swimmers. Always look ahead. Be aware of your
surroundings and where you are going at all times.

Snorkeling

O– Snorkeling is a low-impact recreational activity that requires little effort, and no complicated equipment or training. Activity in the water can be beneficial to those with bleeding disorders due to the support and buoyancy of water, and reduced stress on the joints.
R– Minimal risk.
S– To maximize safety in a natural setting be aware of surroundings, tides and water temperature. Follow proper water safety.

Snowboarding

O– Snowboarding exercises leg muscles, and also uses core muscles
for balance.
R– Common snowboarding injuries occur in the wrist and arm, and include
bruises, ligament injuries and fractures. Most injuries occur during a
fall or crash. Traumatic brain injury is the leading cause of serious injury
and death.
S– Maximize safety by getting instruction, using a specialized snowboarding
helmet, goggles, properly fitted boots, gloves with wrist guards, elbow and
knee pads. Make sure to follow all trail rules, and choose trails that match
your skill level.

Snowmobiling

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.

Soccer

O– Children often participate in supervised soccer games beginning at
very early ages. Benefits include building muscle strength, improving
coordination and teamwork.
R– At older ages, games may become more competitive, resulting in
higher contact and risk of injury. The most common injuries are sprains
and strains in the lower body. Other injuries include fractures, contusions
and overuse injuries. “Heading” the ball carries more risk of neck injury
and concussion, although concussion can also occur due to contact
with another player or the ground.
S– To maximize safety, wear appropriate protective gear, such as shin
and mouth guards.

Softball

See Baseball/Softball/Tee-Ball

Stationary Bike (Training Equipment)

O– Stationary bikes come in two varieties, either upright or recumbent,
a bicycle that places the rider in a laid-back reclining position. Both
types can provide a good aerobic workout.
R– Minimal risk.
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.19
For cycling classes, see Indoor Cycling Classes.

Stepper (Training Equipment)

O– Steppers are excellent for exercising the major muscle groups of
the lower body while providing a cardiovascular workout. The best
steppers keep your feet on an even plane with the floor at all times,
allowing natural foot movement.
R– Minimal risk.
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 hand rails 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.

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