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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

Strength Training/ Resistance Training/ Weight Lifting

O– Using weights or resistance to increase muscle strength is a relatively safe
activity at all ages and fitness levels. Because it is an individual sport, the
participant can easily modify the intensity of training to suit individual
needs and goals. Equipment used can include: dumbbells, long bars,
kettlebells, medicine balls, cables, stretchy bands or machines. There are
many benefits to strength training, which include: cardiovascular fitness,
body composition/weight control, bone mineral density, improved
cholesterol levels and mental health.
R– Injuries to the back, muscle strains and tears, bone fractures and cartilage
damage can occur. Power lifting has significantly greater risks. See Power
Lifting.
S– Maximize safety by following proper technique, getting instruction and
participating at your own pace in a supervised environment. Following
age-appropriate guidelines is important. The American Academy of
Pediatrics states that preadolescents and adolescents should avoid
maximal lifts until they reach physical and skeletal maturity.

Surfing

O– Surfing has benefits that include improved balance, coordination
and strength.
R– Traumatic injuries can be caused by a wipeout, when the surfer contacts
a ground surface, such as the bottom sand or a reef. Overuse injuries can
also occur. The most common injuries occur in the lower half of the body,
face, head and neck. Cuts are the most common injury type.
S– To maximize safety, choose a setting that matches your skill level. Surfing
in an artificial, more controlled setting is predictable and can be safer than
surfing in a natural setting. Consider using a life vest, personal flotation
device or helmet as needed.

Swimming

O– Swimming is a low-impact sport that provides a combination of muscle
strengthening and cardiovascular conditioning. Proper technique will
minimize the risk for repetitive stress injury. It is an activity that can be
continued throughout life.
R– Injuries as well as musculoskeletal bleeding related to swimming
are usually associated with overuse, as well as using improper stroke
technique, especially when fatigued. Swimmers may also develop
too much flexibility, especially in the shoulder. Occasionally swimmers
may develop hip or knee problems from breaststroke kicking.
S– Risk may be minimized by taking care to use proper strokes and
resting as needed.

Tennis

O– Tennis can be played on a variety of surfaces including grass, clay or
pavement. According to a study, tennis has lower injury rates than contact
team sports and as compared to noncontact individual sports, such as golf
and running. Benefits include improved coordination, muscle strength
and endurance.
R– Due to repetitive swinging, overuse injuries to the shoulder, elbow and
wrist can occur. Because the game also includes quick, repetitive and
multidirectional movements, other common injuries are muscle strains,
ligament sprains and stress fractures.
S– To reduce risk, use proper equipment including footwear, and get
instruction on racquet grip and proper technique. Due to the risk of eye
injury, which could be more serious in someone with a bleeding disorder,
consider protective eyewear certified by the American Society for Testing
and Materials (ASTM) for racquet sports.

Track and Field

O– Track and field includes many different events, which can be appropriate
for different people depending on the condition of their joints and
muscles. These range from running in sprints or longer distances to
jumping and throwing.
R– Participating in track and field can cause stress on joints and muscles, and
injuries can result from overuse.
S– Because the events are so varied, specific choices about which activities
to participate in should be discussed with your healthcare provider.

Trampoline

O– Recommendations from the American Academy of Pediatrics (AAP)
discourage recreational trampoline use such as at home or at a
trampoline park.
R– Injuries may occur even with adult supervision. The most common injuries
are broken bones, sprains/strains, bruises, concussions, and head and
neck injuries. Children younger than 6 years old have an increased risk of
fractures and dislocations. Somersaulting, flipping and falls put jumpers at
increased risk of head and cervical spine injury with potentially permanent
paralysis. Therefore, trampoline use is strongly discouraged by the AAP.
S– Frequently inspect equipment for safety and replace protective padding,
net enclosure and any other damaged parts before continued use. Place
trampolines at ground level when possible. All trampolines should be
surrounded by appropriately placed protective padding. Only one person
should jump at a time. Discourage jumpers from performing flipping
stunts in the home recreational setting. An adult should actively supervise
to ensure the above rules are followed.

Treadmill (Training Equipment)

O– Treadmills consist of a power- or manually operated, continuous
moving belt on which a person can walk, jog or run in place. Features
vary widely; models may have shock-absorbing tracks, uphill grades
and preprogrammed workouts. Exercise on a treadmill provides great
cardiovascular benefits.
R– Minimal risk. Injuries may occur if the treadmill is operated at speeds
beyond the user’s ability.
S– To maximize your safety, use the emergency shut-off tether clip when
available, hold handrails and set belt to .5 mph before mounting and
dismounting. Use the handrails if needed while exercising, looking
forward and taking a comfortable stride. Always keep your position
on the belt in the center.

Volleyball

O– Volleyball is a team sport that can be played recreationally or competitively on an indoor or outdoor court, or on sand. Volleyball exercises the upper body and the legs.
R– Trauma can occur from collision with the ground, the ball or other players. The injury risk in recreational volleyball is lower than competitive volleyball. In general, the most common injuries are ankle sprains, and overuse injuries of the knee and the shoulder.
S– Learn proper technique to reduce the risk of injury. Wear knee and elbow pads, and avoid diving for the ball.

Walking

O– Whether slow and steady or brisk, walking is an excellent aerobic
activity that can be done indoors, outdoors and on varied terrain.
It is also a good social experience when done in groups and is a great
lifelong activity. Because the individual controls the setting and pace,
walking is an activity that can be easily modified to the needs and the
goal of the individual.
R– Injuries can occur from overuse or improper stepping.
S– Maximize safety by choosing a safe location, being cautious of uneven
terrain and wearing proper footwear. If you become tired, rest and do
not overexert yourself.

Water Polo

O– Benefits of water polo include increased endurance and improved
cardiovascular health.
R– Water polo is an intense, contact team sport. As in many sports, the risk
of injury increases with age due to more competitive play, contact and
the size of the athletes. Common traumatic injuries include: contusions,
lacerations, sprains, dislocations or fractures. Overuse injuries also occur
due to repetitive throws and kicks. The shoulder is a common area of
injury, as well as head/concussion, facial and eye trauma.
S– Consider wearing eye protection. Make sure that goggles and facemasks
are flexible and free of sharp edges.

Wrestling

O– Wrestling is a sport involving techniques such as throws and
takedowns, joint locks and pins. Wresting helps develop speed,
strength and endurance.
R– This is a high-contact sport with potential for traumatic injury including
concussion, and ligament and muscle injury. A study revealed the most
common injuries presenting to the emergency department as sprains/
strains, small bone breaks and bruising. There is potential for injury
related to bleeding.
S– Wrestlers should wear protective headgear, kneepads, mouth guards,
athletic support (males) and proper footwear.

Zumba® Class

O– Zumba® combines exercise and dance. It is a total body workout that
includes a variety of fitness elements: cardiovascular training, muscle
conditioning, balance and flexibility. Instructor-led classes combine
high- and low-intensity interval training along with energetic music.
R– In one study, there was a 29% rate of injury among participants, most
often involving the knee.
S– To reduce risk, attend classes led by an experienced instructor, follow
proper technique, wear appropriate footwear and modify moves for
your own level if needed.

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