Why e-bikes are becoming a pediatric trauma crisis
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Kids ride e-bikes all around beach neighborhoods in San Diego. Photo: Kevin Carter/Getty Images
E-bikes are on track to become the most common cause of child trauma cases at Rady Children's Hospital this year, trauma medical director Romeo Ignacio told Axios.
Why it matters: As e-bikes have become a popular ride for San Diego kids in recent years, crashes, injuries and ER visits have also spiked.
By the numbers: Rady Children's saw three pediatric trauma patients tied to e-bikes in 2021. That jumped to 262 kids last year.
- There were nearly 90 e-bike-related cases in the first quarter of 2026, which means e-bike injuries are poised to become the most common injury among trauma cases this year, Ignacio said.
- Most of these patients are 12-16 years old, but some are as young as four or five, he said.
- The hospital sees about 900-1,000 trauma patients annually, and more than 25% of such cases are now related to e-bikes.
Zoom in: Many kids are coming into the ER with arm, leg, face, pelvic bone and spinal fractures, Ignacio said.
- They also frequently see severe head injuries, including skull fractures, as well as brain bruises and bleeding, which can have "lifelong, altering consequences," he said.
"These injuries are similar to what we see with motorcycles or low-speed motor vehicle collisions," Ignacio said. "It's just the speed of these bikes is much faster than conventional bikes."
Between the lines: Pedal-assist e-bikes can get up to 20-28mph depending on the type, and some have throttles that allow riders to accelerate up to 20mph without pedaling.
- At 20mph, "colliding into a car that doesn't see them because they're going much faster than expected has dire consequences," Ignacio said.
- He noted he's not anti-e-bike and sees the benefits as a healthy outdoor activity or a way to get to school, but said California and local cities need better regulation, infrastructure and education to make them safer for kids.
State of play: Several cities across San Diego County are cracking down on e-bikes by limiting their use for kids under 12 and restricting the number of passengers. State law already bans kids under 16 from riding e-bikes that go up to 28mph.
- La Mesa became the latest to adopt the ban for young riders, despite pushback from some parents and councilmember Laura Lothian, who argued it unfairly targets families instead of older teens riding recklessly.
- San Diego City Council plans to take up the issue this summer to get new restrictions in place for next school year.
Pro tips: Adults and kids can take a free e-bike safety course developed by local hospitals and the San Diego Bike Coalition last year.
- The roughly hourlong online training lays out e-bike types and maintenance, rules of the road, safety equipment and includes a specific section for teens and parents.
- California Highway Patrol has an e-bike safety and training program, plus Scripps Health offers one for teens.
Tell us: Has your child been injured on an e-bike? What concerns do you have as a parent? What are the benefits for kids to ride e-bikes? What restrictions or regulations do you want to see?
- Email us at [email protected] to share your story.