E-Bike Crashes Pose Unique Brain Injury Risks for Children

A growing body of medical evidence reveals that e-bike crashes are causing far more severe brain injuries in children than traditional bicycle accidents — and the numbers are climbing at an alarming rate. Neurosurgeons, orthopedic surgeons, and trauma specialists across the country are urging parents and policymakers to take immediate action as pediatric e-bike injuries surge nationwide.

A Neurosurgeon’s Harrowing Account

Dr. Blake Taylor, a neurosurgeon at UCSF, recounts a night that has become all too familiar: a 15-year-old girl arrived at his Marin County hospital with severe head trauma after falling off a friend’s e-bike within seconds of trying it. Her skull was fractured. The large blood vessels surrounding her brain were torn. Dr. Taylor spent most of the night drilling and removing the entire right side of her skull to stop the bleeding and relieve the pressure on her brain stem.

“These e-bike injuries are not like those associated with traditional bikes,” Dr. Taylor writes. “They are more like motorcycle injuries, and the risk of dying is greater.”

The Data Behind the Crisis

The statistics paint a stark picture. A study presented at the 2026 Annual Meeting of the American Academy of Orthopaedic Surgeons found that e-bike injuries among youth in San Diego surged over 300% from 2019 to 2023. At a Level 1 trauma center, e-bikes went from accounting for just 2% of pediatric trauma activations in 2017 to a staggering 64% in 2023.

At Rady Children’s Health in Orange County, the trend is even more dramatic. The emergency department saw just one e-bike-related trauma patient in 2021. By 2025, that number had skyrocketed to 201, making e-bikes the leading cause of ED trauma visits — surpassing falls, motor vehicle collisions, and car-vs.-pedestrian accidents.

Why E-Bikes Are Different

Several factors make e-bike crashes uniquely dangerous for young riders. E-bikes are significantly heavier than traditional bicycles and can reach speeds of 20 to 28 mph legally — with illegal modifications pushing speeds to 70 mph. As Dr. John Maa, a general surgeon at MarinHealth Medical Center, explains: “It’s Newton’s principles, right? Force equals mass times acceleration, and also kinetic energy is mass times velocity squared.”

A Rady Children’s-led study published in the journal Injury found that speed-related e-bike injuries were associated with a higher incidence of head, neck, or facial injuries (49.1% vs. 28.7%) and internal organ injuries (24.1% vs. 10.4%) compared to non-speed-related causes.

“We basically have kids riding vehicles that are much more like motorcycles than bicycles, and many of them have not taken a class on how to ride them safely and don’t know the rules of the road,” says Dr. Laura Goodman, a pediatric surgeon and lead author of the speed study. “It’s a big problem.”

The Illegal E-Bike Problem

Compounding the issue is the proliferation of illegal, overpowered e-bikes. A December 2025 study by the Mineta Transportation Institute found that nearly 90% of electric two-wheelers parked at northern California middle and high schools may not meet legal standards. Some devices have up to eight times more power than legal limits and are becoming “status symbols” among teenagers too young to drive cars.

A Call for Action

Major medical organizations — including the American College of Surgeons, the American Association of Neurological Surgeons, and the American Academy of Pediatrics — have issued safety recommendations calling for helmet use, speed limits, licensure, and age-appropriate riding guidelines.

At Penn State Health Children’s Hospital, Dr. Bryanna Emr, pediatric trauma medical director, reports that doctors have already treated more children injured in e-bike and e-scooter accidents in 2025 than in the prior three years combined. “Parents need to know the risks before letting their child ride these vehicles,” she says.

What Parents Can Do

Experts recommend several steps for families: ensure children wear properly fitted helmets (motorcycle-style helmets for higher speeds), understand local e-bike laws and classifications, take safety courses, and avoid modifying e-bikes. Most safety experts agree that children under 12 should not ride e-bikes.

Makenzie Ferguson, an injury prevention coordinator at Rady Children’s, notes that change takes time. “Historically, it can take five to seven years for injury rates to decline as laws, infrastructure, and helmet standards catch up with new technology like e-bikes.”

The Road Ahead

As e-bike popularity continues to grow and the micromobility market expands, the gap between innovation and regulation remains a critical concern. Several states are considering new legislation, but with a patchwork of laws across the country, experts say a coordinated approach is needed. The question is not whether e-bikes are here to stay — they are — but whether safety measures can catch up before more young lives are permanently altered.

As Dr. Taylor puts it: “If parents, youths, the public and elected officials only knew what happens in my operating room, maybe they would rethink their priorities.”