Why trauma doctors are worried about kids on e-bikes

Doctors are sounding the alarm about e-bike safety, especially when it comes to kids showing up in emergency rooms with increasingly serious injuries. Seniors are also at risk, but generally ride more cautiously.

Dr. Brian Blackwood, a trauma surgeon at Saint Anthony Hospital in Lakewood, Colorado, treats children in e-bike accidents regularly, and he says that the bikes’ speed—up to 28 mph (and even higher with some bikes that can be “jailbreaked”)—plus their heavy weight results in much more severe bodily trauma than falls from typical non-powered bikes. The problem, he said, is that parents buy e-bikes thinking they’re toys, and the kids ride them like scooters, often without head protection.

The most common injuries, Dr. Blackwood told Autoweek, “typically involve broken bones in the arms and legs. However, with higher-speed crashes we are seeing facial fractures and traumatic brain injuries. I have also seen spine injuries and internal organ injuries involving life-threatening bleeding.”

Often, Dr. Blackwood said, “people lose control of the e-bike at higher speeds. This leads to them falling off at higher speeds or crashing into stationary objects.”

According to a American College of Surgeons report, “Higher e-bike speeds reduce reaction time for riders to avoid potential collisions. Special caution should be exercised in traffic and when traveling downhill, as the heavier battery can lead to faster acceleration and loss of control.”

Just such an accident claimed the life of 12-year-old Molly Steinsapir in 2021, when she and a friend—wearing helmets—were riding down a steep hill near their home in Pacific Palisades, California, lost control, and were thrown to the pavement. The family has since filed suit against the e-bike manufacturer.

According to Dr. Emily Greenwald, a pediatric emergency medicine specialist at Duke Children’s Hospital and Health Center (the former co-owner of a bike shop), “Many e-bikes, but not all of them, are terrifying,” she said. “Putting a kid on a bike that can produce speeds of 28 mph, especially if it also has a throttle, is scary. What we’re seeing every day in the pediatric emergency department is a huge, huge problem. E-bike riders are 2.4 times more likely to be admitted to the ICU than regular bike riders.”

She added, “We’ve always had injuries from regular bicycles—it’s part of risky play—but with e-bikes we’re not only seeing an astronomical increase in number of incidents, but also injuries that are far, far worse.”

Jeremy Brittain, who owns the CYCL CRFT bicycle store in Fairfield, Connecticut, said that “parents sometimes come in with their kids’ e-bikes and ask us to make them go faster—so they can keep up with their friends. Many of these parents are ignorant of the capabilities of these bikes. Their kids are 13- and 14-year-olds, and they want to go 50 mph. The parents buy these bikes as toys and hope they’ll be safe. But faster e-bikes are supposed to be registered and insured, as well as ridden by someone with a driver’s license.”

Indeed, the law in Connecticut, and many other states, requires that a bike capable of 50 mph be viewed as a motorcycle, requiring insurance, state registration and a license with motorcycle endorsement.

Brittain added that the parents often trust their kids to also assemble the bikes (which come broken down in boxes), which often results in parts being dangerously loose or not torqued down correctly.

The scientific literature comes to varying conclusions about e-bikes. A 2026 study from Norway, “Relative Injury Risk of E-Bikes and Conventional Bikes,” found overall injury risk in Norway was actually lower for e-bikes than for conventional bikes, but in Europe motor assistance is limited to 15.5 miles per hour, which results in safer and lighter bikes than in the U.S., where Class Two allows assist up to 20 mph with a throttle, and Class Three up to 28 mph. The weight of e-bikes sold in the U.S. can be more than 100 pounds, and speeds are up to 40 mph.

A 2026 report, “Is Panic Over E-Bike Safety Justified” in Transportation Research Interdisciplinary Perspectives found that e-bikes crash less frequently than regular bicycles, but “when medical attention was required, e-bike riders more often sustained severe injuries….E-bike riders face higher injury severity and hospitalization than bicycles.”

Dr. Blackwood noted that there are age restrictions on Class 3 e-bikes, but not on Class 1 and 2. “Even though the Class 1 and 2 bikes have lower top speeds, we are still seeing significant injuries. I think overall more education about the potential risks of significant injury with any e-bike is warranted, as we are seeing significant injuries across all age groups. Additionally, I feel that age restrictions on Class 1 and 2 e-bikes could be beneficial in preventing injury in pediatric patients.”

For seniors, relatively brittle bones are an issue, but it’s countered by more cautious riding. A 2022 study in the National Library of Medicine found, however, that being older than 51 “is not associated with a significantly increased probability of severe injury in E-bike and P-scooter riders.”