17 Common Skateboarding injuries (Prevention & Treatment)

All 17 common skateboarding injuries, from wrist fractures and sprains to ankle damage, head injuries, knee trouble and elbow injuries.

Bails also cause shoulder and hip injuries, thigh bruises, road rash, foot and rib damage, broken collarbones, spinal injuries and concussions, each with its causes and warning signs.

Injury Rates and Numbers

The figures below come from injury surveillance data and peer reviewed studies. Each row names the population it was measured in, because rates from elite athletes and from recreational players are not comparable.

Finding	Measured in	Source
An estimated 1,226,868 skateboarding injuries among US children and teens aged 5 to 19 were treated in emergency departments from 1990 through 2008, an average of 64,572 per year.	US children and adolescents aged 5 to 19 years treated in emergency departments (NEISS sample), 1990 through 2008, published 2016	Injury Epidemiology (Lustenberger et al. / NEISS analysis), Injury Epidemiology 2016;3:5
Upper extremity injuries accounted for 44.1 percent of skateboarding injuries treated in US emergency departments, ahead of lower extremity injuries at 31.7 percent.	US children and adolescents aged 5 to 19 years treated in emergency departments (NEISS sample), 1990 through 2008, published 2016	Injury Epidemiology 2016;3:5, NEISS analysis of skateboarding injuries
Fractures and dislocations were the most common skateboarding diagnosis at 32.1 percent, while 96.9 percent of injured young skateboarders were treated and released rather than hospitalized.	US children and adolescents aged 5 to 19 years treated in emergency departments (NEISS sample), 1990 through 2008, published 2016	Injury Epidemiology 2016;3:5, NEISS analysis of skateboarding injuries
Boys accounted for 89.0 percent of skateboarding injuries treated in US emergency departments, and riders aged 11 to 14 made up 44.9 percent of all cases.	US children and adolescents aged 5 to 19 years treated in emergency departments (NEISS sample), 1990 through 2008, published 2016	Injury Epidemiology 2016;3:5, NEISS analysis of skateboarding injuries
Falling off the board caused 76.9 percent of skateboarding head and face injuries seen in US emergency departments, and 14.1 percent of those visits involved a fracture.	All ages presenting to US emergency departments with skateboard-related head and face trauma (NEISS), 2009 through 2018, published 2020	Journal of Oral and Maxillofacial Surgery 2020, NEISS 10-year analysis of skateboarding head and face injuries

Overview

Injury	Body area	Typical time out
Wrist Fractures and Sprains	Hand and wrist	2 weeks to 3 months, longer if surgery
Ankle Sprains and Fractures	Ankle	1 week to 4 months by grade
Head Injuries	Head	Days to several months
Knee Injuries	Knee	2 weeks to 12 months by structure
Elbow Injuries	Elbow	1 to 3 weeks, up to 4 months
Shoulder Injuries	Shoulder	2 weeks to 6 months
Hip Injuries	Hip	1 to 3 weeks, months if fracture
Thigh Bruises and Cuts	Thigh	1 to 6 weeks
Cuts and Abrasions (General)	Skin	3 days to 2 weeks
Foot Injuries	Foot	1 week to 3 months
Spinal Injuries	Spine	1 to 3 weeks, months if fracture
Long Bone Fractures (e.g. femur, fibula, tibia, humerus, radius, and ulna)	Arms and legs	6 weeks to 6 months
Concussions (Head Injury)	Head	1 to 4 weeks, sometimes months
Face Injuries	Face	1 to 6 weeks, longer for dental
Rib Injuries	Chest	3 to 12 weeks
Back Injuries	Lower back	1 to 3 weeks, months with nerve pain
Collarbone Fractures	Shoulder	6 to 12 weeks, 3 months to skate
Scaphoid Fracture and Thumb Ligament Injury of the Hand	Hand	6 to 12 weeks, longer if delayed

Wrist Fractures and Sprains

When you fall off a board you almost always land on an outstretched hand, and the whole body weight passes through the wrist in a fraction of a second. The scaphoid and the lower end of the radius take the bony load, while the scapholunate ligament and the triangular fibrocartilage on the little finger side take the twisting load. A sprain means those ligaments are overstretched or partly torn, a fracture means the bone itself has cracked.

Symptoms

• Pain on the thumb side of the wrist when you push up from the ground
• Swelling across the back of the wrist within an hour of the fall
• You cannot bend the wrist fully back or take weight on the hand
• A deep ache that keeps coming back every time you push or carry
• Bruising that spreads into the back of the hand over the next days

How serious it is: Sprains are graded 1 to 3, from a stretched ligament that stays stable to a complete tear with an unstable joint. The tricky group sits in between: a scaphoid fracture often looks like a mild sprain, hurts in the small hollow at the base of the thumb, and can be invisible on the first x-ray.

Typical time out: Two to four weeks for a grade 1 sprain, six to twelve weeks for a fracture in a cast, and three months or more if a scaphoid fracture heals slowly or needs surgery. The wide range exists because bone healing in the scaphoid depends on a fragile blood supply.

See a doctor if: See a doctor if the wrist looks bent out of line, if pain sits in the hollow at the base of the thumb, or if pain and swelling are unchanged after a week, because a missed scaphoid fracture can fail to heal.

What helps

• Get an x-ray after any fall you could not catch, and ask specifically about the scaphoid if the thumb side hurts
• Short cooling in the first hours for pain relief, then move the fingers and elbow early so the whole arm does not stiffen
• A splint for a sprain, a proper cast for a confirmed fracture, and a fixed date to review rather than open-ended immobilization
• Rebuild grip and forearm strength gradually before you push off the ground again, starting with light loaded wrist extension and rotation
• Wrist guards with a rigid splint on the palm side for every session once you return, since they reduce the force that reaches the joint

Ankle Sprains and Fractures

The classic skateboarding ankle injury happens when you roll off the board or land with the foot turned inward, which overstretches the anterior talofibular ligament on the outside of the ankle. Bailing from a stair set or a ramp lands the whole body on one foot, and if the twisting force is high enough the fibula tip or the talus breaks instead of the ligament tearing.

Symptoms

• Immediate pain on the outside of the ankle, often with a pop at the moment of landing
• Swelling in front of and below the ankle bone within a few hours
• You limp or cannot put full weight on the foot
• The ankle feels loose or gives way on uneven ground
• Bruising that tracks down into the foot after a day or two

How serious it is: Grade 1 is a stretched ligament with mild swelling and a stable joint, grade 2 a partial tear with clear instability, grade 3 a complete tear. Any pain directly over the bone of either ankle knob, or an inability to take four steps, points toward a fracture rather than a sprain.

Typical time out: One to three weeks for a grade 1 sprain, four to eight weeks for a grade 2, and two to four months for a grade 3 or a fracture, longer if the joint needed fixing with plate and screws. Recurrence risk stays high for months, so the return date is set by balance and strength, not by the calendar.

See a doctor if: Go to a doctor if you cannot take four steps on the foot, if the bone itself is tender to touch rather than the soft tissue, or if the foot feels numb or looks pale.

What helps

• Load the ankle early within the limits of pain, since protected walking beats prolonged rest for both healing time and long term stability
• Balance training on one leg, first on the floor, then on an unstable surface, because impaired balance control is the strongest predictor of the next sprain
• Calf and peroneal strengthening, especially the muscles that pull the foot outward
• A lace up brace or tape for the first months back on the board, which measurably lowers reinjury risk
• Imaging if you cannot weight bear or the bone is tender, so a fracture is not treated as a sprain

Head Injuries

Skateboarding head injuries range from scalp cuts and bruises to skull fractures and bleeding inside the skull. The dangerous mechanism is the backward fall, where the board shoots forward and the back of the head hits the ground with nothing to break the fall. Falling off the board caused 76.9 percent of skateboarding head and face injuries seen in US emergency departments, and 14.1 percent of those visits involved a fracture.

Symptoms

• Headache that gets worse rather than better over the first hours
• Feeling dazed, slowed down, or unable to remember the fall
• Nausea or repeated vomiting
• Blurred or double vision, ringing in the ears, sensitivity to light
• Clear fluid or blood from the nose or ear after a hard impact

How serious it is: A minor scalp wound or bruise heals like any skin injury. The serious end is a skull fracture or a bleed between the skull and the brain, which can appear normal for a couple of hours before symptoms build, which is why any head impact with loss of consciousness gets assessed the same day.

Typical time out: A few days for a scalp cut, one to four weeks for a mild brain injury with a staged return, and several months after a skull fracture or a bleed. The range depends on whether the brain was involved at all.

See a doctor if: Call emergency services for any loss of consciousness, seizure, repeated vomiting, worsening headache, one pupil larger than the other, weakness on one side, or fluid from the nose or ear.

What helps

• Stop the session immediately after any head impact and do not skate again the same day, even if you feel fine
• Have someone stay with you for the first 24 hours and check that you can be woken normally
• Same day medical assessment for any impact with loss of consciousness, confusion, or vomiting
• A certified helmet that fits and is replaced after a hard impact, since the foam liner does its job only once
• Learn to fall to the side and roll rather than sitting straight down backward, and keep the chin tucked

Knee Injuries

Landing a drop absorbs several times body weight through the knee, which loads the patellar tendon, the meniscus between the two bones, and the cruciate and collateral ligaments. Landing with the knee twisted inward on a bad bail is the classic mechanism for an ACL or meniscus tear, while repeated hard landings without a tear produce patellar tendinopathy, a degenerative change in the tendon below the kneecap.

Symptoms

• A sharp pain point just below the kneecap that flares when you land or squat
• Swelling that fills the joint within hours after a twisting fall
• The knee catches, locks, or will not straighten fully
• A feeling that the knee gives way when you turn
• Pain sitting with the knee bent for a long time, then stiffness on standing up

How serious it is: Ligament injuries are graded 1 to 3, from stretched to completely torn. A tendinopathy that only hurts at the start of a session is early, while pain that stays through the session and into the next day means the tendon is being loaded faster than it can adapt.

Typical time out: Two to six weeks for a mild sprain or an early tendinopathy caught in time, three to six months for a meniscus repair, and nine to twelve months after ACL reconstruction. The range is wide because ligament reconstruction is rebuilt tissue that needs a full year to tolerate impact.

See a doctor if: See a doctor if the knee swelled up within an hour of the injury, locks in a bent position, or gives way when you walk, since those point to a torn ligament or a trapped meniscus.

What helps

• For patellar tendinopathy, slow heavy resistance work and eccentric decline squats rather than rest, since the tendon adapts only to load
• Cut the number of high drops per session first, then rebuild gradually, because volume of impact drives the pain more than any single trick
• Land with the hips back and the knee tracking over the foot, and use a roll out on drops instead of stopping the landing dead
• Strengthen quadriceps, glutes, and calves, since the calf absorbs a large share of landing force before the knee does
• Corticosteroid injection is not a solution for tendinopathy: it can ease pain briefly but tends to leave the tendon worse over time, so keep it as an exception

Elbow Injuries

Falling on an outstretched arm drives force straight along the forearm into the elbow, which can dislocate the joint or crack the radial head. Landing directly on the point of the elbow instead irritates the olecranon bursa, a small fluid sac over the bone tip, which then swells into a soft egg shaped lump.

Symptoms

• Pain and immediate swelling around the joint after a fall on the hand
• A soft swelling right on the point of the elbow that moves under the skin
• You cannot straighten or bend the elbow fully
• Pain when turning the palm up and down
• Pins and needles in the ring and little finger

How serious it is: Bursitis and a bruise settle on their own. A dislocation or a radial head fracture is the serious form: the joint looks deformed, is locked, and needs reduction and imaging. Warmth, redness, and fever with a swollen bursa suggest infection rather than simple irritation.

Typical time out: One to three weeks for bruising or bursitis, four to eight weeks for a stable radial head fracture, and two to four months after a dislocation, since the elbow stiffens faster than any other joint if it is held still too long.

See a doctor if: Get medical help if the elbow looks deformed or locked, if the hand feels numb or cold, or if a swollen elbow becomes hot, red, and comes with fever.

What helps

• Start gentle bending and straightening within days rather than wearing a sling for weeks, because a stiff elbow is harder to fix than a sore one
• Elbow pads with a hard cap for every session, which is the single measure that prevents repeat bursitis
• Short cooling for pain in the first hours, then normal use of the arm within pain limits
• X-ray after any fall where you cannot straighten the elbow, since a radial head fracture is easy to miss
• Physiotherapy if range of motion has not come back by three to four weeks

Shoulder Injuries

A fall onto the point of the shoulder compresses the acromioclavicular joint, the small joint where the collarbone meets the shoulder blade, and tears its ligaments. A fall with the arm out to the side and rotated back instead pushes the humeral head out of the socket at the front, which stretches the capsule and can chip the rim of cartilage that holds the joint centered.

Symptoms

• Sudden pain on top of the shoulder when you land on it
• A visible step or bump where the collarbone meets the shoulder
• The arm feels like it slipped out and back in, or is stuck out from the body
• You cannot lift the arm overhead or reach across the chest
• Numbness or weakness down the outside of the upper arm

How serious it is: AC joint injuries are classified type I to III for the common range, from a sprained ligament with no visible step to a complete tear with an obvious bump. A first dislocation in a young skater carries a high chance of it happening again, which is the main factor in how it is treated.

Typical time out: Two to four weeks for a type I AC sprain, six to twelve weeks for a type III or a first dislocation, and four to six months after stabilizing surgery or a rotator cuff repair.

See a doctor if: Go to an emergency department if the arm is held stiffly away from the body and cannot be moved, if the shoulder contour looks squared off, or if the arm is numb.

What helps

• Use the sling only for comfort in the first days, then start moving the arm below shoulder height
• Rebuild the rotator cuff and the muscles that pull the shoulder blade back and down, since scapular control is what keeps the joint centered
• Progress to overhead and loaded positions before you attempt tricks where a hand catch is likely
• Imaging if the arm stays weak or a step in the collarbone is visible, so the type is known before you plan a return
• Accept a longer break after a first dislocation, because coming back early is the main reason it recurs

Hip Injuries

Landing sideways puts the whole impact on the greater trochanter, the bony point on the outside of the hip, where a bursa and the gluteal tendons sit right under the skin. That produces a deep bruise or an irritated tendon insertion. Higher energy falls can crack the femoral neck or tear the labrum, the cartilage ring around the socket, especially in awkward twisting landings.

Symptoms

• Pain on the outside of the hip when you lie on that side at night
• A deep ache in the groin when you rotate the leg or pull the knee up
• Pain and stiffness in the first steps after sitting
• Bruising over the bony point of the hip after a sideways landing
• Clicking or catching in the groin when you turn

How serious it is: A bruise or an irritated bursa settles within weeks. Groin pain with an inability to bear weight after a hard fall is the serious form, since a femoral neck fracture in that situation needs surgery quickly. Night pain lying on the side is the typical marker of gluteal tendinopathy rather than a bruise.

Typical time out: One to three weeks for a bruise, six to twelve weeks for gluteal tendinopathy treated with progressive loading, and three months or more after a hip fracture or labral surgery.

See a doctor if: See a doctor the same day if you cannot bear weight after a fall, if the leg looks shortened or turned outward, or if groin pain is severe with every step.

What helps

• Progressive hip abductor loading for tendinopathy, starting with isometric holds that calm the pain, then building to loaded work
• Avoid sitting with legs crossed and lying on the painful side, since both compress the tendon against the bone
• Hip padding or padded shorts if you regularly land on the same side in a park
• Short cooling and normal walking after a bruise, rather than days of sitting still
• X-ray for any fall where weight bearing is impossible, before assuming it is only a bruise

Thigh Bruises and Cuts

A direct hit from the board, a rail, or the coping crushes the quadriceps muscle against the femur, which tears small vessels inside the muscle and fills it with blood. That is a contusion, sometimes called a dead leg. Cuts and scrapes on the thigh come from sliding across concrete or catching the grip tape.

Symptoms

• A deep, tight ache in the front of the thigh that worsens over the first hours
• You cannot bend the knee fully because the muscle will not stretch
• A firm swollen area you can feel under the skin
• Bruising that appears a day or two later, often lower down the leg
• Limping, especially going down stairs

How serious it is: Mild if you can still bend the knee past 90 degrees, moderate between 45 and 90, severe below 45. A thigh that keeps getting harder and more painful over hours instead of settling needs urgent assessment, since pressure inside the muscle compartment can cut off circulation.

Typical time out: One to two weeks for a mild contusion, three to six weeks for a moderate one, and longer if bone forms inside the muscle after repeated impacts to the same spot.

See a doctor if: Seek urgent care if the thigh becomes tense and increasingly painful over hours, if the foot feels numb, or if a wound gapes open or keeps bleeding through the dressing.

What helps

• Keep the knee in a gently bent position for the first hours after a hard contusion, which limits how much the muscle swells
• Short cooling for pain, then start pain free knee bending early rather than immobilizing the leg
• Rebuild with progressive strength work and avoid deep aggressive stretching into pain in the first week
• Clean grazes with water and mild soap, keep them covered and moist rather than letting a hard scab form, and change the dressing daily
• Watch a wound for spreading redness, increasing pain, or fever, and get it checked if any of those appear

Cuts and Abrasions (General)

Sliding across asphalt or a concrete bowl scrapes off the upper skin layers, which is the classic road rash. Deeper cuts come from the board edge, trucks, hardware, or coping and can reach the fat layer below. The wound itself is rarely serious, but grit driven into the skin and the daily reopening of the surface are what cause infection and scarring.

Symptoms

• A raw, stinging area that weeps clear fluid
• Visible dirt or grit embedded in the surface
• Pain that is worse with movement over a joint such as the elbow or knee
• A cut whose edges gape open rather than sitting together
• Increasing redness, warmth, or throbbing after the first day

How serious it is: Superficial grazes heal without scarring in one to two weeks. Deeper wounds that gape, that go through the full skin thickness, or that sit directly over a joint need proper closure and take longer, and any wound with grit left inside will tattoo the skin permanently.

Typical time out: Three days to two weeks for most grazes, longer for a wound over a joint that reopens every time you bend it. Stitched cuts typically need seven to fourteen days before full loading.

See a doctor if: See a doctor for wounds that gape, will not stop bleeding after ten minutes of pressure, still contain grit you cannot rinse out, or become red, hot, and painful with fever.

What helps

• Rinse thoroughly with running water and mild soap to remove every piece of grit, which matters more than any ointment
• Skip alcohol and hydrogen peroxide, since they damage the healing tissue
• Keep the wound moist and covered with a non stick dressing rather than letting it dry out, which speeds healing and reduces scarring
• Cover it again before skating and change the dressing if it soaks through
• Check your tetanus vaccination status for any deep or dirty wound

Foot Injuries

Landing with only part of the foot on the board drives the impact through a small area of the midfoot, which bruises the heel fat pad, irritates the plantar fascia along the sole, or cracks a metatarsal. Repeated ollies also load the fifth metatarsal on the outside of the foot, a bone that is known for stress fractures and slow healing.

Symptoms

• A bruised, tender spot under the heel or across the ball of the foot
• Sharp pain in the sole with the first steps in the morning
• Pain over one specific bone on the outside of the foot that worsens with each session
• Swelling across the top of the foot after a hard landing
• You shift weight to the other foot without meaning to

How serious it is: A bruise or an irritated fascia is mild and settles with load management. A stress fracture is the form that gets worse if you keep skating, and a fracture at the base of the fifth metatarsal is known for failing to heal, which is why persistent bone pain gets imaged rather than waited out.

Typical time out: One to three weeks for a bruise, six to twelve weeks for a metatarsal fracture, and three months or more for plantar fasciopathy or a slow healing fifth metatarsal fracture.

See a doctor if: See a doctor if you cannot bear weight, if a single point on a bone stays tender for more than two weeks, or if the foot is visibly deformed after a landing.

What helps

• Cut session volume and drop height for several weeks rather than skating through bone pain, since a stress reaction becomes a fracture
• Shoes with an intact, thick sole under the landing foot, and replace them once the grip tape has worn a hole through
• Calf and foot intrinsic strengthening, including heel raises with the toes propped up, for plantar fascia pain
• A heel cup or cushioned insole while the fat pad recovers
• X-ray or, if that is normal and pain persists, further imaging for a suspected stress fracture

Spinal Injuries

Landing flat on the back or falling from a height compresses the vertebral bodies and can wedge one of them, most often at the junction between the chest and lower back. In the worst case the fracture fragment or a dislocation presses on the spinal cord itself. Far more commonly the injury stays in the soft tissue: the small facet joints and the deep back muscles get sprained.

Symptoms

• Pain in the middle of the back directly over the spine after a flat landing
• Pain that shoots into an arm or leg
• Numbness, tingling, or weakness in a limb
• Difficulty standing up straight or turning
• Loss of bladder or bowel control, which is always an emergency

How serious it is: A muscular or facet joint sprain hurts but leaves nerve function intact. A vertebral fracture involves point tenderness directly on the bone. Any numbness, weakness, or loss of bladder control means the spinal cord or nerve roots are involved and the situation is an emergency.

Typical time out: One to three weeks for a muscular sprain, eight to twelve weeks in a brace for a stable compression fracture, and many months after spinal cord involvement or surgery.

See a doctor if: Do not move anyone who has numbness, weakness, severe midline back pain, or loss of bladder control after a fall, and call emergency services.

What helps

• Keep the person still and call for help if there is any neurological symptom, and do not try to straighten or lift them
• For a simple sprain, stay moving within pain limits, since bed rest makes back pain last longer
• Rebuild trunk strength and hip mobility, since the lower back takes the load when the hips do not absorb the landing
• Imaging for pain directly over the bone, especially after a drop from height
• Graded return to impact, starting with flat ground before any drops

Long Bone Fractures (e.g. femur, fibula, tibia, humerus, radius, and ulna)

A long bone breaks when the force of the landing exceeds what the shaft can absorb, usually from a drop, a stair set, or a collision at speed. In the arm the radius and ulna break from a fall on an outstretched hand, in the leg the tibia and fibula break from a rotational landing with the foot fixed on the board. Fractures and dislocations were the most common skateboarding diagnosis at 32.1 percent of cases treated in US emergency departments.

Symptoms

• A crack or snap felt at the moment of impact
• Immediate severe pain that does not ease when you stop moving
• Obvious deformity, a bend where there should not be one, or shortening of the limb
• You cannot use the limb at all or bear any weight
• Rapid swelling and bruising around the site

How serious it is: A hairline crack in a stable position can be treated in a cast. A displaced fracture, a spiral pattern, or an open fracture where bone breaks the skin is the severe form and needs surgery, often with a plate or a nail inside the bone.

Typical time out: Six to twelve weeks for bone healing in a simple forearm fracture, three to six months for a tibia or femur, and longer where the fracture was open or the muscle around it wasted during immobilization.

See a doctor if: Call emergency services for any visible deformity, bone breaking the skin, a limb that is pale, cold, or numb below the injury, or pain that keeps rising despite the limb being still.

What helps

• Immobilize the limb as it lies, support it, and get to an emergency department rather than trying to straighten it
• Cover an open fracture with a clean dressing and do not push bone back under the skin
• Follow the surgeon’s weight bearing instructions exactly, since bone healing depends on the right amount of load at the right time
• Start moving the joints above and below as soon as you are allowed, which limits stiffness and muscle loss
• Structured rehabilitation before returning to impact, since the surrounding muscle is always weaker than the healed bone

Concussions (Head Injury)

A concussion is a functional brain injury caused by a blow to the head or a whiplash movement that makes the brain shift inside the skull. The nerve cells are stretched and their chemistry is temporarily disrupted, which is why standard imaging usually looks normal even when the symptoms are clear. In skateboarding it comes mainly from a backward fall onto the back of the head.

Symptoms

• Headache and a feeling of pressure in the head
• Feeling foggy, slowed down, or not quite yourself
• Dizziness, nausea, or balance trouble
• Sensitivity to light and noise, blurred vision
• Trouble concentrating, poor sleep, or unusual irritability in the days after

How serious it is: There is no useful mild or severe grading anymore: what matters is how long symptoms last and whether they are getting better. Symptoms that persist beyond four weeks are treated as a prolonged recovery and need specialist input. A second impact before the first has healed is the situation that causes lasting harm.

Typical time out: Most people recover in one to four weeks, with a staged return to skating rather than a single return date. A small proportion take several months, and previous concussions lengthen the expected recovery.

See a doctor if: Get emergency care for worsening headache, repeated vomiting, seizure, unequal pupils, weakness on one side, slurred speech, or increasing drowsiness.

What helps

• Stop skating on the day of injury without exception, since a second impact while the brain is recovering is the real danger
• Relative rest for the first 24 to 48 hours, then light aerobic activity such as walking or easy cycling, which is now known to shorten recovery compared with lying in a dark room
• Reduce screens and demanding mental work to a level that does not spike symptoms, without cutting them out entirely for days
• A stepwise return, from light activity to flat ground to full skating, with each stage completed symptom free before moving on
• Medical clearance before returning to tricks with a fall risk, especially after a repeat concussion

Face Injuries

The face hits the ground when a fall goes forward and the hands do not get there in time. That produces lip and chin lacerations, broken or knocked out teeth, and fractures of the nose, the cheekbone, or the orbital floor around the eye. Falling off the board caused 76.9 percent of skateboarding head and face injuries seen in US emergency departments.

Symptoms

• A cut on the chin, lip, or eyebrow that gapes open
• A nose that looks bent or bleeds heavily
• Double vision or numbness under the eye
• Teeth that feel loose, chipped, or no longer meet properly when you bite
• Rapid swelling and bruising around the eye socket

How serious it is: Cuts and a bruised nose are minor. The important distinction is whether a bone or a tooth is involved: a cheekbone or orbital fracture with double vision, or a knocked out permanent tooth, both need care within hours, not days.

Typical time out: One to two weeks for a laceration, four to six weeks for a nasal fracture, and six weeks or more after fixation of a facial bone. Dental work can run over months.

See a doctor if: Seek same day care for double vision, numbness in the cheek, a bite that no longer lines up, heavy bleeding, or any head impact that also caused confusion.

What helps

• Keep a knocked out permanent tooth moist in milk or saliva, do not scrub the root, and get to a dentist within the hour, since that window decides whether it can be replanted
• Pinch the soft part of the nose and lean forward for a nosebleed, and get an obviously bent nose seen within a week while it can still be set
• Have any facial cut that gapes closed properly, since scarring on the face depends heavily on how it was closed
• A full face or chin bar helmet for park and downhill riding, and a mouthguard if you have had dental damage before
• Treat every face injury as a possible head injury and check for concussion symptoms as well

Rib Injuries

Landing chest first on coping, a rail, or the edge of a ramp compresses the rib cage against a narrow object, which bruises or cracks a rib and strains the intercostal muscles between them. Because the ribs move with every breath, the injury never gets to rest, which is why it stays painful longer than the size of the injury suggests.

Symptoms

• Sharp pain with deep breathing, coughing, laughing, or sneezing
• Pain when you roll over in bed or push up from lying down
• A tender spot you can press on and reproduce exactly
• Shallow breathing because a full breath hurts
• Bruising over the ribs after a day

How serious it is: A bruise or a single undisplaced crack is uncomfortable but heals on its own. Multiple broken ribs, or any rib injury with breathlessness, is the serious form, since the lung underneath can be punctured or bruised.

Typical time out: Three to six weeks for a bruise or a single cracked rib, six to twelve weeks for multiple fractures. Deep breathing is usually comfortable well before the bone is fully healed, so pain is a poor guide to when to skate again.

See a doctor if: Get urgent care for shortness of breath, coughing up blood, pain in the left upper abdomen after a hard impact, or pain that keeps increasing over days.

What helps

• Take regular pain relief so you can breathe deeply, because good pain control is what prevents the real complication
• Do ten slow deep breaths every hour while awake and hug a pillow to cough, which keeps the lower lung inflated
• Do not strap or bind the chest, since restricting the rib cage increases the risk of a chest infection
• Keep walking and stay upright rather than lying still for days
• Chest x-ray if breathing is difficult or the impact was high energy

Back Injuries

Repeated landings compress the discs and load the small facet joints of the lower back, while the deep spinal muscles work constantly to hold the trunk over the board. That produces muscle strains and facet joint irritation. A disc bulge that presses on a nerve root causes pain travelling down the leg, which is different from ordinary back pain and behaves differently.

Symptoms

• A dull ache across the lower back that is worse after a session and the next morning
• A sudden spasm that locks the back when you twist
• Pain that runs down the back of one leg past the knee
• Numbness or tingling in the foot
• Stiffness getting out of bed that eases after moving

How serious it is: Most back pain is mechanical, settles within weeks, and needs no scan. Pain radiating below the knee with numbness or weakness suggests nerve involvement. Loss of bladder or bowel control, or numbness in the saddle area, is a medical emergency.

Typical time out: One to three weeks for a simple strain, six to twelve weeks or more for disc related nerve pain. The spread is wide because nerve irritation improves slowly and unevenly, often with good and bad weeks.

See a doctor if: See a doctor urgently for leg weakness, numbness around the groin or saddle area, loss of bladder or bowel control, or back pain with fever or unexplained weight loss.

What helps

• Keep moving and return to normal activity early, since prolonged rest reliably makes back pain worse
• Build tolerance with progressive loading of the trunk, hips, and legs rather than isolated stretching
• Reduce the number of hard flat landings for a few weeks and land with the hips and knees absorbing more of the drop
• Skip the scan for ordinary back pain without nerve symptoms, since incidental findings are common and change nothing
• Physiotherapy if pain has not improved in four to six weeks, or earlier if the leg is involved

Collarbone Fractures

The clavicle breaks when you land on the point of the shoulder or on an outstretched arm and the force travels along the bone. Most breaks are in the middle third, where the bone is thin and has no muscle protecting it. The weight of the arm then pulls the outer fragment down while the inner one is pulled up, which is why the break often shows a visible bump.

Symptoms

• Immediate sharp pain over the collarbone after landing on the shoulder
• A visible bump or step along the bone
• You support the injured arm with the other hand and cannot lift it
• Grinding felt when you try to move the shoulder
• The shoulder appears to droop forward and down

How serious it is: An undisplaced fracture heals well in a sling. A displaced fracture with significant shortening, several fragments, or skin tenting over a sharp end is the group where surgery is discussed, because those heal less reliably on their own.

Typical time out: Six to twelve weeks before the bone tolerates load, and three to four months before it takes a fall again. Surgery does not shorten bone healing, it mainly improves alignment in displaced fractures.

See a doctor if: Get seen urgently if the skin over the bone is tented white or broken, if the hand is numb or cold, or if breathing becomes difficult.

What helps

• A simple sling for comfort in the first weeks, with elbow and hand movement from the start
• Pendulum and gentle shoulder movement once the pain allows, rather than keeping the arm still for six weeks
• A follow up x-ray to confirm the position has not shifted before you resume loading
• Progressive strengthening of the shoulder blade muscles before returning to the board
• Wait for the bone, not for the pain: the collarbone stops hurting well before it can take another fall

Scaphoid Fracture and Thumb Ligament Injury of the Hand

The scaphoid is a small boat shaped bone at the base of the thumb and it is the bone that most often breaks when the hand is forced backward in a fall. In the same fall the thumb can be bent sideways away from the hand, which tears the ulnar collateral ligament at the base of the thumb, the ligament that lets you pinch and grip. Both injuries sit in an area where swelling is subtle and the hand still works, which is why they get dismissed as a sprain.

Symptoms

• Tenderness in the small hollow at the base of the thumb when you press it
• Pain when you grip, twist a bottle cap, or push up off the ground
• A weak, unreliable pinch between thumb and index finger
• Mild swelling that never fully goes away
• Pain that returns every time you use the hand, weeks after the fall

How serious it is: A non displaced scaphoid fracture can heal in a cast, while a displaced one or one near the upper end often needs a screw because the blood supply enters from the far end and the fragment can die. Thumb ligament tears range from a partial tear treated in a splint to a complete tear where the torn end folds out of place and needs surgical repair.

Typical time out: Six to twelve weeks in a cast for a scaphoid fracture that heals normally, four to six months if it heals slowly or needs a screw, and four to eight weeks in a thumb splint for a partial ligament tear. The range is wide because scaphoid healing depends on a fragile blood supply and on how early the fracture was found.

See a doctor if: See a doctor if the hollow at the base of the thumb is still tender two weeks after a fall, even with a normal first x-ray, because scaphoid fractures often only become visible later.

What helps

• Ask for a scaphoid specific x-ray series after any fall on the hand with thumb side pain, and a repeat or further imaging if pain persists
• Wear the cast or splint for the full prescribed period, since stopping early is the main cause of a fracture that never joins
• Keep the fingers, elbow, and shoulder moving throughout so the whole arm does not stiffen
• Rebuild grip and pinch strength progressively before you push off the ground or catch a fall again
• Wrist guards that extend over the base of the thumb for every session once you return

First Aid for Soft Tissue Injuries: PEACE and LOVE

Sports medicine has moved on from RICE. The current guidance, published in the British Journal of Sports Medicine in 2019, splits care into the first days after the injury and everything that follows.

PEACE, the first two to three days

• Protect: unload the area and limit movement that hurts, but only briefly.
• Elevate: keep the limb above heart level when you can.
• Avoid anti-inflammatories: they may blunt the healing you need.
• Compress: a bandage or taping limits swelling.
• Educate: your body heals this on its own; passive treatments rarely speed it up.

LOVE, from day three onward

• Load: return to movement as pain allows, early loading builds tissue.
• Optimism: expectations shape recovery more than most people assume.
• Vascularization: easy cardio that does not hurt brings blood to the area.
• Exercise: restore strength, mobility and balance before returning to play.

Ice still helps with pain in the first hours. What changed is the evidence that long icing and routine anti-inflammatory drugs slow tissue repair.

How to Lower Your Risk in Skateboarding

• Wear wrist guards with a rigid splint every session, not just for new tricks. The upper limb takes the largest share of skateboarding injuries treated in emergency departments, and the wrist is where the fall lands first.
• Use a certified helmet that fits snugly and sits low over the forehead, and replace it after any hard impact, because the foam liner compresses once and does not recover.
• Learn to bail before you learn the trick: practice sliding out to the side, rolling over the shoulder, and slapping the ground with the forearm rather than catching yourself on a stiff straight arm.
• Add knee pads and elbow pads for anything in a bowl, on a ramp, or on a rail, since those are the surfaces where you slide rather than step off.
• Build up drop height and stair count in small steps over weeks. Most knee, foot, and back complaints come from a sudden jump in impact volume, not from a single bad landing.
• Check the board before you ride: loose trucks, worn bushings, a cracked tail, and small stones or cracks in the surface cause the sudden stops that throw you forward.

When to Stop and Get Medical Help

Most of the injuries on this page are treated at home. These signs are not.

• Any loss of consciousness, confusion, repeated vomiting, or a headache that keeps getting worse after a fall on the head.
• A visibly deformed or bent limb, bone breaking through the skin, or a joint that cannot be moved at all.
• Numbness, tingling, or weakness in an arm or leg, and any loss of bladder or bowel control after a fall on the back.
• You cannot take four steps on an injured leg, or cannot bear any weight at all on a foot or hip.
• Shortness of breath, coughing up blood, or chest pain that increases over hours after landing on the ribs.
• A limb that turns pale, cold, or numb below the injury, or a muscle that becomes tense and increasingly painful over hours.

Sources

• Injury Epidemiology (Lustenberger et al. / NEISS analysis), Injury Epidemiology 2016;3:5
• Journal of Oral and Maxillofacial Surgery 2020, NEISS 10-year analysis of skateboarding head and face injuries

This article is general information, not medical advice. If you are hurt, a doctor or physiotherapist who can examine you is worth more than any web page. Last reviewed: August 2026.

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