Electric bicycles (e-bikes) and electric scooters (e-scooters) are very popular for recreation and transportation. They are also fun to ride! Their popularity and usage continues to grow, especially in urban and suburban areas. Along with that growth is a rising number of emergency department and urgent care admissions for e-bike and e-scooter injuries, a significant portion of which are traumatic brain injuries (TBIs). Just this past weekend, The Philadelphia Inqurier had an in-depth article on e-bikes, e-scooters and the safety risks they pose.
These small, lightweight forms of transportation fall under the umbrella term “micromobility,” which the U.S. Department of Transportation classifies as any small, low-speed, human or electric-powered transportation device. This includes bicycles, scooters, e-bikes, e-scooters and other small lightweight, wheeled conveyances. Electric forms of powered micromobility vehicles can reach speeds of 30 mph and are sometimes referred to as “powered micromobility vehicles”.
Micromobility-Related Concussions and TBIs
In the May 2026 issue of Neurosurgery, the study The Fast and the Fragile: Neurosurgical Trauma in the Age of Micromobility was published by a researcher team led from New York University Langone Health. The study reviewed the reports of 914 patients who came to the Bellevue Hospital Center due to micromobility-related injuries between 2018 and 2023. The findings were very revealing:
- 8% of the patients suffered a traumatic brain injury (TBI)
- Of the 728 patients who reported if they were wearing a helmet or not, it was found that only 31.7% were wearing a helmet at the time of the injury
- Helmet use was associated with significantly lower TBIs.
Bellevue Hospital Center, located on the east side of Manhattan is home to the lead study author and chief neurology resident, Hannah Weiss, MD. The trauma department at Bellevue has experienced a significant rise in electric mobility related injuries. Dr. Weiss recently told Spectrum News NY 1 that the overall share of trauma cases handled by her trauma center involving e-scooters and e-bikes rose from 10% in 2018 to more than 50% by 2023.
In the Spectrum News NY 1 interview, Dr. Weiss points out the importance of helmets for the operators of these electric mobility devices:
“It’s one of the clearest, most modifiable risk factors that we found in the study. And people with helmets had significantly lower rates of traumatic brain injury. If you had a helmet on, it was protective.”
“I commend Dr. Weiss for bringing attention to the need for helmets when using e-scooters and e-bikes,” says Vincent Schaller, MD, DABFM, CIC, medical director and president of Mid-Atlantic Concussion (MAC) Alliance. “The work she and her colleagues are doing gives us a clear picture as to the traumatic brain injury risks associated with powered micromobility.”
In a 2023 report by the United States Consumer Products Safety Commission examining micromobility product-related injuries and hazard patterns from 2017-2022, researchers found that among an estimated 9,500 micromobility-related injuries treated in emergency departments, only 22% were wearing helmets.
Pedestrians Are at Risk of Micromobility-Related Injuries Too
Circling back to the first research we mentioned at the start of this story that was published in Neurosurgery, there is a significant risk group of this rise of electric mobility that many might have overlooked: pedestrians. Pedestrians suffered higher rates of TBIs than the operators of the devices, at rates of 56.5% vs 30.8%, respectively. According to the study, “Pedestrian injuries involving electric devices also rose; while no pedestrians were [recorded in the study as] struck by electric devices until Q3 2020, they accounted for 37.9% of pedestrian incidents from Q4 2020 to Q3 2023.”
Stricter Micromobility Laws Are Increasing Across the Country
According to personal and commercial e-bike and e-scooter manufacturer OKAI, the laws governing electric micromobility vehicles are evolving fast. In 2026, governments across the states have introduced stricter safety rules for e-bikes and e-scooters. These rules include things like speed restrictions, sidewalk regulations and helmet requirements.
“It is no surprise that more and more states and municipalities all over the country are enacting legislation and regulations to protect electric mobility users and those around them,” says Dr. Schaller. “We can use e-bikes and e-scooters in a safer way and still get the enjoyment and benefits from them.”
For Bikes and Scooters, Plugged or Unplugged, Many of the Same Safety Measures Apply
In 2024, a cross-sectional study examining 45,586 e-bike injuries in the US was published in the Journal of the American Medical Association’s JAMA Surgery. The researchers found a whopping 49-fold increase from 2017 to 2022 in e-bike head traumas, and the researchers attributed a lot of this to a lack of safety practices and regulations. “This gigantic number is shocking, but when you look at the high speeds, increased weight and the wild-west-like lack of meaningful e-bike and e-scooter regulations, it really shouldn’t be,” says Dr. Schaller. “If we are going to reduce the number of concussions resulting from e-bikes and the like, we are going to have to get people using them to comply with meaningful safety measures,” he adds.
Electric Micromobilty Safety Tips
From TuftsMedicine, here are some important e-bike and e-scooter safety tips:
- Always wear a helmet.
- Obey the traffic laws.
- Be visible, day and night.
- Ride defensively and stay alert.
- Start off slowly; practice before riding into busy streets.
- Check your equipment.
The American Academy of Pediatrics recommends that kids under 16 years of age should not operate or ride on motorized e-scooters. If you are a parent and have concerns about if your kid(s) are old enough to ride an e-bike or e-scooter, talk to your child’s pediatrician or family physician about it. And for more great information, be sure to check out our blog on cycling and concussions.
When to Talk to a Concussion Specialist
If you or a loved one has experienced a concussion and are still experiencing symptoms, it may be post-concussion syndrome (PCS). At MAC Alliance, our certified concussion specialists can assist patients throughout Delaware, Maryland, New Jersey, New York, Pennsylvania, Virginia, and Georgia. To find out more, contact us.
