E-bikes are everywhere in San Diego County. And so are the consequences.
Over the past few years, my colleagues and I have watched a troubling pattern emerge in San Diego County trauma centers: young riders coming in with serious brain injuries, broken bones, and internal trauma after e-bike crashes.
These crashes have become one of the leading causes of traumatic injury among people under 18. That’s not a statistic we take lightly, as the injuries can follow someone for the rest of their life.
But I want to be clear about something: this isn’t just a children’s problem.
We’re seeing adults in their 30s, 50s and even 80s showing up after e-bike crashes — many of them experienced cyclists who underestimated just how different these machines are from a traditional bicycle.
An e-bike can reach speeds that outpace a rider’s reflexes, especially when something unexpected happens in traffic. The stopping distance is longer, the physics are different, and the consequences of getting it wrong are much more serious than falling off a beach cruiser.
From a trauma standpoint, the injuries we see most often are preventable. That’s why I was glad to see our injury prevention community outreach program coordinator at Scripps Memorial Hospital La Jolla, Paige Colburn-Hargis, participate in the e-bike safety webinar hosted by San Diego County Board of Supervisors Chair Terra Lawson-Remer on May 12. Bringing medical professionals, community leaders, and families together to have an honest conversation about what we’re seeing — and what families can actually do about it — is exactly the kind of multi-sector response this problem demands.
One of the big points of discussion was the need to understand the basics and avoid simple mistakes. Helmet use remains inconsistent. Riders frequently lack an understanding of how drivers perceive them in traffic — how blind spots work, how long it takes a car to stop, what a driver can and cannot see at an intersection. These aren’t instincts people are born with, but they are skills they can learn. Young people shouldn’t navigate real traffic without them.
What makes this particularly urgent is the gap between how people think about e-bikes and what they actually are. Many riders (including parents) believe they’re dealing with a glorified bicycle. In some cases, they may actually be riding a high-powered electric motorcycle that exceeds legal limits for classification as an e-bike. When families don’t know that distinction exists, they can’t make informed decisions about training, protective gear, or appropriate riding environments.
No single intervention will solve this. But better education, clearer standards for what gets sold as an e-bike, and more opportunities for young riders to develop real skills in safe environments will make a measurable difference.
If your child rides an e-bike — or is asking for one — please treat it as seriously as a motorized vehicle. Make sure they have a properly fitted helmet appropriate for the speed of the bike they are riding – I can’t overstate the importance of this. Talk with them about traffic, not just rules. And take advantage of the free safety training resources being offered across our county.
I don’t want to see you or your child in my hospital. Education, conversations, and a helmet can help ensure it.
Walter L. Biffl, M.D., is the trauma medical director at Scripps Memorial Hospital, La Jolla.
