June 4, 2007 -- Even if one hasn't had firsthand experience zipping across sidewalks on a pair of shoes with wheels in the heels, most everyone is familiar with "heeling," as the activity is called.
Now, doctors are worried that the footwear may put young users at increased risk of sprains and fractures, and a new study may further justify their fears.
According to a study released today in the current issue of the journal Pediatrics, 67 children were treated for injuries from footwear known as Heelys and similar products at Temple Street Children's University Hospital in Dublin, Ireland, over a 10-week period last summer.
"The results are pretty amazing," says study author Dr. Mihai Vioreanu, adding that the unnatural balance needed to successfully pilot the shoes likely contributes to injuries.
"This balanced position with a tendency of the body to fall backwards explains the risk of falling," he says.
The study isn't the first red flag that has been raised over the footwear. According to The Associated Press, the U.S. Consumer Product Safety Commission reported last week that one death and at least 64 roller-shoe injuries could be blamed on the trendy footwear.
And the injuries aren't just in Ireland. In recent years, doctors in Korea, Singapore, the United States and other countries have raised concerns about the shoes and the injuries they may be causing.
All of this comes at a time when the products have already sparked an international craze. Heelys Inc., the company that manufactures the Heelys brand footwear, says it has shipped more than 10 million pairs of the wheeled footwear since its introduction in 2000.
Protective Gear Usually Neglected
The company maintains that its products are safe. Last April, Heelys Inc. announced that a study using Consumer Product Safety Commission data on product-related injuries from January 2001 through September 2006 confirmed that the use of the footwear was significantly safer than bicycling, skateboarding, basketball, soccer and even tennis.
"When Heelys are used in accordance with safety instructions we provide in our packaging and on our Web site [with the proper safety equipment], wheeled sports provide safe opportunities for children to exercise." said Heelys Inc. CEO Mike Staffaroni in a press release.
Perhaps central to the shoes' injurious potential is the fact that most parents and their children believe protective gear is unnecessary, says pediatrician Michael Wasserman of the Ochsner Health System in New Orleans.
"I believe it more likely that the inherent design of being able to rapidly shift from [walking] to enhanced skating will virtually eliminate the usage of any protective gear," he says. "It's a great consumer design for fun, but scary from an accident prevention perspective."
"One could almost think that Heelys would be similar to having a child flap his arms pretending to fly suddenly being able to leap into the sky. Pretending is great; the actuality is frightening and dangerous," he added.
To limit injury, study authors say children should use full protective gear, including a helmet, wrist guards, kneepads, and elbow pads, at all times when using roller shoes.
Is Concern Warranted?
Still, doctors are split over whether the findings are a true cause for concern.
"There are certainly safety concerns," says Ari Brown, a pediatrician and author of the books "Baby 411" and "Toddler 411."
Wasserman agrees. "This is not just 'kids being kids,'" he says, noting that he has seen children with sprains and fractures in their arms and elbows from the use of Heelys.
But many doctors question whether it is yet time to sound the alarms. Though mall shoppers and others may find heeling to be a nuisance — indeed, they have already been banned at many schools and shopping malls — some physicians report that the number of injuries they have seen because of the products is still slight.
"I do not see a cause for alarm at this time," says Dr. George Molzen, past president of the American College of Emergency Physicians. "This is kids being kids and is similar to scooters, climbing trees [and other activities]."
"I have seen orthopedic injuries in kids using these," says Dr. Mark Hauswald, professor of emergency medicine at the University of New Mexico. "Of course, I've seen lots more kids injured playing soccer or running to school. This paper does not tell us anything about the magnitude of the risk associated with these shoes."
Other doctors say that even though injuries may still be few and far between, the implications are worrying.
"I must admit I see the warning signs — 'No Heelys Allowed!' — on the doors of local stores, but have never seen an injury ascribed specifically to these products," said Dr. Richard O'Brien, spokesman for the American College of Emergency Physicians.
"That having been said, I read the study with real concern since supracondylar fractures [just above the elbow] and can be very difficult to manage, have complications [nerve damage]," he said.
And even kids who get injured may not be learning their lesson; study authors note that even though most parents urge their children to toss the footwear after injury, 54 percent of the injured children expressed their intention to continue using them after recovery from injury.
Clearer Warnings Needed
Additional warnings could be on the way for Heelys. According to the AP, the American Academy of Orthopaedic Surgeons, based in Rosemont, Ill., this week is issuing new safety advice that recommends helmets, wrist protectors and knee and elbow pads for kids who wear wheeled shoes.
Dr. Charles Shubin, associate professor of pediatrics at the University of Maryland, says additional warnings will be a welcome change.
"As these function very similarly to roller skates, similar warnings and precautions and warnings should apply," he says.
"There should be recommended safety precautions that come in the shoe packaging," Brown says. "Yes, kids will be kids, but that means we should be even more aware of these potential hazards and try to minimize injuries."
However, if the past is any lesson, it is unlikely that the study or the warnings that arise from it will have much of an effect on heeling among kids. After all, even study author Vioreanu says the footwear has its virtues when used safely.
"In my personal opinion, Heelys are great fun," he says.