Maybe you've seen them zipping around malls or on suburban sidewalks - kids on roller shoes, the footwear with a wheel in the heel.
"Heelys," as they're known, look like fun - and they are. But doctors say kids are getting hurt on Heelys because parents aren't making them take enough precautions.
Meanwhile, some mall operators and guardians of other public spaces are banning them to keep "heeling" youngsters from colliding with shoppers and pedestrians.
The shoes convert to skates when users lean back on their heels - letting children zip over hard surfaces at high speed.
"These roller shoes are giving the same mobility and movements as skateboards [and] roller blades, and yet parents are thinking of them differently. They think of them as just shoes," said Dr. Gary Smith, an emergency room pediatrician in Columbus, Ohio, who chairs the Committee on Injury Violence and Poison Prevention for the American Academy of Pediatrics.
Parents should make sure children take the same precautions as if they were riding a skateboard or a bicycle - wear helmets and other protective gear, Smith and other experts say.
"I tell parents anytime you have a child on wheels, over a hard surface, you need protective equipment," Smith said.
Six-year-old Elie Soueid of Towson learned that the hard way. Given a pair of Heelys as a present in March, he used them without problems at malls and in his neighborhood off Dulaney Valley Road - until about a week ago, when he fell and scraped his knees and elbows near his home.
Since then, his parents have made a rule: Outdoor wheeling requires a helmet, knee pads and elbow pads.
"When he first got them, I'm like, 'What's the big deal? They're shoes,' " said his father, Dr. Nassif Soueid, a plastic surgeon at St. Joseph Medical Center. "But now we know. You have to be careful."
This week, the American Academy of Orthopaedic Surgeons issued a statement recommending helmets, wrist protectors and knee and elbow pads for kids using the wheeled shoes.
Although there are few reports of serious roller shoe injuries from emergency rooms in the Baltimore area, Irish researchers reported this week that the orthopedic department of one Dublin hospital treated 67 children for injuries suffered while "heeling" and "street gliding" between July 1 and Sept. 15, 2006.
The injured children ranged from 6 to 14, and most suffered sprained or fractured wrists, arms and shoulders, according to researchers at Temple Street Children's University Hospital.
"For one hospital, that's a lot in a relatively short span of time," said Smith, the Ohio pediatrician.
The report Monday in the journal Pediatrics said the mishaps generally occurred outdoors, when novice users fell back or forward as they tried to balance themselves on the wheels. Ten of the injuries occurred in shopping malls and seven in homes. None of those treated by the orthopedists was wearing protective gear.
The footwear the youngsters used was based on the design of shoes with the trade name Heelys, which have a retractable wheel in the heel, or Street Gliders, an adjustable set of wheels that can be strapped to the heels of regular shoes. Both have spawned many imitators.
After the release of the Irish study, Heelys Inc. of Carrollton, Texas, which makes the best-known brand of roller shoes, issued a statement saying the company is committed to safety. It also warned against drawing conclusions from a sample of patients at only one hospital during one summer.
Heelys says it has shipped more than 10 million pairs of the shoes worldwide since 2000 and reported $49 million in sales for the first three months of 2007. The shoes are available in sporting goods and specialty stores in 50 countries, according to the company's Web site, priced from $59 to $90.
The company said its analysis of injuries reported to the federal Consumer Product Safety Commission over six years shows that heeling is safer than basketball, soccer, baseball, skateboarding, scooters and bicycles.
Heelys and Glowgadgets Ltd., the British firm that markets Street Gliders, agree with the commission in recommending that children wear helmets and other protective gear when using their products.
"It's just like anything, a skateboard or a bike. If you don't take reasonable precautions, like headgear and pads, you could get hurt," said Chris Taylor, the owner of Glowgadgets, whose strap-on wheels sell over the Internet for about $40.
Baltimore area doctors say they've seen only a small number of roller shoe injuries, and federal consumer watchdogs haven't seen many, either.
But doctors are concerned about the lack of protective gear. They also warn about skating in stores and malls, where people aren't aware that children might be zipping around them, and on sidewalks and pavement where cracks create hazards.
"Most of the kids I've seen, when I ask how they did it [had an accident], say they hit an uneven patch of sidewalk or pavement, and they fell," said Dr. Teri M. McCambridge, a pediatrician specializing in sports medicine at St. Joseph Medical Center and chairman of the American Academy of Pediatrics' council on sports medicine and fitness.
McCambridge says she treats about two wheeled-shoe injuries a month. The most common damage is a wrist injury, she said. At Howard County General Hospital, doctors see occasional cases, commonly involving leg injuries, according to a spokesman.
Nationwide, 64 roller-shoe injuries and one death were reported to the CPSC between September 2005 and December 2006, spokesman Scott Wolfson said.
He had no details about the fatality, but he said about half of the roller shoe injuries were wrist, hand and elbow sprains and fractures. There were five broken legs, three broken arms and one concussion, Wolfson said.
In contrast, he said, skateboard injuries were responsible for an estimated 125,000 emergency room visits in 2006 and unpowered scooters for 44,000.
Wolfson said the commission will continue to monitor roller-shoe injuries.
Meanwhile, malls and schools have created a patchwork of roller-shoe policies. They're prohibited - along with roller blades and skateboards - at the Westfield Annapolis mall. "It's just a safety concern for other people," said Scott deGraffenried, the mall's marketing director.
Children are permitted to wear roller shoes at the Arundel Mills Mall, but "you can't skate with them in the mall," said Gene Condon, the mall's vice president and general manager.
Roller shoes are allowed at Owings Mills Mall and at Towson Town Center, but security guards will remove anyone whose behavior poses a risk to the safety of other patrons, officials said.
Most school systems let individual principals decide. "We have no system-wide policy, but principals can prohibit them in their schools and in fact they all have," said Patti Caplan, a Howard County schools spokeswoman
Baltimore City schools have no system-wide ban, but the issue is being discussed as part of an annual review of dress-code policies, said spokeswoman Vanessa Pyatt.
For some, it's a matter of parental responsibility. Dr. Edward Seade, an orthopedic surgeon from Austin, Texas, with no financial ties to the company, said his two children use Heelys with protective gear and have never been injured.
"It irritates me when people come out and say it's the Heelys' fault," he said. "No, it's not. It's the parents, who have to take more control of their kids."
To report an injury to the Consumer Product Safety Commission, call 1-800-638-2772 or report online at www.cpsc.gov.
Parents should supervise children closely when they're first learning to use roller shoes.
Children should wear protective gear whenever they're "heeling." That includes helmets, elbow pads, knee pads and wrist guards.
Heelers should avoide uneven surfaces and cracked sidewalks or pavement.
Source: American Academy of Pediatrics