I've had three proper offs at any kind of speed:
- Streetmachine vs diesel on left-hand corner: Road rash and bruising to left knee. Grazed elbow. Minor arse bruising. Cosmetic damage to bike.
- Streetmachine, overcooked on right-hand corner: Abraided right ankle on the bony bit. Inconsequential arm bashing. Minmal bike damage, but abraded through an Ortlieb front-roller that broke free in the slide.
- Baron, front wheel blowout at ~40mph: Baboon arse, grazed elbow, minor bruise on foot. Serious damage to bike.
Also various minor offs from the Streetmachine:
- Sustrans mud at low speed leading to chainring vs shin. Leg needed stitches. Bike needed cleaning.
- Crashing into verge due to falling asleep: Landed on hands in press-up position, protected by gloves. Nettle rash. Bruising on hip from handlebar while thrown from the bike.
- Sliding out sideways on gravel: Grazed elbow, minor bruising of hip.
- Clipless moments / learning to ride: One non-bruising painful bash of achilles on front wheel during emergency unclip. Grazed elbow x a few.
About 3 minor offs from the Baron (two while learning to ride, one due to chain coming off at the start of a steep climb and pedalling frantically in neutral rather than putting a foot down), no injuries (hands possibly protected by gloves) or bike damage.
I managed to roll the ICE trike once (low speed, mud, silly camber). No injury or damage.
Various offs from uprights, nearly all off-road (either mountain biking, clipless moments, or using shit cyclepaths with road tyres): Palm of hand usually protected by gloves, countless grazes, cuts and bruises of elbows (my left elbow's scars have scars). Minor cuts and bruises to lower leg. Occasional bruising to body from landing on handlebars, rocks, etc. Occasional clipless-less moments resulting in painful shin brusies or less painful calf bruises. I once shoulder-barged a brick wall in preference to falling into the canal.
I've never hit my head in a cycle accident, except while fettling.
One thing I have noticed is that with under-seat steering, my instinctive reaction in a fall is to pull my hands in from the bars to protect my fingers from being crushed, so the tendency is to land on my elbow and hip. This is the opposite to what happens with tiller steering or uprights, or on foot, where I tend to extend my arms to break my fall.
I'm also suspicious that staying clipped into the pedals in a recumbent crash results in fewer injuries from sliding forward into bits of bike, but it's not like that's something you can reasonably control...
(This all does seem to add up to elbow protection being a fairly good idea, but like helmets I don't think the risks are high enough to justify the inconvenience for normal road riding.)