Cheerleading Injuries Continue to Increase

Despite what some people may think, cheerleading has become more than just catchy cheers and pompoms.  Cheerleading has become increasingly popular over the last 20 years with over 400,000 participants in high schools according to the National Federation of State High Schools (keep in mind this does not include colleges, all star teams or other non-school based programs at any level).  Today cheerleading has become more about stunts and the flyers who perform them and less about cheers and basic dance moves.  The stunts are typically crowd pleasers, but as flyers are tossed higher and higher in the air the risk of injury increases.  Injuries can range from minor sprains and strains to the catastrophic ones (including concussions and neck fractures).  On average, five cheerleaders annually will suffer a catastrophic injury.  Catastrophic cheerleading injuries account for 65% of all catastrophic injuries at the high school level and 70.8% at the college level for girls.  To address the safety concerns associated with cheerleading and its complex stunts the American Academy of Pediatrics (AAP) has issued some safety recommendations.

The position statement issued in November of this year, Cheerleading Injuries:  Epidemiology and Recommendations for Prevention, discusses the current trends in cheerleading injuries and makes several recommendations to improve the safety of all participants.  An overwhelming majority of participants are girls/women (96%) and injury rates have been steadily rising over the last 20 years.  The average injury rate 1 in 1000 athletic exposures, but tends to increase with age and competitive level.  Case in point, the injury rate for college cheerleaders is 2.4 in 1000 exposures.  Overall, sprains and strains account for 53% of all injuries with lower extremity injuries more common in older participants and upper extremity injuries more common in younger participants.  Head and neck injuries (including concussions) account for 4% of all injuries.  Of those injuries seen in the emergency department, concussions (and other closed head injuries) account for 4-6% of injuries while head and neck injuries account for 15% of all cheerleading injuries.

Considering injury rates and risk factors (BMI, type of floor surface, coach with low training or experience), the AAP has made recommendations to improve cheerleader safety.  Some key highlights are below, for the full list click HERE.

• requiring that cheerleading be designated as a sport so it must follow safety guidelines and have access to medical care (such as pre-participation physical, athletic trainers, physicians)
• requiring coach training and certification
• requiring strength and conditioning for participants
• avoiding stunts and tumbling on hard surfaces
• enacting specific rules for performing technical skills
• appropriate spotter training

As a parent of a cheerleader it is important to know whether the program your child is participating in follows these recommendations.  While all of these recommendations should be followed, initial inquiries should focus on whether cheerleading is designated as a sport and about the training of team coaches.  Currently most colleges and over 20 of the states do not recognize cheerleading as a formal sport, making it difficult to oversee program safety and track injury rates.  Often times, if cheerleading is not considered a sport, participants are not screened annually (pre-participation physical exam) or provided regular medical care and coverage like other teams.  Additionally, training and certification for coaches may not be required.  Education and awareness will be your most effective tool for prevention.  Make sure you know what the safety situation is for your cheerleader and help reduce the potential for injury.

For a video discussing the recommendations, click HERE.  

Submitted by Heather L. Clemons, MS, MBA, ATC