Is cheerleading the most dangerous high school and collegiate sport?

By Jason T. Hutchison, M.D.

New studies have shown that the rate of serious injury associated with cheerleading accidents is considerably higher than any other sport in which there is female participation.

The rate of catastrophic injury has actually been higher than that of football over the last several years. In fact, cheerleaders suffered more serious and life-threatening injuries than all other female sports participants combined. This study, as well as news reports, have brought attention to the dangerous side of the sport and caused many of us in the healthcare profession to ask ourselves, “Are we doing enough to help prevent these injuries and educate the participants and coaches?”

The types of injuries in cheerleading vary from simple sprains, strains and muscle injuries all the way up to brain injury, skull fracture and spinal cord injuries. A recent study, which looked at the utilization of emergency room visits by cheerleaders, noted a 110 percent increase. So, the questions loom, why are we seeing such an increase in injuries in cheerleaders and what can we do to prevent it?

These days, cheerleading is certainly much more than standing on the sidelines leading cheers for the fans. It has developed into a true sport with complex gymnastic routines, stunting, pyramid building and tumbling. These types of complex and difficult maneuvers require increased athleticism, training and practice in order to do them safely. Likewise, any miscalculation or error can have catastrophic results, given the fact that cheerleaders are not wearing helmets, pads or any protective gear like other athletes.

The American Association of Cheerleading Coaches and Administrators has issued the following recommendations to help decrease the chance of injury …
  • Encourage coaches to be certified and safe in cheerleading practices.
  • Develop a conditioning and flexibility program that precedes and follows all cheerleading activities.
  • Take time to train spotters and, for high risk stunts, use only spotters who have a significant amount of experience with high-risk maneuvers.
  • Use floor mats when learning new stunts.
  • Use floor mats when performing high-risk stunts.
  • Be aware of the surroundings. (Some stunts should be performed only in open areas, such as during halftime, rather than along the sidelines where crowd involvement could potentially interfere with the stunt routine.)
  • Restrict all stunting when surfaces are wet.
  • Make sure cheerleaders have mastered simpler stunts before allowing them to participate in more complex stunts.
  • Educate coaches, participants, administrators and parents that cheerleading is a sport and must be treated as such with regard to access to athletic trainers, team physicians, and other medical staff.
  • Encourage both volunteer and paid coaches to have certifications in safety when they are involved in cheerleading at a competitive level where complex stunts and gymnastic activities are required.
Cheerleading undoubtedly will continue to have high levels of participation and interest and will likely become more competitive as the years go on.

It’s our hope that the rate of serious injuries in cheerleading will decrease even as participation increases, with increased awareness on behalf of coaches and participants, safety equipment such as mats and training aids, further training of coaches and research into proper teaching safety standards.

Cheerleading Q & A

Information provided by Marty Grooms, OTR/L

Q: What types of injuries are most common in cheerleading?
A: Ankle injuries are the most common injuries, followed closely by knee injuries. Upper extremity injuries also are becoming more prevalent due to increased popularity of tumbling routines while cheering.

Q: What can I do to prevent injuries while cheerleading?
A: All cheerleaders should participate in a year-round fitness program, which includes strength and flexibility training and core (lower back and abdomen) conditioning.

Q: Does the type of shoes I wear matter?
A: Yes. Well-fitted shoes with good cushioning and a stable base are preferred. Cross-trainers or running shoes are good choices. Keep in mind, shoes should be chosen for function and not solely for aesthetics.

Q: If I roll my ankle while cheerleading, should I continue to cheer if I am having mild/moderate pain/swelling?
A: No. Obviously, no athlete enjoys being sidelined due to injury, but it is important that, when injuries do occur, the athlete be properly evaluated and treated. Failure to acknowledge an injury could likely lead to further injury.