Cheerleading Behind Majority of Serious Injuries in Young Female Athletes

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Cheerleaders may make spunky school spirit from the sidelines seem simple, but cheerleading these days is far more than just a carefree sideshow to get the crowd going. It is its very own competitive sport filled with its own serious skill sets and dangers. In fact, a new report shows that cheerleading is the No. 1 sport for severe injuries in high-school and college female athletes.

In the past 25 years, cheerleading accounted for 65% of all "catastrophic" sports injuries (major trauma, permanent disabilities, or death) in high-school girls and about 67% of those in college, according to a report by the University of North Carolina at Chapel Hill's National Center for Catastrophic Sports Injury Research.

Citing "gymnastics-type stunts" as one of the main reasons for so many serious injuries, the report points out the Consumer Product Safety Commission's (CPSC) estimates showing nearly six times more cheerleading injuries in 2004 (more than 28,000) than in 1980 (almost 5,000).

Cheerleading has gained popularity among young girls over the years, which could explain the increase. And there's some good news for the sport now, too: Severe injuries for high-school cheerleaders were at their lowest in 2007 since 2001.

Still, schools can help keep cheerleaders out of harm's way by following some of the report's basic safety suggestions:


  • requiring a medical exam (including a full medical history) before students are allowed to participate in cheerleading and a "qualification system demonstrating mastery of stunts" before cheerleaders are OK'd to try complicated stunts
  • mandating proper training for both coaches and cheerleaders in gymnastics, stunts with partners, and spotting techniques, including "some type of safety certification" for coaches (like the one provided by the American Association of Cheerleading Coaches and Administrators)
  • nixing mini-trampolines and doing any kind of flips or falls off of shoulders or pyramids
  • keeping pyramids no more than two people high — and even then, making sure they're done on mats
  • having a doctor or certified athletic trainer at both games and practices and/or specific emergency procedures outlined in writing and given to all staff and athletes

What This Means to You

No matter which sport your kids choose — whether it's cheerleading or lacrosse, football or field hockey — they can help lower their risk of getting hurt by following some simple preventive precautions.

Here are five safety rules that apply to young athletes of all ages:

1. Make sure they're prepared. Your kids should:


  • be matched for sports according to their skill level, size, and physical and emotional maturity
  • get plenty of training before practices and competition — they should know and understand the rules of the sport, their role in it, and what they're capable of and trained to do
  • be taught how to avoid injuries for each particular sport (for example, how to slide into base for baseball, tackle an opponent in football, or fall and land the right way during cheerleading or gymnastics)
  • not push themselves too hard (or be excessively pushed by you or a coach)
  • warm up and cool down with slow, gradual stretching that can help prepare kids' muscles and protect them from injury
  • drink plenty of fluids
  • be allowed to rest during practices and games

2. Wear the right gear every time. Talk to coaches about which equipment is needed for which sport, such as:


  • helmets (for baseball, softball, hockey, football, biking, in-line skating, and skateboarding). Make sure helmets fit comfortably, but snugly, and that kids always use the right kind for each sport — in other words, no baseball helmets for football!
  • protective pads
  • athletic cups and supporters (for boys)
  • eye protection (like shatterproof goggles for basketball and racquet sports)
  • mouth, wrist, elbow, and knee guards

Protective equipment should be approved by the organizations that govern each of the sports — like the Hockey Equipment Certification Council (HECC) or the Canadian Standards Association (CSA) for hockey facemasks. And bicycle helmets should have a safety certification sticker from the CPSC.

Also make sure that what they put on their feet is appropriate (like cleats for football, baseball, softball, and soccer to grip the ground when kids run around).

3. Ensure that all surfaces and equipment provided are safe — that playing fields aren't full of holes and ruts that might cause kids to fall or trip; and that equipment like goals, basketball nets, and gymnastics bars are sturdy and stable. Make sure surfaces for gymnastics are padded to cushion falls. And for high-impact sports (like basketball and running), kids are safer on tracks and wooden basketball courts, which can be more forgiving than surfaces like concrete.

To ensure effectiveness, all equipment also should be checked regularly for safety and properly maintained, too.

4. See that qualified adults always supervise. Coaches should:


  • have training in first aid and CPR
  • promote young athletes' mental and physical well-being (instead of fostering a win-at-all-costs attitude that may encourage children to play through injury)
  • enforce playing rules
  • provide spotters for sports like gymnastics and cheerleading and workouts that require heavy weightlifting
  • require that safety equipment be used at all times

5. Don't let kids play when they're hurt or still recovering from an injury. Athletes, young and old, are at a much greater risk for being reinjured when they return to the sport before a previous injury has had time to sufficiently heal. When kids get back into the game before completely recovering, it places stress on the injured area and forces the body to compensate for the weakness, which can increase the risk of injuring another body part.

That's why it's so important to get the doctor's OK before letting your kids re-enter their sport after an injury, especially if they took a blow to the head. Immediate medical attention — and waiting for a doctor's clearance to start participating again — is a must with any signs of a significant head injury like:


  • loss of consciousness
  • visual disturbances
  • severe headache
  • trouble walking
  • disorientation

And once kids get the all-clear to get back in the game, make sure they start out gradually, properly warm up and cool down before and after every practice and competition, and let you and their coach know if they feel any pain or discomfort. Explain that easing back into the game at a sensible pace is far better than getting hurt again and possibly missing the whole season.

Reviewed by: Steven Dowshen, MD

Date reviewed: August 2008

Source: "National Center for Catastrophic Sports Injury Research – 25th Annual Report: Fall 1982-Spring of 2007," August 2008.



Related Resources

OrganizationU.S. Consumer Product Safety Commission (CPSC) This federal agency collects information about consumer goods and issues recalls on unsafe or dangerous products.
OrganizationAmerican Academy of Orthopaedic Surgeons (AAOS) The AAOS provides information for the public on sports safety, and bone, joint, muscle, ligament and tendon injuries or conditions.
OrganizationAmerican Academy of Pediatrics (AAP) The AAP is committed to the health and well-being of infants, adolescents, and young adults. The website offers news articles and tips on health for families.
OrganizationAmerican College of Sports Medicine This site has tips on staying safe while playing sports and exercising.
OrganizationNational Youth Sports Safety Foundation This organization offers a newsletter with helpful safety tips and facts about sports injury prevention.
OrganizationNational Athletic Trainers' Association This site contains information on certified athletic trainers and tips on preventing and healing sports injuries.


Related Articles

Concussions The term concussion conjures up the image of a child knocked unconscious while playing sports. But concussions can happen with any head injury, often without any loss of consciousness.
Signing Kids Up for Sports Organized sports can help kids grow in many ways. But first consider your child's personality and developmental level so that being involved in sports is a positive experience.
Broken Bones, Sprains, and Strains Broken bones and torn muscles, ligaments, and tendons are not uncommon in children. Find out what to do if your child experiences any breaks, strains, or sprains.
Preventing Children's Sports Injuries Participation in sports can teach kids sportsmanship and discipline. But sports also carry the potential for injury. Here's how to protect your kids.




Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

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