NEW ORLEANS -- Over the past
few decades, cheerleading has evolved from leading the crowd in cheers at
football games to a competitive, year-round sport featuring complex acrobatic
stunts performed by a growing number of athletes – and as a result the number and severity of
injuries from cheerleading has also surged.
In a new policy statement,
the American Academy of Pediatrics (AAP) urges coaches, parents and school
officials to follow injury-prevention guidelines, develop emergency plans and
ensure cheerleading programs have access to the same level of qualified
coaches, medical care and injury surveillance as other sports.
“Cheerleading has become extremely competitive in the past
few years, incorporating more complex skills than ever before,” said pediatric
sports medicine specialist Cynthia LaBella, MD, FAAP, member of the AAP Council
on Sports Medicine & Fitness and co-author of the new guidelines.
“Relatively speaking, the injury rate is low compared to other sports, but
despite the overall lower rate, the number of catastrophic injuries continues
to climb. That is an area of concern and needs attention for improving safety.”
The policy statement,
“Cheerleading Injuries: Epidemiology and Recommendations for Prevention,” will
be released at a news conference at 9 a.m. Monday, Oct. 22, at the AAP National
Conference & Exhibition in New Orleans and published in the November 2012
issue of Pediatrics (published online Oct. 22).
Although most high schools
and colleges have cheerleaders, only 29 state high school athletic associations
recognize cheerleading as a sport, and the National Collegiate Athletic
Association (NCAA) does not include competitive cheerleading in its list of
sponsored sports. This is important, according to the AAP, because being classified
as a sport gives athletes valuable protection including qualified coaches,
well-maintained practice facilities, access to certified athletic trainers,
mandated sports physicals and surveillance of injuries.
From 1990 to 2003, the number
of U.S. cheerleaders age 6 and older increased by roughly 600,000, from 3
million to 3.6 million. Since 2007, there are 26,000 cheerleading injuries in
the U.S. annually. Cheerleading accounts for 66 percent of all catastrophic
injuries in high school female athletes over the past 25 years.
Most injuries are sprains and
strains to the lower extremities, followed by head and neck injuries.
Cheerleading can include
fast-paced floor routines and physically demanding skills, including pyramid
building and lifting, tossing, and catching athletes in the air. These stunts
account for 42 percent to 60 percent of all injuries, and 96 percent of all
concussions. Cheerleading is one of the highest risk sporting events for direct
catastrophic injuries that can result in permanent brain injury, paralysis or
Risk factors for cheerleading
injuries include previous injury, cheering on hard surfaces, higher body mass
index, performing complicated stunts, and inadequate coaching. As in other
sports, cheerleading injury rates increase with competition level and age.
Collegiate cheerleaders have a higher rate of injury than middle and high
"Most serious injuries,
including catastrophic ones, occur while performing complex stunts such as
pyramids, according to Jeffrey Mjaanes, MD, FAAP, FACSM, member of the AAP
Council on Sports Medicine & Fitness and co-author of the new guidelines.
“Simple steps to improve safety during these stunts could significantly
decrease the injury rate and protect young cheerleaders."
The AAP makes key
recommendations for preventing injuries, including:
Cheerleading should be
designated as a sport in all states, allowing for benefits such as
qualified coaches, better access to medical care and injury surveillance.
All cheerleaders should
have a pre-season physical, and access to qualified strength and
Cheerleaders should be
trained in all spotting techniques and only attempt stunts after
demonstrating appropriate skill progression.
Pyramid and partner
stunts should be performed only on a spring/foam floor or grass/turf.
Never perform stunts on hard, wet or uneven surfaces. Pyramids should not
be more than 2 people high.
Coaches, parents and
athletes should have access to a written emergency plan.
Any cheerleader suspected
of having a head injury should be removed from practice or competition and
not allowed to return until he or she has clearance from a health
The American Academy of Pediatrics is an organization of 60,000 primary
care pediatricians, pediatric medical subspecialists and pediatric surgical
specialists dedicated to the health, safety and well-being of infants,
children, adolescents and young adults. For more information, visit www.aap.org.