Most people consider cheerleading to be a relatively safe sport, especially compared to other contact sports, like football (Magna’s Campus Legal, 2006). However, cheerleading injuries, especially catastrophic injuries, have been dramatically rising over the last twenty-five years and are continuing to do so (Magna’s Campus Legal, 2006). It is estimated that there are about one million participants in cheerleading activities in the United States, ranging from elementary school through professional sport levels (Jacobson, Redus, & Palmer, 2005). Four-hundred and fifty thousand of those participants are in high schools and colleges. Cheerleading has quickly become more appealing and is now one of the four most popular organized sports activities for females in high school (Boden, Tacchetti, & Mueller, 2003).

Even though the number of participants in cheerleading activities is increasing, the rates of injuries are still disproportionately high. The National Center for Catastrophic Sports Injury Research (NCCSI) has included a special section on severe cheerleading injuries in their 2007 annual report (Mueller & Cantu, 2007). The report has indicated that cheerleading is the leading cause of direct catastrophic injuries for all high school and college females, accounting for 55% of all high school direct catastrophic injuries, and 59.3% of comparable college injuries.

The 2007 NCCSI Annual Report also indicated that cheerleading injuries are a major cause of all sports-related fatalities for females (Mueller & Cantu, 2007). There were 75 direct deaths reported among high school and college female athletes from the fall of 1982 to the spring of 2007. Forty-two of these deaths resulted from cheerleading injuries. High school deaths totaled 25, and college deaths totaled 17. The majority of the deaths that were not caused by cheerleading were the result of gymnastics. The two sports share a variety of dangerous movements (e.g. tumbling).

There is a wide variety of injuries experienced by cheerleaders, varying also in severity. In an attempt to identify those most likely to experience injury and what type of injury is most common, Jacobson, Redus, & Palmer conducted a study of 30 Division IA schools in 2005. The median age of active cheerleaders responding was just over 20 years, and 78% of all respondents had been injured at some point in their cheerleading career. Most had been injured multiple times, with a median of 3.5 total career injuries and 16.7% reporting 5 or more career injuries. Roughly 87% of the injuries required treatment by a doctor and 40% required surgery. There is definitely a large amount of serious injuries resulting from this once relatively harmless activity.

The most common site for injury is the ankle (44.9%). Other sites include wrist/hand (19.3%), back (9.2%), and knee (11.2%). Varying sources cite that head and neck injuries, which tend to be much more serious, account for between 7 and 10% of all cheerleading-associated injuries (Jacobson, Redus, & Mueller, 2005). As the data indicates, cheerleading injuries occur most often in females. This is predominantly because the overwhelming majority of cheerleading participants are female. Females are also more likely to be the ones that perform the most dangerous aspect of stunts, such as being a “flyer” (one who is tossed or held up in the air by other cheerleaders). Data is unclear on male cheerleading injuries. Sometimes they are even intentionally left out of statistical studies (Mueller & Cantu, 2007).

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Also, there is little or no enforcement of the guidelines as they are only recommended. Likewise, there are rarely any penalizations for not cooperating with recommendations. Some organizations will not allow a team to participate or their score will be deducted, but the effectiveness of this type of policy is unknown. It is important to remember that many injuries occur during practices, not just at competitions.

There also seems to be discrepancy between the different levels of teams. Varsity teams seem to receive more safety training and have higher levels of safety compliance than less-skilled junior-varsity teams (Kozlowski, 2001). This is especially worrisome as the lower-skilled teams likely need more safety guidance and supervision.

As discussed earlier, the lack of a central tracking/reporting system is a major deterrent for preventing injuries. To adequately assess the situation and make positive changes, one must first understand the nature and complexity of the problem. Because of the multiple differences in safety guidelines, and because most areas do not classify cheerleading as a sport, data is very difficult to collect. Even the NCCSI has been identifying incomplete information sources. The NCCSI began collaborating with the National Cheer Safety Foundation in 2008 for data collection on cheerleading-related injuries and deaths. Through this collaboration it was determined that the NCCSI (which previously reported 70 catastrophic injuries from 1982 to 2007) did not have record of at least 30 additional injury events (Mueller & Cantu, 2007).

Additional risk factors that may limit injury prevention stem from the current disjointed safety system. There may be a considerable lack of experience of both participants and coaches that are not recognized. In addition to improperly trained coaches, insufficient supervision is an issue. Participants may not be conditioned properly for performing stunts with increased difficulty, and such stunts may be practiced and/or performed on inappropriate surfaces/equipment.

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Boden, B. P., Tacchetti, R., & Mueller, F. O. (2003). Catastrophic cheerleading injuries [Electronic version].The American Journal of Sports Medicine, 31(6), 881-888. From JSTOR.

Dorning, A. m. (2008, April 22). Cheerleader deaths: unimaginable but true. Retrieved April 4, 2009, from EbsoHost.

Jacobson, B. H., Redus, B., & Palmer, T. (2005). An assessment of injuries in college cheerleading: Distribution, frequency, and associated factors [Electronic version]. Br J Sports Med, 39, 237-240. From JSTOR.

Kozlowski, J. P. (2003). Lack of safety information and training faulted in cheerleader injury [Electronic version]. NRPA Law Review, 34-41. From American Search Premier.

Mueller, F. O., & Cantu, R. C. (2007). Catastrophic sports injury research [Electronic version]. . From JSTOR.

Pennington, Bill. (2007, March 31). As Cheerleaders Soar Higher, So Do the Risks. New York Times (Late Edition (east Coast)), p. A.1. Retrieved April 6, 2009, from ProQuest Newsstand database.

Three cheers for safer cheering! [Electronic version] (2006). Magna's Campus Legal, 21(2). From EbsoHost.

What would you do if injuries to your cheerleaders were increasing [Electronic version]. (2005). American School Board Journal . From EbsoHost.

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