Most people who do not follow competitive cheerleading don’t realize is its high number of injuries. In recent months, I have operated on two cheerleaders for shoulder instability and one for a torn ACL from cheerleading. These are certainly not catastrophic injuries, but all three required surgery and extensive rehabilitation.
Statistics on catastrophic injuries
Brenda Shields and Gary Smith published a study in Pediatrics that used data from the National Electronic Injury Surveillance System to estimate the number of cheerleading-related injuries treated in emergency departments across the country. The number of injuries treated rose from approximately 10,900 in 1990 to 22,900 in 2,002, which represented an increase of 110% over that time. Over that period of time, 84.8% of the injuries occurred in the 12- to 14-year age group as opposed to children in the 6- to 11-year age group. The injuries involved the lower extremities in 37.2%, the upper extremities in 26.4%, and the head/neck in 18.8%.
Jacobson et al. published a study in the British Journal of Sports Medicine looking at cheerleading injuries at 30 Division I universities in the United States. The authors questioned all of the coaches and members of the squads at these schools. They found that 78% of the cheerleaders had suffered at least one injury during their careers, and those athletes had an average of 3.5 injuries throughout their careers. In their study, the most commonly injured areas involve the ankle (44.9%), the wrist/hand (19.3%), and the knee (11.9%). Over half of the injuries occurred during stunting, including pyramids and gymnastic maneuvers. In a study of cheerleading injuries in North Carolina high schools published in The American Journal of Sports Medicine, Schulz et al. showed that 43.5% of injuries caused the cheerleader to miss at least a week of participation, and 28.3% of the injuries required a visit to an emergency room.
What is more worrisome is the potential for catastrophic injuries in cheerleading. By that I mean injuries involving the head or cervical spine that are fatal or cause permanent or serious disability. Boden et al. presented the injuries reported to The National Center for Catastrophic Sports Injury Research from 1982 to 2002 in a study published in The American Journal of Sports Medicine. Cheerleaders suffered more than half of the catastrophic injuries that occurred among all female athletes. There were 42 catastrophic cheerleading injuries reported over that time, and the authors were able to contact 29 of them or their families. 59% of these cheerleaders suffered a severe head injury, while 28% suffered a cervical fracture or major cervical ligament injury. Of the 29 they contacted, nine cheerleaders were injured performing a pyramid, eight during a basket toss, and four during advanced floor gymnastics stunts.
Should cheerleading be considered a sport?
Bottom line about catastrophic injuries in cheerleading
I don’t present these statistics in order to scare people about the dangers of cheerleading. I think it’s a fantastic sport (or activity, for all of you opponents of cheerleading), and as I’ve said many times, you have to be a tremendous athlete to perform the gymnastics stunts that they perform. Overall the injury rate when compared to other sports is still relatively low. You have to remember that there are over 3.5 million cheerleaders ages six and older. Even though over half of the catastrophic injuries in female athletes occur in cheerleading, the absolute number of these injuries is very low. More importantly, these studies help to point out some important safety measures that could significantly decrease the injury rate. In part two of this series, I will discuss some of these measures that the athletes and cheerleading squads can implement.
Boden BP, Tacchetti R, and Mueller FO: Catastrophic cheerleading injuries. Am J Sports Med 31(6): 881-8, 2003.
Jacobson BH, Redus B, and Palmer T: An assessment of injuries in college cheerleading: distribution, frequency, and associated factors. Br J Sports Med 39(4): 237-40, 2005.
Shields BJ and Smith GA: Cheerleading-related injuries to children 5 to 18 years of age: United States, 1990-2002. Pediatrics 117(1): 122-129, 2006.
Schulz MR et al. A prospective cohort study of injury incidence and risk factors in North Carolina high school. Am J Sports Med 32(2): 396-405, 2004.