Cheerleading and Catastrophic Injuries

"Cheerleaders incur two-thirds of all catastrophic injuries to female athletes in high school and college. According to the National Electronic Injury Surveillance Survey, emergency room visits increased110 percent from 1990 to 2002. In 2007 alone almost 27,000 cheerleaders ended up in the ER, one in six for head or neck injuries" Those are quite the statistics and certainly cause for concern. These statistics are from the Catastrophic Sport Injury Research 28th Annual Report 2010 by Dr. Frederick O. Mueller of the National Center for Catastrophic Sport Injury Research. Too often athletic trainers look upon cheerleaders as a nuisance.  They are not considered a sport by various governing bodies so therefore they are treated differently in regards to physicals, athletic trainer access, and practice coverage. We never see them until an injury occurs which usually happens at the same time we are covering another contest. They become a distraction from our main duty and we sometime resent them for it. This does not change the fact the fact that it is a dangerous sport/activity (you decide). The federal government does not consider cheerleading a sport for purposes of Title IX. Cheerleading has evolved from the sideline cheer to a variety of gymnastics and dance routines, and sometimes all choreographed to music.

Dr. Mueller makes some recommendations in his report:

1. Cheerleaders should have medical examinations before they are allowed to participate.Included would be a complete medical history.

2. Cheerleaders should be trained by a qualified coach with training in gymnastics and partner stunting. This person should also be trained in the proper methods for spotting and other safety factors.

3. Cheerleaders should be exposed to proper conditioning programs and trained in proper spotting techniques.

4. Cheerleaders should receive proper training before attempting gymnastic and partner type stunts and should not attempt stunts they are not capable of completing. A qualification system demonstrating mastery of stunts is recommended.

5. Coaches should supervise all practice sessions in a safe facility.

6. Mini-trampolines and flips or falls off of pyramids and shoulders should be prohibited.

7. Pyramids over two high should not be performed. Two high pyramids should not be performed without mats and other safety precautions.

8. If it is not possible to have a physician or certified athletic trainer at games and practice sessions, emergency procedures must be provided. The emergency procedure should be in writing and available to all staff and athletes.

9. There should be continued research concerning safety in cheerleading.

10. Cheerleading coaches should follow the concussion policy and guidelines published by the NFHS.

11. Cheerleading coaches should have some type of safety certification.

12. The NFHS should make cheerleading a sport, which will place cheerleading under the same restrictions and safety rules as all other high school sports (physical exams, qualified coaches, safe facility, athletic trainers, practice limits, and starting and ending dates for practice and games or competitions). The NCAA should follow this same recommendation.

As Health Care providers we need to look past our own personal prejudices and accept the fact that cheerleading is dangerous and we may be called upon to deal with injuries ranging from serious to catastrophic. The best route is to be proactive in regards to yours and your schools administration of the sport. They should be treated the same as any other sport.  Physicals should be mandatory, access to the athletic training room should be no different than it is for any other athlete, they should be included on the athletic insurance policy, and practice coverage extended to them. Cheerleading coaches should be qualified and safety certified.  This they can do through the American Association of Cheerleading Coaches and Administrators  (AACCA). It is not a governing body as much as it is a business entity promoting the sport.  Even though, they do have an interest in keeping cheerleading as safe as possible. Take a look at their Safety Rules. Guidelines that any school would be smart to implement.

The best course to follow in reducing these serious injuries in Cheerleading is to have coaches that are properly trained, have safety guidelines installed, and have access to the health care that there athletes deserve.