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Cheerleading Injuries

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Wednesday, February 8th, 2006 Marc Straus | CWK Network Senior Producer

“If you don’t take the steps that are necessary to get over an overuse injury, it’s just going to keep wearing you down.”

– Michael Umans, Physical Therapist at Children’s Healthcare of Atlanta

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Years ago, high school cheerleaders did little more than wave pom-poms and shout for the team. But times have changed. Sophisticated routines and national competitions have raised the stakes – and the injury count.

Lindsey Bowers, 16, started cheering back in fifth grade. 

“It was just little rec league cheerleading,” she says. “We didn’t do much but stand on the sidelines and yell. So it wasn’t hardcore anything.”

That changed as she got older.

“It got harder in ninth grade, definitely, when I cheered for the school,” she admits. “And then with competition cheerleading, it’s more competitive. So it was harder stunts and harder routines to do. And it was practicing a lot more.”

All the jumps, the flips and the lifts eventually took a toll on her body.

“My back just started hurting one day at practice,” she explains. “And then it started getting worse [from], I don’t know, I guess over-cheering. …[I] kept on doing competitions [and] my back would start hurting even more.”

According to a new study in the journal Pediatrics, between 1990 and 2002 cheerleading injuries more than doubled.

Michael Umans, a physical therapist at Children’s Healthcare of Atlanta, says, “It goes back to the overuse issue. The fact that cheerleading is a year-round sport plays a role in the incidence of injury. Another reason that we’re seeing so many injuries is just the progression of skills.”

Even with physical therapy, Lindsey’s back pain never really went away, so she had to quit the team.

“If you don’t take the steps that are necessary to get over an overuse injury,” Umans explains, “it’s just going to keep wearing you down.”

He says parents should discuss potential stunts with coaches to make sure they’re not too dangerous – and they should monitor their kids at home.

“Pay attention to their body language,” he says. “I have adolescents, [who’ll] come in and say, ‘I feel fine,’ but they’re limping.”

Lindsey’s taken up competitive dancing now, which is much easier on her body. As for cheerleading, she says, “I do miss it sometimes, because when I see other cheerleading things, I wish that I could still do it, but I’d rather not be hurting than doing cheerleading.”

Umans is calling for the creation of a national database to track cheerleader injuries. He also says cheerleader coaches should be required to take certified safety courses.

What We Need To Know


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The Dangers of Cheerleading

Education Feature
The Dangers of Cheerleading
By Yvette J. Brown
CWK Producer

“Over 50 percent of [serious injuries] that occur in female athletes are due to the sport of cheerleading.”
-Dr. Sally Harris, a sports medicine and pediatrics specialist,
Palo Alto Medical Foundation.-

Cheerleading is simply not what it used to be. The pom-poms and high kicks are still there, but today’s cheerleaders look more like professional gymnasts performing daring and risky routines.

“When people say this isn’t a sport, that’s just no way to look at it,” says Meagan, a high school competitive cheerleader. “We’re doing just as much as the football players are doing.”

“It’s really changed,” says Dr. Sally Harris, a sports medicine and
pediatric specialist with the Palo Alto Medical Foundation. “I think the whole term “cheerleading” is a misnomer. It’s not leading the crowd in cheer anymore. That’s a minor part of what these athletes are doing. It’s competing at a high level of gymnastics with stunts and tricks.”

Those stunts and tricks can sometimes lead to injuries.

“If she gets dropped or gets in the wrong position and lands on her head or neck, you can die or become paralyzed. More often you end up breaking something. But, that’s still pretty serious,” says Dr. Harris.

According to Dr. Harris’ research on cheerleading injuries, emergency room visits have increased five-fold over the past 20 years. In 2001, there were 25,000 hospital visits for cheerleading injuries to the ankle, shoulder, head and neck.

Harris says schools are partly to blame for the rise in injuries.

“A lot of the problems with cheerleading come indirectly from the fact
that at many schools it’s not recognized as an official school sport,” Dr.
Harris says. “Cheerleading doesn’t get the support other sports get in terms of access to an athletic trainer and appropriate facilities to practice on like soft mats instead of the last empty space in the gym or hallway.”

Experts say parents should insist on coaches with experience, especially if the cheerleaders try complicated and potentially dangerous routines. Also, make sure children get physicals, especially if they have already been hurt.

Harris advises, “If there [are] any aches and pains or pre-existing joint, ankle or knee problems, get those checked out with a sports physical ahead of time because the biggest predictor of injuries is a previous injury that hasn’t been rehabilitated.”


By Mandy Rider
CWK Network, Inc.

Once considered just a “popularity contest,” cheerleading is now considered by many to be a legitimate high school sport. Pep rallies and Friday night football games are only part of the program for many squads as local and national cheerleading competitions take center stage. Cheerleadering season never ends and squads spend more hours in practice than most football and basketball teams.

Participation in cheerleading is skyrocketing, with the numbers tripling to almost three million teens over the past eight years (ESPN). Movies, media focus and it’s a new competitive nature have all helped make cheerleading more popular … and more hazardous. Cheerleading is now considered one of the most dangerous school activities. The U.S. Consumer Product Safety Commission reported nearly 25,000 cheerleading related injuries requiring emergency care in 2001.

The main source of injuries results from the increased difficulty of stunts, also referred to as pyramids. Stunts are used at pep rallies and games, but are used more frequently at competitions. Most stunts involve one flier (person on top of pyramid) and two, three or four bases (people on bottom of pyramid). During competitions, up to 40 stunts may be performed by a single squad in three to five minutes. A large portion of a squad’s competition routine is focused on the use of gymnastic elements. Common cheerleading related injuries may include:

  • Ankle sprains
  • Back injuries
  • Head injuries (including concussions)
  • Broken arms
  • Knee injuries
  • Elbow injuries

If your teen decides to sign up for competitive cheerleading, there are some steps you should take to ensure their safety. The Children’s Hospital of Pittsburgh suggests:

  • Make sure your teen’s cheerleading coach is certified and properly trained for the job.
  • Read the American Association of Cheerleading Coaches and Advisors (AACCA) safety guidelines. The AACCA regularly updates its guidelines for high school age and younger, and college age level.
  • The National Federation of State High School Associations publishes the “Spirit Rule Book,” a technical and safety reference resource for cheerleading coaches.
  • Be sure your children practices and performs cheerleading only when supervised by their coach.
  • Be sure your youngster receives proper training for gymnastics and other stunts and techniques.
  • Make sure your child knows his or her ability level and does not attempt advanced stunts before mastering lower level skills.
  • Warm-up exercises and stretches are as important for cheerleaders as for other athletes.
  • If your child sustains an injury, get them the proper medical attention and follow-up.

The AACCA also offers the following guidelines for stunt safety:

  • All pyramids and partner stunts are limited to two persons high. “Two high” is defined as the base (bottom person) having at least one foot on the ground.
  • The top person in a partner stunt, pyramid or transition may not be in an inverted (head below the waist) position, with the exception of a double based forward suspended roll.
  • Suspended splits in a transition are allowed provided there are a total of four bases supporting the top person. At least three of the bases must support the legs of the top person, and the fourth base may support under the legs or make contact with the hands of the top person. The top person must have hand contact with the bases.
  • Partner stunts and pyramids higher than shoulder stand level must have a continuous spotter for each person over shoulder stand level.
  • When one person is bracing another (including overlapping of arms), one of the individuals must be at shoulder height or below. (Exception: Extensions may brace other extensions.)
  • If a person in a partner stunt or pyramid is used as a brace for an extended stunt, that brace must not be supporting a majority of the top person’s weight. To demonstrate this, the foot of the top person’s braced leg must be at or above the knee of their supporting leg.
  • Triple-base straddle lifts must have an additional spotter for the head and shoulders of the top person.
  • Hanging pyramids must have a continuous spotter for each shoulder stand involved in suspending another person.
  • All vaults are prohibited.
  • Basket tosses, toe pitch tosses, or similar tosses are limited to no more than four tossers and must be dismounted to a cradle position by two of the original bases, plus an additional spotter at the head and shoulder area. These tosses may not be directed so that the bases must move to catch the top person.

For additional safety guidelines, visit the AACCA website.


Palo Alto Medical Foundation
American Association of Cheerleading Coaches and Advisors
Children’s Hospital of Pittsburgh
U.S. Consumer Product Safety Commission



Schools Ban ‘Suggestive’ Cheerleading

Education Feature
Schools Ban ‘Suggestive’ Cheerleading
By Robert Seith
CWK Senior Producer

“I don’t feel that it is sexy.”
-Markeisha Booker, Age 17.-

In some schools around the country cheerleaders and dance team members are adopting a new style. A modern style of dance that includes plenty of pelvic twisting and shoulder shakes. A style that some compare to what you might see in an adult nightclub.

But 17-year-old dance team member Markeisha Booker says, “I don’t feel that it is sexy, it’s just the way we express our feelings and the way that we dance. I don’t think it’s sexy.”

“We’re obviously not going to do anything that we think makes us look trashy or in any way distasteful,” adds 17-year-old Brittany, a cheerleader.

But some parents disagree. And some experts say the new style of dancing may send a message to girls who want to be on the squad. “That you will be accepted to the extent that you act sexy, dress sexy and conform,” says therapist Rita Grayson.

So what do you do if your daughter wants to be a cheerleader, but the clothes and the moves are too sexy for you?

“If a parent says ‘there’s no way you’re going to wear that in public, you can’t be on the cheerleading squad,’ there’s going to be a war,” Grayson says.

To avoid that war, she has a few suggestions for parents: First, listen. “Listen to their daughter and understand, what does cheerleading mean to her. Why is this important to her?” says Grayson.

And then explain why it’s important to you that she not dance or dress in a suggestive way… and why she doesn’t need to send that message. “’We think you’re a great young woman, you have a lot of strengths, and your strengths go far beyond your appearance,’” Grayson says.

And, she says, parents may find out their daughter doesn’t really like to dance or dress that way.

“That may lead to the parents calling the parents of the other girls, and finding out how they feel about it,” explains Grayson. “And that may lead to the parents getting together and talking to the school and saying ‘you know, we don’t think this is necessary, (we) think there could be some modifications.’”


By Tom Atwood
CWK Network

As parents, we are often confused and concerned about changes in our children growing up. Teenagers, especially, struggle with a sense of identity, including sexual identity. And we struggle with them. Sexuality is a difficult topic for many families to discuss, but the non-profit group Advocates for Youth says young people who “feel connected to family” are more likely to avoid risky sexual behaviors in adolescence. As the primary educator of your children, there are several things you can do to communicate your attitudes and beliefs regarding sexuality. Some are simple; some are more complicated.

Here are some suggestions from Advocates for Youth:

  • Teach very young children the appropriate words for parts of the body.
  • As they grow older, answer their questions honestly about relationships, puberty and intimacy.
  • Educate yourself and be willing, even when uncomfortable, to talk with your children about issues of sexuality, relationships, love, and commitment.
  • Discuss explicitly with preadolescents and teens the value of delaying sexual initiation and the importance of love and intimacy as well as of safer sex and protecting their health.
  • Encourage strong decision-making skills by providing youth with age-appropriate opportunities to make decisions and to experience the consequences of those decisions. Allow young people to make mistakes and encourage them to learn from them.
  • Encourage teens to create a resource list of organizations they can turn to for assistance with sexual health, and other issues. Work together to find books and web sites that offer accurate information.
  • Encourage your faith community to offer a sexuality education program for young people.
  • Actively support comprehensive sexuality education in the schools. Find out what is being taught about sexuality, who is teaching it, and what your teens think about it.
  • Demonstrate unconditional love and respect for your children.
What Parents Need To Know

Your teenager is an individual with a unique personality. Like you, he has special interests, likes and dislikes. The American Academy of Child and Adolescent Psychiatry says there are also various developmental issues that all teenagers face. Some of the normal feelings and behaviors of middle school and early high school adolescents are listed below.

  • Feeling awkward or strange about one’s self and one’s body.
  • Focus on self, alternating between high expectations and poor self-concept.
  • Interest in clothing style influenced by peer group.
  • Moodiness.
  • Improved ability to use speech to express feelings.
  • Complaints that parents interfere with independence.

In terms of sexuality:

  • Shyness, blushing, modesty.
  • Girls develop physically sooner than boys.
  • Increased interest in the opposite sex.
  • Movement toward heterosexuality with fears of homosexuality.
  • Concerns regarding physical and sexual attractiveness to others.
  • Frequently changing relationships.
  • Worries about being normal.

Remember that developing a sense of identity is an important task for teenagers, who may sometimes feel uncomfortable talking to parents about their thoughts and feelings, especially about sexuality.


Advocates for Youth
American Academy of Child and Adolescent Psychiatry



CWKNetwork — Is Cheerleading a Sport?

Education Feature
Is Cheerleading a Sport?
By Robert Seith
CWK Senior Producer

“It’s intense. I’ve been knocked out. One of my friends got her teeth knocked out.” Kelly, age 17, on ‘competition cheerleading.’

“You want to beat the other person, or the other team so bad,” says 14-year-old Crystal.

Competition cheerleading, as it’s called, resembles regular cheerleading in some ways, but it differs dramatically as well. In competition cheerleading, the primary goal is to win state and national championships. And athleticism, not looks, is what counts.

It took Crystal’s father, ex-NFL football player Randy Cross, a little while to understand the distinction. “(They said) ‘We want to do competition cheerleading,’ and I looked at them and said, ‘Which one do you want? Do you want to do competition, or do you want to be a cheerleader?’”

It’s a distinction that also has been lost on federal policy makers. Under Title 9, competition cheerleading, like regular cheerleading, does not count as a sport. That means almost no school in the country will fund it.

Yet competitive cheerleading has exploded in popularity in the past decade. An estimated 64-thousand girls across the country take part in competitions for state and national championships.
“So I think the cheerleading establishment is kind of caught in a bad term,” says sports author Jim Brown, “and it may be time to come up with something better than ‘cheer-leading.’”

So if a girl is a serious athlete, and wants to be a competitive cheerleader, parents need to help make her aware of the challenges she’ll likely face.

“I think a lot of kids don’t understand what goes into it, and some of the baggage that is associated with cheerleading, being sort of frivolous, and perhaps sexist to some people,” says Brown.

Cheerleading: Is It A Sport?

By Sally Atwood
CWK Network

Society often portrays cheerleaders as a group of popular, giggly girls. But an honest look at today’s cheerleaders reveals them to be much more. Many cheerleaders are hardworking student athletes. While cheerleading has been around since the 1890s, it became a predominately women’s activity during World War II. Over the years, it has become more competitive and athletic. By 1980, universal standards were set and safety guidelines were established. Today, cheerleading is an international activity.

According to the American Association of Cheerleading Coaches and Advisors (AACCA), today’s cheerleading involves skills which require:

  • the strength of football
  • the grace of dance
  • the agility of gymnastics

The University of Georgia agrees. The university’s cheerleading training regime consists of

  • weight training
  • aerobic conditioning
  • scheduled practices.

Cheerleaders and coaches regularly attend training camps and take part in competition. However, what distinguishes cheerleading from other sports activities is that its primary purpose is not competitive. According to the AACCA, the primary purpose of cheerleading is to raise school unity through leading the crowd at athletic functions and therefore does not meet the criteria of a competitive sport.

Regardless of the AACCA criteria, cheerleaders are officially recognized as “student athletes” in some states. This recognition opens the door for academic honors and scholarships. Scholarships range from book waivers to full tuition in some colleges.

Cheer Leaders

The AACCA points out that today’s cheerleaders are:

  • Campus leaders active in activities and athletics.
  • Consistently well above average in grades
  • Go on to higher education in much higher percentages than the general student population.

American Association of Cheerleading Coaches and Advisors,
University of Georgia,
University of Wisconsin-River Falls,