Is cheerleading more dangerous than other sports?

In part one of this series on cheerleading, I discussed a recent policy statement from the American Academy of Pediatrics. In that statement, the AAP’s Council on Sports Medicine and Fitness recommended that cheerleading be designated as a sport. The statement also provided some useful injury statistics and recommendations to try to prevent cheerleading injuries.

Here in part two of this series, I will share some of the data provided by the American Academy of Pediatrics based on epidemiology studies of injuries in the sport. In part three, I will share some of the committee’s recommendations for injury prevention and add my own perspective.

The injury rate in cheerleading varies by age and skill level.

In terms of injuries per 1000 athletic exposures, college cheerleaders have the highest injury rate at 2.4 injuries per 1000 exposures. After college cheerleading, the next highest were elementary school (1.5), high school (0.9), all-star (0.8), middle school (0.5), and recreational (0.5).

Compared to other girls’ high school sports, high school cheerleading has a lower overall injury rate.

Again in terms of injuries per 1000 exposures, the sports with the highest injury rates among female high school athletes are gymnastics (8.5), soccer (5.3), basketball (4.4), field hockey (3.7), softball (3.5), volleyball (1.7), and cheerleading (0.9).

Stunting accounts for a majority of injuries.

Up to 60% of all cheerleading injuries and 96% of concussions and closed head injuries result from stunting. Up to 66% of head and neck injuries result specifically from pyramid stunts. Other common mechanisms of injury are spotting and basing (23%), tumbling (up to 26%), and falls from heights (up to 25%).

Head and neck injuries are uncommon in cheerleading compared to other sports, but they are increasing.

In terms of concussion rates per 1000 exposures, the girls’ high school sports with the highest rates of concussions are soccer (0.36), basketball (up to 0.21), and lacrosse (0.20). While the rate of concussions in cheerleading is low (0.06 per 1000 exposures), the rates of concussions increased by an average of 26% per year between 1998 and 2008. This increase was faster than that of any other girls’ sport.

Cheerleading accounts for the majority of the catastrophic injuries that occur in female sports.

These catastrophic injuries in cheerleading include cervical spine injuries, skull fractures, and closed head injuries that result in permanent brain damage, paralysis, or death. Between 1982 and 2009, 65.0% of direct catastrophic injuries in female high school athletes resulted from cheerleading. At the collegiate level, cheerleading accounted for 70.8% of the direct catastrophic injuries.

Several factors are thought to lead to an increased risk for injuries in cheerleading.

Different studies have shown that these risk factors include performing stunts, cheering on harder surfaces, a higher body mass index, prior musculoskeletal injury, and coaches with lower levels of experience or training.

Reference:

Cheerleading Injuries: Epidemiology and Recommendations for Prevention. Council on Sports Medicine and Fitness. Pediatrics; Volume 130, Number 5, November 2012.