As Cheerleading Evolves, Injuries Mount
Experts say it's a competitive sport whose athletes need better protection
FRIDAY, June 28, 2013 (HealthDay News) -- Cheerleading is definitely not your grandmother's pastime anymore, injury experts warn, but rather a highly competitive activity that's light on the pom-poms and heavy on risky daredevil acrobatics.
The not-surprising result: Cheerleading injuries are on the rise.
"Over the past few decades, cheerleading has evolved from leading the crowd in cheers at sporting events to a competitive, year-round activity featuring complex acrobatic stunts performed by a growing number of athletes," said Dr. Cynthia LaBella, medical director of the Institute for Sports Medicine at the Ann & Robert Lurie Children's Hospital of Chicago. "As a result, the number and severity of injuries from cheerleading has also surged."
"Relatively speaking, the overall injury rate is low compared to other girls' sports, such as soccer and basketball," LaBella said. "But despite the lower overall injury rate, cheerleading accounts for a disproportionate number -- 60 percent to 70 percent -- of all the catastrophic injuries in girls' high school sports. That is an area of concern and needs attention for improving safety."
LaBella, who is also an associate professor of pediatrics at the Northwestern University Steinberg School of Medicine, was scheduled to discuss the issue Thursday at the annual meeting of the National Athletic Trainers' Association, in Las Vegas.
According to a policy statement issued by the American Academy of Pediatrics (AAP) last fall, the number of students aged 6 and up who engaged in cheerleading either at school or as members of offsite competitive squads skyrocketed from just 600,000 students in 1990 to somewhere between 3 million and 3.6 million in 2003.
The vast majority of participants -- 96 percent -- are girls, according to the AAP, and what these girls are now asked to do goes far beyond the stereotypical image of fun-loving dance routines. Rather, girls must routinely execute taxing feats of gymnastic prowess, with sequences that involve tumbling, leaping, jumping, tossing and human-pyramid building.
What's more, "injury rates increase with age and skill level, due to more complex stunts being performed at these levels," LaBella said.
The result has been a notable increase in the frequency with which cheerleaders fall, sometimes from great heights. A range of limb, head, neck and trunk injuries, as well as sprains and strains, can ensue, with some -- such as concussions -- being serious enough to require medical attention.
It is no longer unheard of to see cheerleading participants leave the field of play having suffered permanently disabling or even fatal catastrophic injuries.
"For those who have not seen cheerleading in 20 years, it really would be an eye-opener," said Lisa Kluchorosky, a sports medicine administrator at Nationwide Children's Hospital in Columbus, Ohio. "So many [people] still think it's the world of Annette Funicello. But cheerleading has gone from a more recreational, more supportive kind of role to being very competitive and very athletic, which means that the demands placed on these kids are really enormous.
"And the skill level and the types of stunts they are doing have gone up tremendously, as they have with most sports over the years," Kluchorosky added.
With this new reality in mind, the AAP now takes the position that state athletic associations should move to classify cheerleading as a sport, in order to ensure that the activity is treated in the same manner as all other traditional contact athletics.
"Cheerleading is still not considered a sport in many states, and it very much should be," said Kluchorosky, who is the National Athletic Trainers' Association liaison to the AAP. "If it were designated as such, it would be subject to the rules of all other sports, which means participants would be afforded the same resources and health care, and held to the same regulations."
For example, under a sports designation, cheerleaders would have to engage in strength and conditioning programs during both competition and preseason periods. Practice time would be regulated, and training facilities certified as safe. Participants also would have access to onsite medical staff when needed, all of whom would be prepped with detailed emergency medical plans.
As part of a recognized sport, cheerleading coaches, in turn, would have to be certified as to their proficiency in teaching key cheerleading skills, such as spotting techniques.
Beyond that, the AAP further recommended placing specific boundaries on the kinds of activities cheerleaders can be asked to do, including limiting human pyramids to a certain height and banning tumbling on hard surfaces that lack appropriate landing matting.
"There's still some of the feeling out there that [cheerleading] is not a real sport," Kluchorosky said. "But it is. And we're talking about real risks, so we have to try to move the needle forward and deal with it appropriately."
For more on the AAP's cheerleading recommendations, visit the American Academy of Pediatrics (http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Offers-New-Guidelines-to-Prevent-Cheerleading-Injuries.aspx ).
SOURCES: Cynthia LaBella, M.D., medical director, Institute for Sports Medicine, Lurie Children's Hospital of Chicago, and associate professor of pediatrics, Northwestern University Steinberg School of Medicine; Lisa Kluchurosky, M.Ed., A.T.C, National Athletic Trainers' Association liaison to the American Academy of Pediatrics, and sports medicine administrator, Nationwide Children's Hospital, Columbus, Ohio; June 27, 2013, presentation, National Athletic Trainers' Association meeting, Las Vegas