Only in recent years has cheerleading been included in epidemiological studies that properly use participation and exposure data to help determine the actual risks involved in cheerleading as well as provide a detailed analysis that safety experts and rules-writing bodies can use to help minimize risk.
A review of available data shows that not only are cheerleading injury rates much lower than have been reported in the media, serious injuries are on a steep decline over the last 5 years.
High School Sports Injury Surveillance System Ranks Cheerleading 17th out of 20 Sports
A recent study from Nationwide Children’s Hospital, conducted by lead researcher Dawn Comstock, PhD. for the National Federation of High Schools shows that cheerleading overall injury rates were lower than all but three other sports, girls’ and boys’ swimming and boys’ volleyball. Again, the sport with the highest injury rate was boys’ football, with 11.8 injuries per 1,000 athletic exposures (AE) compared to cheerleading with 0.5 injuries per AE, a rate 23 times higher than cheerleading. It is worth noting that there were eight girls’ sports (Track, Volleyball, Lacrosse, Gymnastics, Softball, Field Hockey, Basketball, and Soccer) with a higher injury rate for both practices and games/competition (See Chart 1).
Emergency Room Visits Lower Than Several Other Girls’ Sports
Emergency Room visits are often used to give the impression that cheerleading injuries are above the norm. The total number of ER visits is rarely if ever compared to other female sports, and rarely is it reported that over 98% of ER visits result in the cheerleader being treated and released, meaning the injury was not severe enough for hospitalization or surgery. Several other female sports for the same age range reported a much higher number of emergency room visits compared to cheerleading; in fact, girls’ basketball had over 2.5 times the number of cheerleading emergency room visits (See Chart 2). Again, this data is readily available at the Consumer Product Safety Commission.
Catastrophic Injuries Trending Downward
Recent media reports incorrectly have claimed that cheerleading makes up the majority of sports injuries in high school and college sports. That claim is false and clearly refuted by simply looking at the publicly available data. It is clear that the sport with the highest number of catastrophic injuries by far is football. In fact, the National Center for Catastrophic Sport Injury Research 2011 reports shows that over the past ten years, there have been 358 direct catastrophic injuries for football and 62 for cheer. Football also has a far higher number of direct deaths, with 39 compared to 1 for cheer over this 10 year period (data is spread over two reports, here and here).
More importantly, cheerleading catastrophic injuries have been on a sharp decline since additional safety rules and safety training were put into place in 2005-2006. That year there were 12 high school and college catastrophic injuries. In each successive year, the number of catastrophic injuries has dropped, with only 1 reported catastrophic injury in 2010-2011 (See Chart 1).
Catastrophic claims with the NCAA have also dropped significantly. According to the Mutual of Omaha, “the Cheer Safety Initiative began in 2006 and since this time there has only been one injury for which benefits are payable under the NCAA Catastrophic policy and the injury is not truly catastrophic in nature.” Prior to this initiative, 25% of catastrophic claims at the college level were due to cheerleading.
In addition to a stark reduction in catastrophic injuries, there has also been a 50% reduction in injuries across the board at the college level. Mutual of Omaha states, “the NCAA Group Basic Accident Program was started in 2006 as an optional program to NCAA member institutions to cover the deductible for the catastrophic policy. The percent of paid claims attributable to cheerleading has steadily declined from 2.5% in 2007 to 1.2% in 2010.”
The truth is that cheerleading safety is paramount to those involved at every level of cheerleading, from the athletes and coaches, to the parents, to those that conduct training camps and competitive events.
When data from the NFHS study showed that a high percentage of high school cheer head injuries were occurring in practice and that the majority of those injuries were due to body-to-body contact, the cheerleading rules committees passed rules prohibiting the double twisting dismount, the skill credited with creating those injuries. The NCAA and many state high school associations have enacted requirements for cheerleading coaches’ safety training, even though they do not require sport-specific safety training for other sports. The US All Star Federation has rules for each of the levels involved in All Star cheerleading. These are all rules that have already been put into place and are followed by the vast majority of the country.
USA Cheer and the American Association of Cheerleading Coaches and Administrators (AACCA) partnered with the CDC Heads Up program to develop and distribute head injury awareness information to over 450,000 cheerleaders and their coaches. In 2010, the AACCA convened an expert panel to develop “return to play” recommendations for cheerleaders who have suffered concussions.