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American Academy of Pediatrics National Conference and Exhibition
October 22, 2012
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New guidelines aim to prevent cheerleading-related injuries

NEW ORLEANS — New guidelines presented here at the 2012 AAP National Conference and Exhibition and published online in Pediatrics are intended to prevent cheerleading-related injuries, which have increased more than 400% in the past 3 decades.

According to Cynthia LaBella, MD, FAAP, member of the AAP Council on Sports Medicine & Fitness and co-author of the policy statement, “Cheerleading has become extremely competitive in the past few years, incorporating more complex skills than ever before. Relatively speaking, the injury rate is low compared to other sports, but despite the overall lower rate, the number of catastrophic injuries continues to climb. That is an area of concern and needs attention for improving safety.”

Cynthia LaBella, MD 

Cynthia LaBella

Data included in the guidelines indicate that the number of hospital ED visits for cheerleading injuries increased more than 400% between 1980 and 2007, and that the number of catastrophic injuries related to cheerleading increased from 1.5 annually from 1982 to 1992 to 4.8 per year from 2003 to 2009. Catastrophic injuries listed in the statement include closed-head injury, skull fractures and cervical spine injuries resulting in permanent brain injury, paralysis or death.

The researchers attributed the increased injury rate to there being more participants in the sport (girls represent 96% of all cheerleading participants, according to the researchers); the incorporation of complex maneuvers such as partner stunts that include tossing and catching one another; and better reporting of cheerleading injury rates.

Because cheerleading is not uniformly recognized nationally as a sponsored sport, the guidelines authors cited a lack of standardized regulations for qualified coaches, adequate practice facilities and access to certified athletic trainers as some of the obstacles to injury prevention.

“Most serious injuries, including catastrophic ones, occur while performing complex stunts such as pyramids, according to Jeffrey Mjaanes, MD, FAAP, FACSM, member of the AAP Council on Sports Medicine & Fitness and co-author of the new guidelines. “Simple steps to improve safety during these stunts could significantly decrease the injury rate and protect young cheerleaders.”

The key recommendations in the guidelines include:

  • National designation of cheerleading as a sport for better quality control.
  • Mandated preseason physicals and access to qualified strength and conditioning coaches.
  • Mandatory spotting technique training for all participants.
  • Not allowing participants to perform stunts until they have demonstrated appropriate skill progression.
  • Pyramid and partner stunts should be performed only on a spring/foam floor or grass/turf; pyramids should not be more than two people high.
  • All participating coaches and parents should have access to a written emergency plan.
  • Cheerleaders with head injuries should not be allowed to participate in the sport until given clearance from a health professional.

For more information:

Council On Sports Medicine and Fitness. Pediatrics. 2012;doi:10.1542/peds.2012-2480.

Disclosure: The researchers report no relevant financial disclosures.