AAP updates guidelines to prevent injuries in cheer athletes
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Key takeaways:
- Although injuries are not as common as in other sports, cheer injuries take a significant amount of recovery time.
- The AAP’s recommends establishing safety protocols and fostering a safe, inclusive environment.
The AAP released updated recommendations for preventing injuries and fostering a safe environment in cheer, a sport that an estimated 3.5 million youth participate in in the United States.
The AAP’s first set of guidelines on the subject were published in 2012 and called for mandatory preseason physicals, limiting certain stunts with high injury rates, and not allowing athletes with a concussion to return without medical clearance.
The new guidelines echo those from 12 years ago and have expanded recommendations about training for coaching staff and fostering a safe, inclusive environment for athletes.
“With the increasing physical demands, year-round participation and competitive nature, pediatricians need to be prepared for performing focused preparticipation evaluations, managing associated injuries and advocating for injury prevention,” Greg Canty, MD, FAAP, medical director of the sports medicine center at Children’s Mercy Kansas City, and colleagues wrote.
Cheerleading injuries are not as common as injuries in other girls’ sports like soccer, basketball and gymnastics, with 0.71 injuries per 1,000 athletic exposures vs. 2.46, 1.91 and 1.81 for the other sports, respectively, Canty and colleagues wrote.
“The rate of injury in cheer is actually quite low, and high school data suggest it is one of the safest sports for females,” Canty told Healio. “However, when injuries do occur, they may be serious and lead to a significant time away from sport.
They estimated that 41% of athletes return between 1 and 3 weeks, and 11% of athletes take more than 3 weeks to recover from injuries. Canty and colleagues found that the most common injuries that take more than 3 weeks of recovery time were concussions (35%), fractures (31%) and ligament sprains (16%). Additionally, 5% of athletes were medically disqualified from returning to cheer after an injury.
According to a report from the National Center for Catastrophic Sport Injury Research, 89 cheer athletes sustained catastrophic injuries between fall 1982 and spring 2022. Of these injuries, nine were fatal. For every 100,000 female high school athletes, the fatal injury rate was 0.3, the nonfatal injury rate was 0.82 and the serious injury rate was 1.5, Canty and colleagues wrote.
“Reported injuries in cheer for participants in their teen years seem to be declining; injuries in the 8- to 12-year-old category are rising,” Canty said.
Only 31 states have organizations that oversee competitive cheer, which limits injury reporting in some states, Canty and colleagues wrote. Canty told Healio that pediatricians should “encourage all state organizations to recognize cheerleading as a sport or spirit activity with the resources that come along with this.”
The AAP maintains its position on mandating pre-participation physicals for all athletes.
“During this visit, (pediatricians) should discuss topics such as decreasing risk for overuse injuries, proper progression of skills with trained coaches and monitoring for any disordered eating or body dysmorphia in participants,” Canty said.
Patients with disabilities can and should be encouraged to participate in cheer, if they are interested, the researchers wrote. Paracheer International and USA Cheer offer resources for getting involved.
Additionally, physicians should report any catastrophic injuries to the National Center for Catastrophic Sport Injury Research, Canty and colleagues wrote.
“Better injury reporting can lead to improved safety for all participants,” he said.
The report also includes recommendations for gyms, like ensuring coaching staff have proper training and certifications, establishing an emergency action plan to practice with staff and athletes, and having a process for athletes and parents to anonymously report abuse or misconduct.
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