Investigating Injuries in Cheerleading
Introduction
Since 1980, cheerleading has evolved into an activity demanding high levels of skill and athleticism (Brenda, Shields, & Gary, 2006). Cheerleading in the United States is a year round competitive activity spanning three typical sports seasons (fall, winter, and spring), and culminating with summer camp and competition. Catastrophic injuries have increased over the years, presumably because of an increase in the gymnastic-like stunts common in cheerleading (Mueller & Cantu, 2003; Jacobson, Redus, & Palmer, 2005).
Table 1: Comparison of percentage distribution of annual injuries by injury site for high school and college cheerleaders. (Jacobson, Redus, & Palmer, 2005)
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*Responses < 1%. |
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| Injury site | High school (n=425) | High school & college (n=?) | College (n=184) |
|---|---|---|---|
| Ankle | 23.7 | 22 | 44.9 |
| Wrist/hand | 17.8 | 21 | 19.3 |
| Back | 15.5 | 12 | 9.2 |
| Elbow | 10.4 | 5 | * |
| Knee | 8.4 | 15 | 11.9 |
| Face | 7.1 | Not included | 1.8 |
| Head/neck | 4.5 | 7 | 10.2 |
| Thigh | 3.7 | 2 | 2.7 |
| Shoulder | 3.5 | 8 | * |
| Hip | 2.0 | 2 | * |
| Foot/toe | 1.4 | 2 | * |
| Leg (shin) | * | Not included | * |
| Abdomen | * | 2 | * |
| Other | * | Not included | * |
Table 2: Estimated Number and Rate of Cheerleading-Related Injuries Treated in U.S. Hospitals From 1990 Through 2002 for the Three Most Commonly Injured Body Parts and Injury Types According to Age Group. (Brenda, Shields, & Gary, 2006).
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The percentages represent the children in each age group who sustained each category of injury. The body part injured was not documented for 330 cases. The type of injury was not documented for 497 cases. |
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| 5-18y | 6-11y | 12-17y | |
|---|---|---|---|
| Body part injured | |||
| Lower extremity | |||
| Total, n (%) | 77,590 (37.2) | 6,651 (29.1) | 67,949 (38.4) |
| Average number per year | 5,968 | 512 | 5,227 |
| Number per 1,000 participants per year | n/a | 0.4 | 3.1 |
| Upper extremity | |||
| Total, n (%) | 54,974 (26.4) | 9,379 (41.0) | 44,149 (25.0) |
| Average number per year | 4,229 | 721 | 3,396 |
| Number per 1,000 participants per year | n/a | 0.5 | 2.0 |
| Head/neck | |||
| Total, n (%) | 39,112 (18.8) | 3,693 (16.2) | 32,660 (18.5) |
| Average number per year | 3,009 | 284 | 2,512 |
| Number per 1,000 participants per year | n/a | 0.2 | 1.5 |
| Type of injury | |||
| Strain/sprain | |||
| Total, n (%) | 108,981 (52.4) | 10,241 (44.7) | 94,960 (53.8) |
| Average number per year | 8,383 | 788 | 7,305 |
| Number per 1,000 participants per year | n/a | 0.6 | 4.3 |
| Soft tissue injury | |||
| Total, n (%) | 37,412 (18.4) | 3,850 (16.8) | 32,479 (18.4) |
| Average number per year | 2,955 | 296 | 2,498 |
| Number per 1,000 participants per year | n/a | 0.2 | 1.5 |
| Fracture/dislocation | |||
| Total, n (%) | 34,230 (16.4) | 5,754 (25.1) | 27,566 (15.6) |
| Average number per year | 2,633 | 443 | 2,120 |
| Number per 1,000 participants per year | n/a | 0.3 | 1.3 |
Cheerleading Injuries and Risk Factors
Mueller & Cantu (2003) reported that in 2002, there were an estimated 3.5 million cheerleading participants who were ≧ 6 years of age, representing an estimated 18% increase in the number of participants since 1990. Therefore, increases in the number of cheerleading-related injuries have occurred in response to the change from previous cheerleading styles to more gymnastic-type cheerleader skills (Ebersol, 2001; Jacobson, Hubbard, Redus, et al., 2004). Most injuries in cheerleading occur during gymnastics maneuvers and partner stunts. Cheerleading maneuvers, such as pyramid formations and basket tosses, expose cheerleaders to an increased risk of sustaining fall-related injur (Brenda, Shields, & Gary, 2006).
Boden, B.P., Tacchetti, R., Mueller, F.O. (2003) discussed that suggestions for reducing catastrophic injuries in cheerleaders include enhancing the number and training of spotters, mandating floor mats for complex stunts, restricting complex stunts when surfaces are wet, and encouraging safety certification for coaches. Pyramids and basket tosses should be limited to experienced cheerleaders who have mastered all other skills and should be performed with spotters and landing mats.
Conclusion
Brenda, Shields & Gary, Smith (2006) investigated the causes of injuries to girls actively engaged in cheerleading and have suggested that a set of uniform rules and regulations directed at increasing the safety of cheerleading should be universally enforced. However, the establishment of a national database for cheerleading-related injuries would facilitate the development and evaluation of injury-prevention strategies based on epidemiologic evidence. Thus, it’s important for cheerleading athletes and coaches educate themselves on the risk factors for injuries and incorporate sport safety training and coaching certifications within their programs.
References
Boden, B.P., Tacchetti, R., & Mueller, F.O. (2003). Catastrophic cheerleading injuries. American Journal of Sports Medicine. 31 (6), 881-888.
Brenda, J., Shields, & Gary, A. Smith (2006). Cheerleading-Related Injuries to Children 5 to 18 Years of Age: United States, 1999-2002. PEDIATRICS, 117,122-129.
Ebersol, R. (2001). Thrills and Spills. Curr Sci 2001;87:6–7.
Jacobson, B.H., Hubbard, M., Redus, B., et al. (2004). An assessment of high school cheerleading: Injury distribution, frequency, and associated factors. J. Orthop Sports Phys. Ther., 34:261–5.
Jacobson, B.H., Redus, B., & Palmer, T. (2005).An assessment of injuries in college cheerleading：distribution, frequency, and associated factors. British Journal of Sport Medicine. 39, 237-240.
Mueller, F.O., & Cantu, R.C. (2003). National Center for Catastrophic Sport Injury Research: 20th Annual Report Fall 1982-Spring 2003. Chapel Hill, NC: University of North Carolina.