Epidemiology of Cheerleading Fall-Related Injuries in the United States

Abstract

Context: Over the past several decades, cheerleaders have been performing fewer basic maneuvers and more gymnastic tumbling runs and stunts. As the difficulty of these maneuvers has increased, cheerleading injuries have also increased.Objective: To describe the epidemiology of cheerleading fall-related injuries by type of cheerleading team and event.Design: Prospective injury surveillance study. Setting: Participant exposure and injury data were collected from US cheerleading teams via the Cheerleading RIO (Reporting Information Online) surveillance tool.Patients or Other Participants: Athletes from 412 enrolled cheerleading teams who participated in official, organized cheerleading practices, pep rallies, athletic events, or cheerleading competitions.Main Outcome Measure(s): The numbers and rates of cheerleading fall-related injuries during a 1-year period (2006)(2007) are reported.Results: A total of 79 fall-related injuries were reported during the 1-year period. Most occurred during practice (85%, 67/79) and were sustained by high school cheerleaders (51%, 40/79). A stunt or pyramid was being attempted in 89% (70/79) of cases. Fall heights ranged from 1 to 11 ft (0.30-3.35 m) (mean 5 4.7 6 2.0 ft [1.43 6 0.61 m]). Strains and sprains were the most common injuries (54%, 43/79), and 6% (5/79) of the injuries were concussions or closed head injuries. Of the 15 most serious injuries (concussions or closed head injuries, dislocations, fractures, and anterior cruciate ligament tears), 87% (13/15) were sustained while the cheerleader was performing on artificial turf, grass, a traditional foam floor, or a wood floor. The fall height ranged from 4 to 11 ft (1.22-1.52 m) for 87% of these cases (13/15).Conclusions: Cheerleading-related falls may result in severe injuries and even death, although we report no deaths in the present study. The risk for serious injury increases as fall height increases or as the impact-absorbing capacity of the surfacing material decreases (or both).

The Potential for Brain Injury on Selected Surfaces Used by Cheerleaders

“…Data from our companion study 32 illustrate the potential effectiveness of using our findings to help prevent brain injuries among cheerleaders. All the concussions reported in that study were sustained by cheerleaders who fell from higher heights than the critical heights reported in the present study for the surfaces on which they landed.…”

Epidemiology of cheerleading injuries presenting to NEISS hospitals from 2002 to 2007

“…These activities are the highest risk activities for cheerleader and have proven to result in catastrophic injuries and even death in rare instances. 3,4,7 Obtaining a large dataset that can focus on these injuries could be invaluable in identifying risk factors and implementing safety measures. Further access to information of the details of more significant injuries could also be highly beneficial.…”

“…[3][4][5] Surprisingly, the cheerleaders on the bottom of this human structures can be at a greater risk than those held aloft or tossed in the air. 3,4 Given the advancement of competitive cheerleading and increase in routine complexity, attempts at providing proper supervision 5 and implementing advanced safety measures/equipment 8 and rules have been made to limit risk and help protect participants. Mandatory injury reporting has also been purposed as a means of monitoring injury patterns.…”

“…Tosses (especially basket tosses) can propel a single cheerleading into the air upward 15 to 20 feet after which they must be caught by teammates. 3 Those who are elevated into the air are at risk and so are those below who must ensure the safety of those above. 4 With the increase in the difficulty of the stunts, there has been an associated increase in the injury rates and severity of injuries.…”

Cheerleading Injuries in United States High Schools

“…4,5 These numbers rank cheerleading the fourth most popular high school girls' athletic activity, and rank competitive spirit squads alone as the ninth most popular high school girls' sport. Although several studies have described cheerleading injury epidemiology generally, [6][7][8][9][10] in terms of specific activities, mechanisms or diagnoses, [11][12][13] injuries presenting to emergency departments 14 and catastrophic injuries, 15,16 no study to date has examined the injury epidemiology of high school sanctioned cheerleading, comparing it to other sports. Using a large national sports injury surveillance data set, this study aimed to (1) describe injury rates and patterns in high school cheerleading, (2) compare injury rates and patterns by type of exposure (ie, practice, competition, or performance), and (3) compare injury rates and patterns in high school cheerleading to other sports.…”