Nothing to Cheer About: Head and Neck Injuries in Cheerleading

By Ellen Kuwana
Neuroscience for Kids Staff Writer
August 13, 2004

Cheerleading combines gymnastics with dance and "spirit." Traditionally, high school cheerleaders give support to a football team or basketball team. Nowadays, cheerleaders are both female and male. And while cheerleaders still cheer at sporting events, they also participate in cheerleadering competitions.

Especially at the college level, cheerleading has become as much about competing against other cheerleading squads at national competitions as it is about supporting the home team. College cheerleaders perform routines with twisting back flips (called "fulls") and stack themselves into complex pyramids. Another manuever is the gravity-defying "basket toss" where a cheerleader is thrown high into the air, flips or does a pose such as a straddle and is caught by a partner on the ground. When one of these high-flying stunts goes wrong, however, there is a great potential for serious injury. The National Collegiate Athletic Association (NCAA), which oversees all college sports, does not categorize cheerleading as a sport, however, and thus does not maintain statistics on cheerleading injuries.

Cheerleading injuries do occur. Cheerleaders often perform their routines on football fields (grass, artificial turf or the running surface of the track) or on the wooden floors inside gymnasiums. These unforgiving surfaces contribute to minor injuries such as bruises, twisted ankles and shin splints -- and also can result in serious head and neck injuries.

According to injury statistics reported to the National Center for Catastrophic Sports Injury Research for the period between 1982 and 2002, the majority of catastrophic injuries to females were from cheerleading. (Most cheerleading injuries happen to females, in part because females are the ones who get thrown up in the air and because there are more female than male cheerleaders.) At the high school level, of 60 direct injuries in all activities, 28 were from cheerleading (46.7%). At the college level, of 28 direct injuries, 18 were from cheerleading (64.3%).

Last year, a team of epidemiologists led by Dr. Barry Boden from the University of North Carolina analyzed 29 of the 39 catastrophic cheerleading injury reports. The majority of injuries (27 out of 29) were to females. Dr. Boden and his team found that the rate of injury was five times higher for college cheerleaders as compared to high school cheerleaders. Injuries resulted most commonly from pyramid formations and basket tosses.

Of the 29 cases examined by researchers, 17 cases involved severe head injuries (including 13 skull fractures and 2 deaths), 8 involved fracture or injury to the neck and 3 involved injury to the spinal cord. One case involved both a head injury and a neck fracture.

According to Dr. Boden, to reduce serious injuries, cheerleaders should:

  1. always use mats for complex stunts
  2. increase training of coaches
  3. increase training of "spotters," people who are not involved in the actual stunt, but are nearby ready to catch anyone who falls
  4. limit the number of cheerleaders involved in pyramid formations

Did You Know?
  1. Each year, more females are severely injured in cheerleading than athletes in any other sport (National Center for Catastrophic Sports Injury Research).
  2. A first-year medical student named Jack Campbell at Minnesota became the first documented cheerleader in 1898. It wasn't until World War II that women started to dominate cheerleading, because the men were off to war.
  3. In July 2004, the University of Maryland became the first Division I-A school to recognize competitive cheerleading as a varsity sport and count it toward its Title IX requirements.

Reference and further information:

  1. Boden, B.P., Tacchetti, R. and Mueller, F.O., Catastrophic cheerleading injuries, Am J. Sports Med., 31:881-888, Nov/Dec 2003.

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