Public Release: 

Cheerleading among safest high school sports, say Colorado School of Public Health experts

But injuries can be severe, calls for more protections

University of Colorado Anschutz Medical Campus

AURORA, Colo. (Dec. 10, 2015) - Despite popular perceptions, cheerleading is one of the safest high school sports, yet the relatively few injuries sustained are often some of the most severe, according to a new study from the Colorado School of Public Health at the University of Colorado Anschutz Medical Campus.

"We found that cheerleading is actually relatively safe compared to the other high school sports we studied, ranking 18th out of the 22 sports we looked at in terms of overall injury rate," said lead author Dustin Currie, a researcher and doctoral student at the Colorado School of Public Health at CU Anschutz.

The study, the first to examine the injury epidemiology of high school cheerleading compared to other sports, was published today in the journal Pediatrics. And like so many CU Anschutz studies, it aims to apply research to real world problems.

The data was collected from the National High School Sports-Related Injury Surveillance System, High School RIO (Reporting Information Online), directed by Dawn Comstock, PhD, senior author of the study and associate professor of epidemiology at the Program for Injury Prevention, Education and Research (PIPER) at the Colorado School of Public Health.

According to researchers, a total of 752 female cheerleader injuries occurred in 1,090,705 `athletic exposures,' or one athlete participating in one practice, competition or performance. Most happened during practice.

"Cheerleading's overall injury rate was significantly lower than that of all other sports combined and all other girls sports combined," the study said, relying on information gathered from an average 107 high schools over 5 years.

The most common injuries were concussions at 31.1 percent, ligament sprains at 20.2 percent, muscle strains at 14.2 percent and fractures at 10.3 percent. Surgery was required for 4 percent of the injuries, mostly for fractures and sprains.

Male cheerleaders had significantly higher injury rates at 25 per 18,784 athletic exposures.

The majority of injuries occurred during stunts, often during dismounts.

When injuries did occur, they were often serious. Currie found that cheerleading had the second highest proportion of injuries resulting in time loss of at least three weeks of all 22 sports studied.

"These findings...demonstrate that although cheerleading is relatively safe overall, when injuries do occur, they may be more severe," he said. "Prevention efforts should focus on activities placing cheerleaders at risk for severe injuries."

For generations, cheerleading has been marginalized as a sideline activity, rather than a sport requiring actual athletic abilities. Yet as its popularity has grown with more than 400,000 students participating, cheerleader routines have become increasingly complex leading many to believe that it's extremely dangerous.

While this study largely disproves that belief, the authors note that cheerleader injuries have increased and are often serious. They say one way to make the activity safer is to have states classify cheerleading as a sport.

Currently, it is up to each state high school athletic association to determine whether cheerleading is a sport or a club activity.

"It is time that every state high school athletic association recognizes the vast majority of today's high school cheerleaders are athletes," said Comstock, a national expert on athletic injuries. "So even if the state does not recognize cheerleading as a sport, at a minimum, they should ensure cheerleaders benefit from the same safety measures and risk minimization efforts afforded to all other high school athletes."

California recently passed legislation designating cheerleading as a sport. Colorado also considers it a sport. Comstock said that likely means cheerleaders are safer in Colorado than in states where cheerleading is considered an after school activity like the chess or drama club.

"As athletes, cheerleaders should have access to the same safety standards as any other sport," said Currie. "That means, for example, having a qualified coach present at every practice, a designated space in which to practice, and appropriate safety measures like mats and spotters when learning new skills."

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The study's co-authors include Sarah K. Fields, JD, PhD, of the University of Colorado Denver and Michael J. Patterson, MD, of Lemak Sports Medicine in Alabama.

The Colorado School of Public Health is the first and only accredited school of public health in the Rocky Mountain Region, attracting top tier faculty and students from across the country, and providing a vital contribution towards ensuring our region's health and well-being. Collaboratively formed in 2008 by the University of Colorado, Colorado State University, and the University of Northern Colorado, the Colorado School of Public Health provides training, innovative research and community service to actively address public health issues including chronic disease, access to healthcare, environmental threats, emerging infectious diseases, and costly injuries.

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