Health Information

AAP Issues Safety Guidelines for Cheerleading

< Oct. 24, 2012 > -- The number of injuries from cheerleading has increased steadily over the last 20 years, a trend that has prompted the American Academy of Pediatrics to urge that the activity be designated a sport.

In new guidelines issued online this week in the journal Pediatrics, the AAP points out that cheerleading has become a year-round activity with complex acrobatic stunts and pyramid structures, often done on unforgiving surfaces.

And those daring feats have led to a rise in injuries. The U.S. Consumer Product Safety Commission says that in 1980, nearly 5,000 visits to the emergency department were because of cheerleading injuries. By 2007, that total had reached nearly 27,000.

"Although the overall risk of injury is lower in cheerleading than in most other sports, the risk of direct catastrophic injury is considerably higher for cheerleading," the AAP report says. "From 1982 to 2009, cheerleading accounted for 65.0 percent of all direct catastrophic injuries to girl athletes at the high school level and 70.8 percent at the college level."

The most common types of cheerleading injuries are sprains and strains to the legs and feet, followed by head and neck injuries.

Serious injuries

The most serious injuries happen to cheerleaders who are positioned at or above the "critical height" for the surface the students are performing on. The critical height for a landing mat on a foam floor, for instance, is 11 feet, but only 4.5 feet for a wooden gym floor.

In addition to harder surfaces, other factors that raise the risk for injury include a previous injury, a higher body mass index, and performing stunts. Another factor is being supervised by a coach who has had little training or experience with cheerleading.

The AAP guidelines recommend that:

Cheerleading should be designated as a sport in all states, allowing for benefits such as qualified coaches, better access to medical care, and injury surveillance.
All cheerleaders should have a physical before starting the season, and have qualified strength and conditioning coaches.
Cheerleaders should be trained in all spotting techniques and only try stunts after showing that they have the appropriate skills.
Pyramid and partner stunts should be done only on a spring/foam floor or grass/turf. Stunts should never be done on hard, wet, or uneven surfaces. Pyramids should not be more than two people high and should only be done with spotters.
Coaches, parents and athletes should have access to a written emergency plan.
Any cheerleader suspected of having a head injury should be removed from practice or competition, and not allowed to return until he or she has clearance from a health professional.

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Tips for Preventing Sports Injuries

Although not all sports injuries can be prevented, these tips from the National Institute of Arthritis and Musculoskeletal and Skin Diseases can reduce your child's risk for harm:

Make sure your child has a physical exam before joining a sports team. A physical can find out whether your child is able to safely meet the sport's demands.
Enroll your child in organized sports groups or clubs that show a commitment to preventing injuries. Coaches should be trained in first aid and insist on proper use of safety equipment.
Ensure that your child uses the appropriate safety gear-for example, helmets for football and biking, shin guards for soccer, mouth guards for hockey, and good-fitting athletic shoes for every sport.
Make sure your child warms up and cools down before and after practices and games. Doing so can reduce the risk for muscle strains and pulls.
Encourage water breaks every 20 minutes.
Watch for overuse injuries. Kids who do too much too soon or for too many hours a day have an increased risk for overuse injuries, which can be difficult to treat and have lasting effects.