1. This epidemiological study found that high school cheerleading injury rates ranked 18 out of 22 surveyed sports, nationally.
2. Practice and competition injury rates were comparable, while performance injury rates were significantly lower than other high school sports. The most common injury was concussion, though concussion rates remained significantly lower than in all other sports combined.
Evidence Rating Level: 2 (Good)
Study Rundown: In recent years, cheerleading has been firmly established as a sport through the introduction of competitive spirit squads. With competition, the athleticism and skills required of cheerleaders has greatly increased, raising safety concerns. This study is the first to analyze cheerleading injuries and compare them to those in other sports. Overall, cheerleading injury rates ranked 18 out of 22 different high school sports. Competition and practice injury rates were comparable, while performance rates were significantly lower. The most common injury sustained was concussion, representing almost 33% of all injuries. However, concussion rates were significantly lower than the rates of all other sports combined. Despite the low concussion rates, practice-specific concussion rates were significantly higher than in most sports, ranking third behind boys’ football and wrestling. The majority of injuries occurred during stunts, with the base as the most commonly injured athlete. The majority of concussions resulted in 1 to 3 weeks off sports. Ligament strains were the second most common injury diagnosis. Clinically, these results are important in that they provide insight into injury mechanisms, allowing clinicians to anticipate the safety risks of this sport. While this study offers valuable insight, its generalizability is limited by the data collection methods.
Study Author, Mr. Dustin W. Currie, MPH, talks to 2 Minute Medicine: Colorado School of Public Health, Department of Epidemiology, Aurora, Colorado.
“One of the important findings of our study is that cheerleading injury rates are quite low compared to other sports when looking at all time loss injuries, although injuries that did occur tended to be more severe than in other sports. This puts the potential risks of cheerleading into a broader context than previous studies that focused specifically on catastrophic injuries or emergency department visits. It is important to consider the overall risk of injury in addition to injury severity when conveying information about potential risks of sport participation to parents and athletes.”
In-Depth [retrospective cohort study]: This study used data from the National High School Sports-Related Injury Surveillance Study from school years 2009/2010 through 2013/2014. Athletic exposures (AEs) were defined as 1 athlete participating in 1 practice, competition, or performance. Seven hundred and ninety three injuries out of 1 109 489 cheerleading exposures were reported over the time period. Cheerleading had an overall injury rate of 0.71 per 1000 AEs, ranking 18 out of 22 sports in the study. The competition injury rate was 0.85 per 1000 AEs, comparable to the practice injury rate of 0.76. The performance injury rate was significantly lower (0.49 per 1000 AEs) than competition and practice rates. The overall injury rate was significantly lower than the injury rate of all other sports combined (RR 0.37, 95%CI 0.35-0.40). Concussions made up 31.1% of injury diagnoses for a rate of 2.21 per 10 000 AEs, followed by ligament sprains (20.2% of injuries). Concussion rates in cheerleading were significantly lower than all other sports combined (RR 0.58, 95%CI 0.51-0.66). However, practice concussion rates (2.51 per 10 000 AEs) were ranked third behind boys’ football (4.78) and wrestling (3.02). Stunt injuries made up 53.2% of all injuries, followed by tumbling (20.5%). The most common mechanism of injury was contact with another person (40%). Bases were the most commonly injured players, accounting for 45.5% of injuries. Most injuries were moderately severe, with 40.7% of injuries resulting in 1-3 weeks of loss of play, and 34.3% with less than 1 week of play loss.
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