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By Kelly Boutchyard, PT, DPT

Cheerleading has been around since the late 1800s. What began as a men’s-only
sideline event full of encouraging Ssst! Boom! Ahh! chants has evolved throughout
the last century into a highly competitive sport all its own.

Watch any cheerleading event today and you’ll witness a spectacular showcase of
athleticism filled with high-flying stunts, impressive dance routines and gymnastics-
style tumbling. This new competition-styled cheerleading creates an exciting
dynamic, but with the amped-up routines comes an increased risk of injury.

The popularity of cheerleading has increased tremendously in the U.S. in the past 30
years, with participants as young as age three. Cheering takes many forms and
functions. These include traditional school-based cheerleading squads, as well as
“all-star” competition cheerleading squads, whose exclusive purpose is competing
and is often a year-round commitment. With the increased physical demand,
complexity of skills and increased participation, cheerleading has developed an
intense competitive spirit, which makes injury prevention a worthy discussion.

The National Center for Catastrophic Sport Injury Research reports that within high
school sports, football had the highest total number of direct catastrophic events,
followed by female cheerleading. However, when accounting for the number of
participants in the sport, cheerleading and male gymnastics topped the list with the
highest rates per 100,000 participants.

The areas of the body most commonly injured in cheerleading include wrists,
shoulders, ankles, knees, head/neck and back. These injuries can range from muscle
strains and ligament sprains to complete tears that require surgical repair. Other
injuries can range from fractures and dislocations, to even more catastrophic
injuries such as spinal cord or traumatic brain injuries. The most common injury
mechanisms in cheerleading are basing/spotting stunts, tumbling and falls from

According to the American Academy of Pediatrics, some risk factors for injury
include cheerleaders who have a higher body mass index (BMI), have sustained
previous injury, perform stunts, and have coaches with a low level of training and
experience. The Consumer Product Safety Commission reported 4,954 hospital
emergency department visits for cheerleading injuries in 1980. By 2007, the
Commission found this number had climbed more than 400 percent to 26,786.

Head and neck injuries account for about 15 percent of all cheerleading injuries
seen in U.S. emergency departments. In a prospective surveillance study, it was
found that from 1998-2008, “concussion rates in cheerleading increased by 26
percent each year, a rate greater than any of the other girls’ sport studied.
Concussion rates increase with age and competitive level, likely because of the
increasing difficulty of stunts.”

The data collected over the decades demonstrate very clearly why injury prevention
in cheerleading is so important. To prevent injury, it is vital for cheerleaders to have
active warm-ups and participation in strength training exercises. These training
sessions should focus on core, legs and shoulders.

Proper body mechanics is critical to preventing injury, particularly when
performing tumbling passes, jumps and stunting. The American Association of
Cheerleading Coaches and Administrators (AACCA) has enforced rules and
recommendations to increase safety, including required coach training and
certification, proper strength and conditioning for all cheerleaders, and avoiding
stunting and tumbling on hard surfaces, to name a few. The AACCA clearly lists all
safety regulations to prevent injuries on their website, here.

Physical therapists can play a key role in injury prevention for these athletes.
Physical therapists perform musculoskeletal evaluations and screens to identify
areas of muscle imbalance, joint restriction, overall stability and coordination
deficits that could precipitate an injury and/or pain in the future. Physical therapists
then provide exercise prescriptions to address these impairments with the goals of
improving flexibility, increasing strength and teaching young athletes proper body

In addition to therapeutic exercises, physical therapists use manual therapy
techniques to improve joint arthrokinematics and correct alignment, as well as soft
tissue mobilization techniques to enhance muscle activation and performance.
Preventing injury is always the goal, but properly treating and training after an
injury is important to longevity in any sport and overall lifelong mobility. Working
with a physical therapist after an injury can help cheerleaders and any athlete
recover to maximum sport-specific potential and prevent future injury. Specific to
concussions, an unfortunate and common sports injury, vestibular rehabilitation is
used post-concussive injury to facilitate safe return to play.

Whether you’re recovering from an injury or if you are interested in taking steps to
prevent injury, you are in good hands with a physical therapist. Visit Bon Secours
Orthopedics to learn more and schedule an appointment today.

Posted By VNN