"When people say this isn't a sport, that's just no way to look at it," says Meagan, a high school competitive cheerleader. "We're doing just as much as the football players are doing."

"It's really changed," says Dr. Sally Harris, a sports medicine and
pediatric specialist with the Palo Alto Medical Foundation. "I think the whole term "cheerleading" is a misnomer. It's not leading the crowd in cheer anymore. That's a minor part of what these athletes are doing. It's competing at a high level of gymnastics with stunts and tricks."

Those stunts and tricks can sometimes lead to injuries.

"If she gets dropped or gets in the wrong position and lands on her head or neck, you can die or become paralyzed. More often you end up breaking something. But, that's still pretty serious," says Dr. Harris.

According to Dr. Harris' research on cheerleading injuries, emergency room visits have increased five-fold over the past 20 years. In 2001, there were 25,000 hospital visits for cheerleading injuries to the ankle, shoulder, head and neck.

Harris says schools are partly to blame for the rise in injuries.

"A lot of the problems with cheerleading come indirectly from the fact
that at many schools it's not recognized as an official school sport," Dr.
Harris says. "Cheerleading doesn't get the support other sports get in terms of access to an athletic trainer and appropriate facilities to practice on like soft mats instead of the last empty space in the gym or hallway."

Experts say parents should insist on coaches with experience, especially if the cheerleaders try complicated and potentially dangerous routines. Also, make sure children get physicals, especially if they have already been hurt.

Harris advises, "If there [are] any aches and pains or pre-existing joint, ankle or knee problems, get those checked out with a sports physical ahead of time because the biggest predictor of injuries is a previous injury that hasn't been rehabilitated."

By Mandy Rider
CWK Network, Inc.

Once considered just a "popularity contest," cheerleading is now considered by many to be a legitimate high school sport. Pep rallies and Friday night football games are only part of the program for many squads as local and national cheerleading competitions take center stage. Cheerleadering season never ends and squads spend more hours in practice than most football and basketball teams.

Participation in cheerleading is skyrocketing, with the numbers tripling to almost three million teens over the past eight years (ESPN). Movies, media focus and it's a new competitive nature have all helped make cheerleading more popular … and more hazardous. Cheerleading is now considered one of the most dangerous school activities. The U.S. Consumer Product Safety Commission reported nearly 25,000 cheerleading related injuries requiring emergency care in 2001.

The main source of injuries results from the increased difficulty of stunts, also referred to as pyramids. Stunts are used at pep rallies and games, but are used more frequently at competitions. Most stunts involve one flier (person on top of pyramid) and two, three or four bases (people on bottom of pyramid). During competitions, up to 40 stunts may be performed by a single squad in three to five minutes. A large portion of a squad's competition routine is focused on the use of gymnastic elements. Common cheerleading related injuries may include:

• Ankle sprains
• Back injuries
• Head injuries (including concussions)
• Broken arms
• Knee injuries
• Elbow injuries

If your teen decides to sign up for competitive cheerleading, there are some steps you should take to ensure their safety. The Children's Hospital of Pittsburgh suggests:

• Make sure your teen's cheerleading coach is certified and properly trained for the job.
• Read the American Association of Cheerleading Coaches and Advisors (AACCA) safety guidelines. The AACCA regularly updates its guidelines for high school age and younger, and college age level.
• The National Federation of State High School Associations publishes the "Spirit Rule Book," a technical and safety reference resource for cheerleading coaches.
• Be sure your children practices and performs cheerleading only when supervised by their coach.
• Be sure your youngster receives proper training for gymnastics and other stunts and techniques.
• Make sure your child knows his or her ability level and does not attempt advanced stunts before mastering lower level skills.
• Warm-up exercises and stretches are as important for cheerleaders as for other athletes.
• If your child sustains an injury, get them the proper medical attention and follow-up.

The AACCA also offers the following guidelines for stunt safety:

• All pyramids and partner stunts are limited to two persons high. "Two high" is defined as the base (bottom person) having at least one foot on the ground.
• The top person in a partner stunt, pyramid or transition may not be in an inverted (head below the waist) position, with the exception of a double based forward suspended roll.
• Suspended splits in a transition are allowed provided there are a total of four bases supporting the top person. At least three of the bases must support the legs of the top person, and the fourth base may support under the legs or make contact with the hands of the top person. The top person must have hand contact with the bases.
• Partner stunts and pyramids higher than shoulder stand level must have a continuous spotter for each person over shoulder stand level.
• When one person is bracing another (including overlapping of arms), one of the individuals must be at shoulder height or below. (Exception: Extensions may brace other extensions.)
• If a person in a partner stunt or pyramid is used as a brace for an extended stunt, that brace must not be supporting a majority of the top person's weight. To demonstrate this, the foot of the top person's braced leg must be at or above the knee of their supporting leg.
• Triple-base straddle lifts must have an additional spotter for the head and shoulders of the top person.
• Hanging pyramids must have a continuous spotter for each shoulder stand involved in suspending another person.
• All vaults are prohibited.
• Basket tosses, toe pitch tosses, or similar tosses are limited to no more than four tossers and must be dismounted to a cradle position by two of the original bases, plus an additional spotter at the head and shoulder area. These tosses may not be directed so that the bases must move to catch the top person.

For additional safety guidelines, visit the AACCA website.

Palo Alto Medical Foundation
American Association of Cheerleading Coaches and Advisors
Children's Hospital of Pittsburgh
U.S. Consumer Product Safety Commission