Sis, Boom, Ow: Cheerleading Injuries Spiral Upward

Kim Fernandez was at her desk when the phone rang with the news that her oldest daughter had been hurt during cheerleading practice.

“I just remember hearing the words ‘lots of blood,’ ” Fernandez said. “Becky caught an elbow in the nose. It was broken in five pieces, and she ended up having surgery.”

Such injuries have become more common in cheerleading, a world that has changed vastly from the days when all one had to do was be perky, peppy and fill out a sweater.

Cheerleading-related injuries more than doubled over a 13-year period evaluated this month in the journal Pediatrics, though the number of youngsters participating rose 18%. About 209,000 people ages 5 to 18 were treated at U.S. hospitals for such injuries from 1990 to 2002.

Researcher Brenda Shields of Columbus Children’s Hospital attributes the rise to ever more breathtaking maneuvers. As with gymnastics and figure skating, the higher-flying the acrobatics, the more oohs from the crowd. “It used to be that cheerleaders were just waving their pompoms on the sidelines,” said Shields, research coordinator in the hospital’s Center for Injury Research and Policy. “But now they’re doing all kinds of complex gymnastic moves and getting thrown into the air.”

For Fernandez, that harrowing phone call in 2004 did nothing to curb her enthusiasm for back flips, human pyramids and X-out double full twists. All three of her daughters have cheered competitively for years, and the benefits far outweigh the risks, she said.

“If the coaching is good, the environment is controlled and the kids aren’t pushed to do things they’re not comfortable with, it’s fine,” Fernandez said.

In the Pediatrics study, researchers analyzed data from the National Electronic Injury Surveillance System, which monitors injuries treated in U.S. hospital emergency departments. They found that 52% of the cheerleading injuries were strains or sprains, 18% bruises or other soft-tissue abrasions, and 16% fractures or dislocations.

Age affected the way children were hurt. Between 12 and 18, they were more likely to injure ankles and knees; among students in elementary school, fractures were more common, occurring mostly in arms and wrists.

“We believe that’s because younger kids haven’t been taught the right way to fall, so they stick out their arms and try to catch themselves,” Shields said. “Older kids have more training and know how to roll into a fall.”

The incidence of serious injuries was low -- 1.3% required hospitalization.

The study underestimated the true number of injuries, because it did not include patients treated at doctors’ offices, student health centers or nonemergency facilities.

About 4.1 million youngsters participated in cheerleading in 2004, according to the Sporting Goods Manufacturers Assn.

Shields said she would like to see a uniform set of rules and regulations, mandatory completion of safety training and a certification program for all coaches, as well as a national database that tracks injuries.

The issue of cheerleading safety surfaces periodically, usually after a fatal mishap such as occurred in August in Massachusetts. Ashley Burns, 14, died after being hurled into the air and landing on her stomach, causing her spleen to rupture. Her mother is pushing for laws requiring protective equipment and emergency medical technicians at all cheerleading gyms.

Most experts say those measures would be excessive, but they agree that more precautions need to be taken.

Dr. Anthony Rinella, an orthopedic surgeon at Loyola University Medical Center, said he had seen many injuries to the back, neck and legs related to cheerleading.

“As we push kids to get into more competitive sports at younger ages -- to take on attitudes that are more like junior Olympians -- we need to be careful. During puberty, in particular, the bones are growing extremely fast and are just not as strong as they are in an adult,” said Rinella, who would like to see more emphasis on stretching and conditioning.