A Kansas City doctor and the American Academy of Pediatrics have issued a report analyzing the unique injury risks in cheerleading and how to improve safety for the first time in over a decade. They’re calling for a series of changes, including broad recognition of cheerleading as a sport.
It’s late on a Tuesday night in December and a handful of cheerleaders are ironing out their routine at Triple Threat KC, a gym in Lenexa.
The gym’s advanced team is preparing for competitions later this month: one in Sedalia where they’ll square off against 75 teams, and another in Kansas City featuring more than 100 teams. They’re working on new stunts — aerial maneuvers that involve jumping, tumbling and tossing cheerleaders into the air — in hopes of winning.
Despite those ambitions, Charles Moore, the gym’s owner and coach, wants to make sure his athletes don’t put success over safety.
He says a good stunt can look incredibly complex, but if he breaks it down step by step — he compares it to a Lego set — it helps kids understand what the movement is supposed to look and feel like when they stick the landing.
For each person someone hoists into the air — the flyer — there is at least one back spotter, often a coach.
“If I can get somebody to practice something in a safe environment where they know they aren’t going to get injured they’ll give full effort to the technique,” Moore says. “It’s when they don’t feel safe when they try to get it over as fast as possible.”
Cheerleading is the fastest-growing female sport in the country. Most of the 3.5 million kids participating are girls between the ages of six and 17. The Kansas City metro has more than a dozen all-star cheer gyms, and most schools have some sort of cheer team.
What was once a grounded, male-dominant activity meant to energize school spirit through chants has grown to be incredibly athletic and complex. That’s why, for the first time in over a decade, doctors with the American Academy of Pediatrics have issued a report analyzing the unique injury risks in cheerleading and how to improve safety.
Dr. Gregory Canty of Children’s Mercy Hospital in Kansas City co-authored the November statement by the American Academy of Pediatrics released. In his medical practice, Canty treats cheerleading patients every day. He’s seen concussions, broken bones and catastrophic injuries.
“Because of that risk, we need to do everything we can as parents, as physicians and as a community to continue to make the sport safer,” Canty says.
Conflicting data
Overall, considering the rapid growth of the sport, Canty and his co-authors say there’s been a decrease in the rate of injuries for female cheerleaders.
Their report suggests the overall rate of injury in cheerleading is two to three times lower than in girls’ soccer or basketball, for example. But cheerleading injuries, particularly concussions, can be especially severe and have a prolonged recovery time.
Stunting is 70% of the concussions reported in high school cheerleading, according to the report. And concussions suffered during cheerleading practice rank third behind boys’ football and wrestling practices.
“Cheer appears to be one of the safer sports from the places we got data, but there is data that suggest when cheerleaders do get injured the risk of a serious injury is there,” Canty says. “Some of those can be things like concussions, fractures, dislocations, those types of injuries. You have to be alert to those types of things that could keep you away for more than a couple of weeks.”
Canty notes one big change is concussion recognition, and that could be why there are a greater number of concussions reported now than in the previous report in 2012. But Canty also says data reporting on the sport isn’t great.
There’s no database where all gyms and schools report cheer injuries, so collection can be piecemeal. That’s something to consider when reviewing overall rates, says Kimberly Archie, a founder of the National Cheerleading Safety Foundation – established by former coaches, cheerleaders and their parents.
And sometimes, injuries might be mislabeled as gymnastics-related because of the similarities in some of the moves, Archie says.
She points to other research done in collaboration with the National Center for Catastrophic Sports Injury Research that suggests the number of catastrophic injuries sustained by cheerleaders is greater than the sum of all female athletes playing other high school or college sports combined.
“It’s prevalent, it’s been normalized and it’s causing a health epidemic in cheerleading,” Archie says. “Cheerleaders aren’t just at risk of arthritis or knee problems, but to have brain health issues for the rest of their life.”
Brittany Poinson at Children’s Hospital New Orleans reports seeing “quite a few cheerleaders for persistent post-concussion symptoms,” according to reporting by NPR.
But USA Cheer, an organization overseeing safety regulations recognized by various Olympic committees, says those metrics are outdated and there have been great strides in addressing these injury concerns in the past few decades.
Nearly twenty years ago, several of the sport’s governing bodies changed requirements for the basket toss. That’s when a team of people whose hands are interlocked launches a cheerleader into the air.
A study on catastrophic injuries later found that making sure teams did the move on absorbent surfaces, like grass or rubber mats, made it four times safer over the next decade.
Overcoming bias and finding a path forward
Canty says other changes would make the sport even safer.
A major step would be state associations and high school athletic departments overseeing and formally recognizing cheerleading as a sport.
“It would solidify cheerleader’s access to trained individuals, to making sure they have athletic trainers that are available, they have strength and conditioning personnel,” Canty says. “All those things kind of open up.”
Canty says this would also help improve injury reporting and data collection.
Kansas and Missouri already list cheer as a sport under their high school athletic associations. But Archie says cheer must also be recognized under Title IX – the federal law that prohibits sex discrimination and ensures students in educational settings are treated equally.
Without that, Archie says, school teams don’t feel any real legal pressure to abide by regulations. That includes having an emergency action plan, which the AAP report says should be commonplace and clearly posted in all schools and gyms.
“Think about the janitor at the school district,” she says. “If they get up on a ladder above six feet, they need a fall protection plan. High school cheerleaders often do acrobatics and tumbling above six feet and they don’t have a fall protection plan.”
Archie knows this from firsthand experience. Her daughter broke an arm at cheerleading practice, and there was no plan in place for getting her help.
One roadblock to Title IX and broad recognition is a bias against cheerleading, Archie says. Depending on your age or exposure to the sport, you might still see it as the pom-pom-waving sport it was decades ago. It’s also the only sport with its own category on PornHub, Archie says.
“When I say that people are pretty taken aback, but it affects how seriously people take this issue,” she says.
Another roadblock is the organizations charged with oversight of the sport. While USA Cheer supports high schools and colleges recognizing and regulating the sport, it does not support placing cheerleading under Title IX. USA Cheer and Varsity Spirit, an organization that helped create USA Cheer and holds a near monopoly over the sport — have routinely opposed Title IX certification in court.
Jim Lord, USA Cheer’s director of education and programs, says that’s because under Title IX, teams should be competitive in nature and not every sport is.
“In Missouri and in Kansas they have requirements for training either for their coaches, the same types of training that other sports coaches have to follow,” Lord says. “They provide opportunities for competition, but also they make them follow the safety rules and they do that without being necessarily a Title IX type of sport.”
Many teams are also uneasy about speaking on the issue. Out of eight teams KCUR contacted around the Kansas City metro, only Triple Threat KC responded.
Lord says that’s because of media scrutiny unfairly characterizing the issue. Archie, however, says she suspects organizations like Varsity and USA Cheer want to keep the problems quiet.
Ground level changes
In its policy statement, the AAP also calls for physical health screenings for prospective athletes. Lord says USA Cheer supports all the recommendations in the report.
Many of them, such as physicals and an emergency action plan, are already suggested by USA Cheer. But they are just recommendations. Lord says the organization has its own safety council made up of doctors, trainers, surgeons and other experts who review new data yearly to make necessary changes.
They will meet in February to go over the rules for high school and in April for college.
“We’ll be bringing all those things together to see if there are rules out there we have been allowing that we have a concern about and whether we need to address those through education or if we’ve done that, to make a rule change,” Lord says.
With large-scale changes such as Title IX recognition unlikely to happen in the immediate future, individual gyms and schools can still institute things like an action plan to help keep more kids out of Dr. Canty’s clinic at Children’s Mercy.
At Triple Threat KC, Moore requires all cheerleaders to get a physical before they join the gym. And he is especially particular about concussions.
“We have a concussion protocol so that a way we can check the symptoms of a concussion and if I deem it a light to moderate concussion, we’re shutting it down,” he says. “It’s not worth the risk. The brain is a significant organ and we want to make sure it’s working at all times so we’re gonna shut it down.”
Kansas News Service
