A growing number of teenage girls land in hospital emergency rooms with serious injuries as a result of poor supervision and the increased number of cheerleaders, says Sally Harris of the Palo Alto (Calif.) Medical Foundation.
She spoke at the AAP meeting in Boston. "Girls are doing more dangerous routines," she says. "It's not just a sideline, low-key activity anymore."
There are 3.8 million cheerleaders in the United States, mostly high school and college-age girls, according to American Sports Data Inc., a firm that tracks athletic participation. That's up from 3 million in 1990.
In the past several years, competitive cheerleading teams not tied to schools have mushroomed, Harris says. They practice, travel and compete year-round, "doing harder stunts, attracting a lot of ex-gymnasts," she says. "Girls may be thrown up in the air, and hopefully they'll be caught, but sometimes they're not."
Safety guidelines for young cheerleaders vary widely, Harris says. In most schools cheerleading isn't recognized as an official sport, so girls may not have experienced coaches ordering them to stretch and work on conditioning; also, they aren't allowed in the training room used by other school athletes, she says.
Emergency room visits for cheerleading injuries rose fivefold from 1980 to 2001, Harris says. Last year, there were about 25,000 such visits. Partner and gymnastic stunts cause most of the injuries, some research suggests.
Cheerleading is "reasonably safe," says Jim Lord, executive director of the American Association of Cheerleading Coaches and Advisors. Most injuries occur because coaches let young athletes attempt things they're not skilled enough to do, he says.
Private firms sponsor some cheerleading competitions and may allow unsafe activities, Lord says. "And we still have school administrators who flip a coin to see who's coaching the cheerleaders."
The cheerleading coaches association publishes a safety manual and offers training courses, taken by a growing number of coaches, Lord says. Judging by the number of participating athletes and emergency room visits, cheerleading is safer than soccer, basketball or football, he adds.
But the emergency room statistics may be misleading, says Harvey Lauer of American Sports Data.
"Many, many injuries are due to overuse, and they come on gradually. . . . These girls may never wind up in the emergency room."
Also, it's important to know how much time kids spend on an athletic activity to determine injury risk. "Cheerleading can be a very dangerous sport," he says.