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Concussions Found to Be the Most Common H.S. Cheerleading Injury

Concussions comprised nearly one-third of all high school cheerleading injuries, although concussion rates are far lower in cheerleading than in all other sports, according to a study published online Thursday in the journal Pediatrics.

The study analyzed high school cheerleading data from 2009-10 through 2013-14, with an average of 107 schools reporting data annually during the study period. Cheerleading ranked 18th of 22 high school sports in terms of injury rate, with 0.71 injuries per 1,000 athletic exposures—defined as each instance of a cheerleader participating in a practice or a competition. It ranked 19th in competition injury rates (0.85 per 1,000 athletic exposures) and 15th in practice injury rates (0.76 per 1,000). The overall injury rate for cheerleading was "significantly lower" than the rate of all other sports combined and all other girls' sports combined, according to the study.

Of the 793 injuries reported during more than 1.1 million cheerleading exposures, concussions were the most common (245), followed by ligament sprains (159), "other" (134), muscle strains (112) and fractures (81). According to the data, "a significantly higher proportion of practice injuries were concussions compared with performance injuries." To wit: 33.1 percent of all practice injuries were concussions, compared to just 27.7 percent of competition injuries. Ligament sprains, meanwhile, comprised 24.6 percent of competition injuries and just 19.3 percent of practice injuries.

While concussion rates are lower in general compared to all other sports combined, practice concussion rates were higher in cheerleading (2.51 per 10,000 athletic exposures) than in most sports. In fact, cheerleading ranked third behind only boys' football (4.78 per 10,000) and wrestling (3.02 per 10,000). Concussion symptoms took more than six days to resolve in 44.2 percent of the reported concussions, and only 34.3 percent of cheerleaders were able to return from any injury within a week of suffering it. Among all injured cheerleaders, 40.7 percent took one to three weeks to return, 11.1 percent needed three weeks or more, and 5.1 percent were medically disqualified.

"These findings of low overall injury rates despite historically high catastrophic injury rates in cheerleading relative to other sports demonstrate that although cheerleading is relatively safe overall, when injuries do occur, they may be more severe," the study authors concluded.

What cheerleading activities led to participants' injuries? Unsurprisingly, stunts (53.2 percent) led the way, followed by tumbling (20.5 percent) and pyramids (10.8 percent). Stunts represented a majority of concussions (69.0 percent), while pyramids (15.7 percent) and tumbling (9.1 percent) trailed far behind.

Based on their findings, the study authors suggested focusing prevention efforts on "activities placing cheerleaders at risk for severe injuries. Understanding the epidemiology of cheerleading injuries is the important first step toward that goal."

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