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Pediatrics Study: Applause and Perspective

In response to the recent cheerleading injury study released in the journal Pediatrics, we would like to applaud the call for safety training for coaches. The AACCA has been providing safety training for cheerleading coaches since 1987. In that time, the AACCA had conducted safety training for over 20,000 coaches. Unfortunately, whether through a lack of emphasis or funding, or due to the plague of coaching turnover experienced across the spectrum of athletics, there are still many coaches that do not take advantage of the risk management course offered by the AACCA.

The AACCA has partnered with the National Federation of High Schools in their Coaches Education Program to offer a very comprehensive training course for spirit coaches, and it is our sincere hope that this study will encourage schools, districts and even state associations to require coaches training for their cheerleading coaches. Several states have already taken this bold step, including South Dakota, Minnesota and Vermont, while many others offer NFHS and AACCA safety courses at their coaches conferences.

The study in Pediatrics has put the spotlight on the need for coaches training and for better statistical information for this athletic activity.  Unfortunately, there are also some that have taken the study and used it to proclaim things as ludicrous as "cheerleaders are getting hurt more than the players".  There is nothing in the study which suggests that, and anyone attending athletic events regularly will recognize that the incidence of injury on the field is certainly higher than on the sidelines.

Cheerleading emergency room visits should be viewed next to other athletics in order to provide some perspective. In addition to this perspective, we need accurate participation numbers and the number of exposures to injury in order to more accurately gauge and compare injury rates.  We have listed several other athletic activities from the NEISS database for the year 2004, and from ages 5 - 18.  Keep in mind that each of these activities has different levels of participation, but that most of them are primarily a one-season activity. Cheerleading participation continues year-round.

Activity Estimated Emergency Room Visits
Cheerleading        27,005
Football       395,088
Softball        46,644
Gymnastics        29,247
Basketball (F)        94,641
Basketball (M)       267,810

Figures are for 2004

One alarming statistic to come from the study is that the emergency room visits rose 100% in the 13 year period of the study, while participation rose only 18%. The increase is a concern, and we have to balance out being alarmist with understanding that cheerleading has become an athletic endeavor, equal to any other athletic opportunity to which young men and women have access.   In addition, the advent of "non-school" cheerleading - called "all star" cheerleading - has created programs that practice solely to participate in multiple competitions.  These programs, along with the increasing number of school programs that are participating in more competitions, has increased the opportunity for injury. There are simply more athletes performing at more events than ever before.

There are two issues with how the "100% increase" statistic is being presented by the media. Many people reading the headlines will not make it far enough into the article to realize that the increase is over a long period of time. "100%" is a much more inflammatory number than saying the injuries rose "8% from the year before". In the only article we've seen to compare cheerleading emergency room visits to other sports, the cumulative 13-year figure was given for cheerleading, and it was compared to only one year of football-related ER visits.

As stated earlier, we feel that the low increase in the number of cheerleaders is incorrect. With the advent of all star cheerleading over the same time period of the study, and especially in the last five years, there are many more cheerleaders now participating in many more events.  Some all star cheerleading gyms have over 1,000 participants. If the participation numbers do not count these athletes, we cannot get an accurate reflection of the state of cheerleading.

The question is, "what is an acceptable risk for our young athletes?"   Cheerleading is clearly athletic, and that athleticism brings many benefits to the participants in the same way as do other athletic endeavors. With those benefits come inherent risks.  Our role as administrators, educators, coaches, parents, and athletes is to manage that risk to an acceptable level, keeping in mind that the idea that our children should not risk any harm also means that they will not risk success.

There has also been mention of the idea that there are more injuries than this due to cheerleaders receiving treatment from their family doctor or the school athletic trainers. This is certainly more true of other athletic sports in the school system, as cheerleading programs often do not have ready access to the athletic trainers at the school. As we recommend in our safety course, coaches should err on the conservative side and get an athlete to an emergency room if there is any question of whether or not they should go.

The last point we wish to make is to be cautious of the recommendation that designating cheerleading as a sport will improve the situation. In order to be a recognized sport by the Office of Civil Rights, cheerleading programs must be primarily competitive. The unintended consequence of this action is that a team that cheers for 10 athletic events for their school would have to compete at 11 events to be "primarily competitive". Currently, most school teams across the country do not compete at all, and those that do compete usually only participate in 2 or 3 competitive events a year.  The other alternative would be to create a program that does nothing but compete, whereby the number of athletes doubles, and the injury numbers would quickly follow suit.

Our purpose is not to diminish the fact that cheerleading is athletic, and that it does carry risks to the athletes that participate. Our overriding goal is to minimize injuries to participants, to continue to have cheerleading as the healthy athletic activity that it is.  However, without perspective, parents and administrators are likely to overreact by putting undue restrictions on cheerleading programs. If cheerleading injuries are unacceptable, we had better eliminate tackling from football immediately to save our young athletes who die at an average of 4 per year in football.

How do we keep cheerleading safe? The answer is for activities and athletics associations, administrations, coaches, parents and athletes to recognize cheerleading for what it is - a very athletic activity that requires the proper environment and the supervision of a mature, qualified coach that only allows his or her team to perform skills they are qualified to attempt.

For more information on area safety courses, visit www.aacca.org and www.nfhs.org.

All content is the property of The American Association of Cheerleading Coaches and Administrators unless otherwise noted. Reproduction without consent is expressly prohibited with the exception of personal use for cheerleading and dance teams.

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