Catastrophic Cheerleading Injuries

BACKGROUND: There are few epidemiologic studies of cheerleading injuries. PURPOSE: To develop a profile of catastrophic injuries in cheerleading and to describe relevant risk factors. STUDY DESIGN: Retrospective cohort study. METHODS: We reviewed 29 of 39 incidents of cheerleading injuries reported to the National Center for Catastrophic Sports Injury Research from 1982 to 2002. RESULTS: Twenty-seven of the injured cheerleaders were women. There were 1.95 direct catastrophic injuries per year or 0.6 injuries per 100,000 participants. The rate of injuries among college cheerleaders was five times that of high school participants. The most common stunts performed at the time of injury were a pyramid (9) or a basket toss (8). Catastrophic injuries included 17 severe head injuries, resulting in 13 skull fractures and 2 deaths; 8 cervical fractures or major ligament injuries; 3 spinal cord contusions; and 1 concomitant head injury and cervical fracture. CONCLUSIONS: Suggestions for reducing catastrophic injuries in cheerleaders include enhancing the number and training of spotters, mandating floor mats for complex stunts, restricting complex stunts when surfaces are wet, and encouraging safety certification of coaches. Pyramids and basket tosses should be limited to experienced cheerleaders who have mastered all other skills and should be performed with spotters and landing mats.