Treat Cheerleaders as Athletes, Pediatrics Academy Advises

By KATHERINE HOBSON

The nation's pediatricians say cheerleaders should be treated more like athletes to help prevent serious injuries from stunts and pyramids.

In a report published online Monday, the American Academy of Pediatrics recommends that cheerleading should be designated a sport at the high school and collegiate levels "so that it is subject to rules and regulations set forth by sports governing bodies," such as the NCAA.

There are an estimated 400,000 participants in high school cheerleading, almost all women, and 29 states recognize high school cheering as a sport.

The National Collegiate Athletic Association doesn't track the number of college cheerleaders because it isn't considered a sport.

Sports must petition to be recognized by the NCAA, and the criteria for inclusion, among other things, state that there must be an element of competition. Two groups emphasizing tumbling and stunts have asked for cheerleading recognized as an emerging sport. An NCAA spokeswoman says the petitions will be reviewed for three years. Sideline cheerleaders wouldn't be included.

Cheerleading has a lower overall injury rate than women's sports like gymnastics, soccer and basketball. But the rate of catastrophic injury, causing death or permanent disability, is comparatively high, according to previously published data cited in the pediatrics academy report.

According to researchers at the University of North Carolina's National Center for Catastrophic Sport Injury Research, about 65% of the 128 direct catastrophic injuries to high-school female athletes between the 1982-1983 and 2010-2011 school years were received while cheerleading, according to the center's research.

Among college female athletes, cheerleading accounted for 71% of 51 direct catastrophic injuries, according to the center.

The pediatrics academy report cites statistics indicating a rise in the number of cheerleaders ages 6 and older, including traditional cheer squads on the sidelines at games and competitive squads that aren't affiliated with schools, from 3.0 million in 1990 to 3.6 million in 2003.

Cheerleading injury rates have actually decreased over the past few years, after increased attention to safety, says Frederick Mueller, director of the UNC sport-injury research center, which collects injury reports.

Cheering squads often maintain intense workout schedules throughout the school year, not just during a single season, he says. They would benefit from better facilities, qualified coaches, access to athletic trainers and limits on practice.

The AAP says cheerleaders, like other student athletes, should have a pre-participation physical. Coaches should be specially trained in the types of gymnastic stunts that cheering squads increasingly perform.

The most dangerous stunts and pyramids shouldn't be done on hard surfaces, the AAP says. Cheerleaders with signs of a head injury should leave the competition or practice and shouldn't return until they have been cleared by a doctor or medical professional.

"Participation has increased, and the demands of the sport have increased," says Cynthia LaBella, lead author of the report and an associate professor of pediatrics at Northwestern University's Feinberg School of Medicine. "The things that they're doing are more dangerous."

The academy hopes coaches, administrators and state high-school athletic organizations will follow the guidelines, which aren't binding.

Jim Lord, executive director of the American Association of Cheerleading Coaches & Administrators, says he agrees with most of the pediatricians' recommendations.

Whether or not cheerleading is deemed a sport, participants should be treated as athletes, with access to the same level of facilities, medical personnel and qualified coaches, he says.

He does have a quibble with the recommendations: Use of a thick landing mat when performing pyramids may actually increase the danger by leading to instability, he says.

The policy recommendations appear online in the journal Pediatrics.