Online Program

Epidemiology of high school cheerleading injuries relative to other sports, 2009/10-2013/14

Wednesday, November 4, 2015 : 11:00 a.m. - 11:15 a.m.

Dustin W. Currie, MPH, Department of Epidemiology, Colorado School of Public Health, Aurora, CO
R. Dawn Comstock, PhD, Epidemiology, Pediatric Injury Prevention Education and Research Program, Colorado School of Public Health, Aurora, CO

Approximately 400,000 students participate in US high school cheerleading annually, including 123,508 involved in competitive spirit squads. A relatively new high school sanctioned sport, competitive spirit has increased the skill difficulty and athleticism required of high school cheerleaders, renewing safety concerns. This study describes high school cheerleading injury epidemiology relative to other sports.


We analyzed data collected during the 2009/10-2013/14 academic years from a national sports injury surveillance system (High School RIO).


Injury rates in cheerleading ranked 18thof 22 sports, with an overall injury rate of 0.71 per 1,000 athlete-exposures (AEs).  Only boys’ cross country (0.70), boys’ track and field (0.68), and girls’ (0.32) and boys’ swimming and driving (0.22) had lower rates. Cheerleading’s overall injury rate was significantly lower than all other sports combined (RR: 0.37, 95% CI: 0.35, 0.40), and all other girls’ sports combined (RR: 0.49, 95% CI: 0.46, 0.53).  While concussions were the most common cheerleading injury (31.1% of all injuries), the concussion rate was significantly lower in cheerleading (2.21 per 10,000 AEs) than all other sports combined (3.78) (RR: 0.58, IPR: 0.51, 0.66) and all other girls’ sports (2.70) (RR: 0.82, 95% CI: 0.72, 0.93).


While safety remains a concern among cheerleaders, overall injury rates are lower than in most other sports. Although concussions represent nearly a third of cheerleading injuries, concussion rates are lower in cheerleading than in many other sports. A detailed knowledge of cheerleading injury patterns relative to other sports is needed to drive evidence-based prevention efforts.

Learning Areas:


Learning Objectives:
Compare high school cheerleading injury rates to injury rates of other high school sports.

Keyword(s): Violence & Injury Prevention, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I worked in injury epidemiology throughout the completion of my MPH. I am now the Senior Professional Research Assistant of the National High School Sports-Related Injury Surveillance Study, as well as an Epidemiology PhD student. I have presented and published in the field of sports-related injuries.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.