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

Background/Purpose:

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.

Methods:

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

Results/Outcomes:

Injury rates in cheerleading ranked 18^thof 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).

Conclusions:

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.