Cheerleading Safety From AACCA. Solutions to address the risks involved in cheerleading.

As happens around this time every year the National Center for Catastrophic Injury Research at the University of North Carolina headed by Drs. Frederick Mueller and Robert Cantu releases the results of their Catastrophic Sport Injury Research Annual Report. This past week they released the 26th such report, which covers the catastrophic injuries from the fall of 1982 through to the spring of 2008 for many high school and college sports. This is laudable work as it is necessary in gathering information about sports injuries so that patterns can be established in order to minimize the chance of injury – especially catastrophic injury – to those participating.

Unfortunately, the recent trend in the media is that immediately following the annual release, inaccurate articles spring up about one sport/activity covered in the report – cheerleading.

The best way to show the inaccuracies and sensationalism is to start by breaking down the reported injuries. To do this, I’m not going to use total catastrophic injuries for now as any statistician will tell you that totals are not an accurate reflection of risk. If we’re going to talk about “America’s Most Dangerous Sport” as a Fox News headline read, then we need to talk about what “danger” means. Danger is the risk of participation, and that means that the number of participants must be considered. If sport “A” has 10 injuries and sport “B” has 5 injuries, you’d say sport “A” was more dangerous – until you found out that sport “A” has 100 participants and sport “B” has 10. Now you have a more accurate portrayal of “risk” when you see that 10% of sport “A”‘s participants got injured and 50% of sport “B”‘s participants got injured.

The NCCIR study has such a risk statistic. They consider the participation and produce a “catastrophic injuries per 100,000 participants” figure. Here are those figures for direct catastrophic injuries to high school participants over the life of the study:

All of these figures, with the exception of cheerleading are taken from the Data Tables provided by the study. The two figures for cheerleading are taken from the Annual Report itself.

* Note I have listed cheerleading twice. The first listing is the catastrophic injuries per 100,000 given by Dr. Mueller’s report for the 2007-2008 year, where there were 0 fatalities, 3 non-fatal, and 0 serious injuries for approximately 400,000 participants. The study does not provide a “per 100,000″ figure for the range of the study like the rest of the sports. Therefore, second listing was created by me, taking the full range of the study and assuming the same participation over the course of the study. I feel this is fairly accurate being that virtually every high school has had cheer teams for the duration of the study, unlike many female sports like soccer and softball.

That puts cheerleading at eighth amongst all high school sports, and third amongst female sports. Granted, there aren’t many participants in female ice hockey or gymnastics which should be considered when determining where to focus efforts. But this shows the problem with headlines that read “Forget football or hockey – the most dangerous sport is cheerleading” (Examiner.com June 26, 2009).

One other very important factor to note is that cheerleading, unlike all of the other sports, has year-round participation. This must be considered if we are truly going to paint an accurate picture of the risk of participation. If an athlete participated in sport “A” for one season with a risk of .25 per 100,000 and then participated in sport “B” for one season with a risk of .25 per 100,000, his risk of injury is still .25 per 100,000 for the year. Likewise, if an athlete participates in cheer for two seasons, the risk should be looked at for each individual season. So the combined risk of .75 should be halved to .375 per 100,000 for each of those two seasons in order to accurately measure it against sport “A” and sport “B” in determining “risk” or “danger”.

When taking the two-season issue in to account, cheerleading has a catastrophic injury rate of .375 per 100,000, which falls below girls’ soccer which has a risk of .40 catastrophic injuries per 100,000.

Even if you do go back and use the total catastrophic injuries, that “most dangerous” headline is patently false. There were 635 direct high school football catastrophic injuries over the study period and 73 for cheerleading. Those figures include 104 deaths in football and 2 in cheer. Looking at just the 2007-2008 season, there were 32 football catastrophic injuries including 3 deaths, while there were 3 cheerleading catastrophic injuries with 0 deaths. Even reading the report itself, it says “As indicated in Tables I through VIII, football is associated with the greatest number of catastrophic injuries. For the 2007 football season there were a total of 32 high school direct catastrophic injuries, which is an increase of 12 over 2006.”

But what about the 65.2%?

The fact that over the 26 year study cheerleading accounted for 65.2% of the catastrophic injuries to females is certainly a concern. However, as explained and detailed above, it isn’t an accurate measure of actual risk. In addition, it is a number reflective of the entire course of the study and it only is a comparison to female athletes, not all athletes. If compared to all athletes, it would be a fraction of the total. It also doesn’t show what is happening in recent years. The improvements in cheerleading safety and awareness were noted in the study, but basically were not reported.

Why is this misreporting such an issue?

First of all, it’s wrong. In America, we depend on our media to get it right, to look at all the facts and not to take one line of a report and make a story of it.

Secondly, it’s unfair to all of the coaches, athletes, parents and administrators that do the right thing every day with regard to cheerleading safety. Their efforts have shown improvements, and those improvements should be recognized.

Third, there is a real risk of losing cheerleading when this kind of misreporting happens. People generally understand the risk involved in football and while no one excuses an injury, they have for the most part accepted that risk of participation when weighed against the benefits of participation. When they see headlines that purport that cheerleading is more dangerous than football, they rightfully are concerned about their cheer programs. But the premise is incorrect.

And it’s not just the public. Insurance companies that provide insurance to schools have also looked at these reports. After all, it was the liability concerns of insurance companies that drove gymnastics out of most high schools. If they are given hyper-inflated, inaccurate numbers that make cheerleading appear to be more dangerous than football, we all run the risk of losing cheerleading in schools. Several college programs have already used these false media reports as an excuse to replace their cheer programs with dance-style entertainment teams.

There are other inaccuracies as well. In one case on a show called “Sports Science”, they claim that a cheerleader generates forces larger than an NFL football player. They got this by making the claim that a cheerleader can be thrown as high as 24 feet in a basket toss, and if she hits the ground unaided, she lands with a force of 2000 lbs. That’s 200 lbs. more force than an NFL player hits another player at full speed. That’s also a false premise. We contacted the producers of the show to find out how they measured a basket toss at 24 feet but got no answer. We took a screenshot of the show where they demonstrate a supposed 24 foot basket toss and did our own measurements. You can see the results for yourself to the right.

We’ve posted this on our Facebook page, so it is in the public, yet people continue to make this false claim.

Fourth, when these false media stories come out, it is our duty to respond to them. This takes away in part from our primary duty which is educating coaches, parents, athletes and administrators about cheerleading safety and what they can do to minimize injury. We would much rather be spending our time speaking with another state high school association about what can be done to regulate their cheer programs and provide them with the tools to help reduce injuries. In fact, our recent efforts have resulted in 13 states requiring safety training for their coaches, with many more promoting safety education. Most states already have some level of regulation requiring coaches to follow safety rules and many have requirements for Sport First Aid and CPR training for their coaches. It is our goal that every state association require their cheerleaders to follow specific cheerleading rules and have mandated coaches’ safety training like that provided by the National Federation of High School Associations.

Some people say we are making excuses for cheerleading injuries when we dispute these false allegations. Nothing could be further from the truth. Everything we do and have done over the last 21 years has been to improve cheerleading safety. From working with various studies to funding studies ourselves to working with the organizations directly responsible for athletics like the NCAA, the National Federation of High Schools, the National Athletic Trainers Association and more.

It is a lofty goal to state our goal is no injuries, but that is not realistic in any athletic endeavor. Any injury is one too many, and our goal is to minimize the chance of injury, especially catastrophic, life-changing injuries, and reduce them to a point where any injury is due to an accident, not something that could have been prevented.

We feel that we, along with countless other organizations, coaches, athletes, parents and administrators have made great strides in reducing catastrophic cheerleading injuries and we will continue to work to reduce them even further.