Whatever you call it, cheerleading today is cartwheels away from what it once was.  Rewind to a Princeton football game in 1884 when a man gave the first official cheer to encourage his team to do better. Fifteen years later, an all-male "yell squad" cheered at a University of Minnesota football game. In 1923, women joined in. In the olden days, cheerleading, while not extremely vigorous, was athletic — involving toe-touch jumps and splits.

Jump to the present: cheerleading has literally flipped to a new level. Nowadays over 400,000 American high school cheerleaders are routinely performing fast-paced, complex acrobatic stunts and tumbles. Cheerleading today combines "the strength of football, the grace of dance, and the agility of gymnastics," according to the American Association of Cheerleading Coaches and Administrators (AACCA).

Like football players, dancers and gymnasts, cheerleaders sometimes fumble a catch or lose their balance.  These wrong moves happen most commonly during stunts when they are lifting, tossing and catching their teammates. And with stunts known as pyramids, whirlybirds and superman – face it, injuries happen! Within 30 years (1980-2007), cheerleading-associated emergency room (ER) visits increased five-fold.  In 2007 alone there were 26,786 ER visits; 98 percent of these patients were treated and sent home but 221 were hospitalized, 217 were treated and transferred to another hospital, and 64 were held for observation.

Cheerleaders suffer a disproportionate number of catastrophic injuries. Although most injuries are sprains and strains, some are much more serious and are, in fact, catastrophic. Injuries are termed catastrophic when they result in permanent brain injury, paralysis or death. Cheerleading accounts for more than 65 percent of the catastrophic injuries experienced by high school and college female athletes. Most catastrophic injuries result from stunts that involve tumbling accidents, falling from heights, or being a supporting base. Pyramid stunts are especially risky and are responsible for the majority of head and neck injuries. Risk factors for cheerleading injuries include having a previous injury, having a high body mass index, cheering on hard surfaces, performing complicated stunts, and having an inadequately trained coach.

The opposing sides of the cheerleading "split": On one side are those who take the position that cheerleading is just an activity. Many groups, like the National Collegiate Athletic Association, do not consider cheerleading a sport mainly because not all teams compete. On the other side are those like the National Cheer Safety Foundation who advocate for making cheerleading a recognized sport and creating universal safety standards. Yep, I'm on their team!

Pediatricians agree: safety is # 1. In an effort to make cheerleading safer, the American Academy of Pediatrics recommends the following:

  • Recognize cheerleading as a sport in all states.
  • Provide access to qualified coaches with expertise in cheerleading.
  • Give cheerleaders pre-season physicals and ongoing injury surveillance.
  • Train cheerleaders in spotting techniques and make sure they demonstrate appropriate skills before attempting stunts.
  • Perform stunts only on spring/foam floors or grass/turf surfaces.
  • Limit pyramid height to two people.
  • Remove from practice or competition any cheerleader with a possible head injury; require clearance from a health professional before returning.

As of 2014, the National Federation of State High School Associations lists 32 states that recognize cheerleading as a sport. Three cheers! for Pennsylvania for being among them. Here we go! New Jersey and Here we go! Delaware (they're not on the list and they need some cheering to do better)!

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