Cheerleading

Is cheerleading safe?

Mostly, yes. Cheerleading almost never kills: US school and college records from the National Center for Catastrophic Sport Injury Research (NCCSIR) contain two traumatic cheerleading deaths in 43 years. Everyday injuries are less common than in most high-school sports. On our estimate a practice or performance carries about 0.01 to 0.03 micromortsMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary.

The worry is the rare, life-changing fall. When a stunt goes wrong, a flyer can fall head first from well above head height, and the injuries that follow are to the brain and spine. That is why cheerleading appears near the top of lists of catastrophic injuries in girls' sport while being near the bottom for ordinary injuries.

How we worked out the micromorts

The NCCSIR counts 1 traumatic death and 9 medical deaths, mostly heart-related, among US high-school cheerleaders from 1982 to 2025. Measured against its participation figures, that is 0.29 deaths per 100,000 cheerleaders a season. The centre warns that this overstates the rate. It uses school competitive spirit numbers, about 165,000 in 2018–19, while a market survey counted about 613,000 cheerleaders aged 13 to 17 who cheered at least 50 times a year, a three-fold difference.

So the true rate is about 1 to 3 micromortsMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary a season. Cheer squads practise through much of the year, and over about 100 practices, games and competitions that gives 0.01 to 0.03 micromorts each.

Catastrophic injuries: how often and why

A study using NCCSIR data found 54 catastrophic cheerleading injuries in US high schools and colleges from 2002 to 2017, about 3.6 a year, or 2.12 per million cheerleaders a year. Half were serious injuries without lasting disability, such as a fractured neck without paralysis. Most happened in practice (69%), and they hit the head (52%) and the cervical spine (32%).

The basket toss, in which bases throw a flyer high and catch her, caused 35% of them. After 2006–07, US rules banned basket tosses on hard surfaces, and the catastrophic basket toss injury rate fell from 1.55 to 0.40 per million cheerleaders, almost four-fold. Flyers make up about 70% of catastrophic injuries.

The American Academy of Pediatrics noted in 2012 that cheerleading accounted for about 66% of catastrophic injuries in high-school girl athletes over the previous 25 years. Its risk factors were cheering on harder surfaces, performing stunts, previous injury, higher body mass index and supervision by a coach with little training or experience.

Everyday injuries and concussion

In US high-school surveillance from 2009 to 2014, cheerleading had 0.71 injuries per 1,000 practices, games and competitions, 18th of 22 sports. Boys, a small minority of cheerleaders, were injured at about twice the rate of girls. Stunts caused 53% of injuries.

Concussion was the most common injury, at 31%. But the concussion rate itself, 2.21 per 10,000 exposures, was lower than the average for other high-school sports and for other girls' sports.

Emergency department data show the volume. From 2010 to 2019, US hospitals treated an estimated 30,000 to 35,000 cheerleading injuries a year in people aged 5 to 25, and the injury rate per cheerleader fell 27%. Hospital admissions, though, more than doubled, and concussions and head injuries became more common.

Rule changes help. In 2012–13, USA Cheer banned the "double down", a dismount with two full twists, for high-school and younger teams. Head injuries among child cheerleaders in emergency data improved after the change.

How to cheer more safely

1. Stunt only on mats or sprung floors, never on hard surfaces, and stop if the surface is wet.
2. Use a trained spotter for every flyer, and keep the bases' eyes on the flyer throughout the catch.
3. Progress one skill at a time. Do not attempt a new stunt until the easier version is solid, and drop difficulty when tired or returning from injury.
4. Choose a squad with a credentialed coach who has safety training. Poorly trained supervision is a known risk factor.
5. Treat any head or neck injury as serious. Do not move a cheerleader who may have hurt her neck, call emergency services, and follow concussion protocols before returning.
6. Know where the defibrillator is at practice and competition venues.

How we scored it

Fatality risk (98) is very low, at about 0.01 to 0.03 micromortsMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary per session. Serious injury risk (68) reflects low everyday injury rates offset by rare but grave head and spine injuries. Controllability (75) is high because surface rules, skill limits and spotting work. Rescue (90) is close in gyms and stadiums. Cheerleading scores well above American football and close to volleyball, but the catastrophic tail is real.