Cheerleading seems, well, so cheery, it's hard to associate it with skull fracture, paralysis and death.
But cheering accounts for two-thirds of catastrophic injuries among high school girl athletes, a number that hasn't decreased despite repeated attempts to make the sport less dangerous.
The flips, pyramids, and tosses that make modern-day cheerleading so eyepopping mean it's also far more risky than the splits-on-the-sidelines version that parents remember. Alarmed by the injuries, the American Academy of Pediatrics today called for cheerleading to be recognized as an official sport so it would have to follow the same rules for safety and coaching as gymnastics, soccer, basketball, and other popular girls' sports.
That lands the doctors in the thick of a fight over whether labeling cheerleading a sport would let high schools and colleges cut other girls' sports, while using cheerleading to meet the requirement of the federal Title IX law.
In August, a federal appeals court ruled that Quinnipiac College couldn't count cheerleaders to justifying disbanding women's volleyball. And the NCAA has yet to recognize cheering as either a sport or a so-called emerging sport, with just 29 state high school athletic organizations considering it a sport. So it looks like the doctors have their work cut out for them.
Still, the push from the nation's pediatricians may help make girls and their parents more aware of the risks in an activity that often looks a lot more like Olympic-level gymnastics than rah-rah. It's also wildly popular, with more than 500,000 high school girls either cheerleading at sports events or on competitive cheer teams.
Cheer coaches tend to draw a line between sideline cheering and competitive cheer, in which teams compete against each other. But the daring tosses and other high-risk moves have made their way from competitive cheer to the sidelines.
"With this growth in participation and the more physically demanding routines comes a greater number of injuries," the pediatricians wrote in the new policy statement, published in Pediatrics. And, they added, more cheerleaders showing up in their offices and emergency rooms for treatment of injuries.
Sprains remain the most common injury among high school cheerers, fortunately, accounting for 53 percent of injuries, while concussions and other head injuries account for just 4 percent. Gymnastics still posts the highest overall injury rate for any high school girls' sport, but the catastrophic injury rate is much higher for cheering.
Those catastrophic injuries are due to lack of trained coaches, training in proper spotting, and to performing technical stunts like pyramids and tosses on concrete and other hard surfaces, the doctors say. They're asking pediatricians, especially those who advise schools, to push for sport designation, and better supervision and training.
Spotting might have helped Laura Jackson, a Michigan teenager who feel backwards while practicing a back handspring for cheerleading tryouts at age 14. The girl spotting her didn't know what to do. Jackson hit her head on the gym floor, and is paralyzed from the neck down. Her story and others can be found on the website of the National Cheer Safety Foundation, which tracks cheerleader injuries and prevention efforts.