10 Tips to Prevent Cheerleading Injury

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Cheerleading involves intense gymnastics tumbling, partner stunts, lifts, and tosses for both school-based cheer squads and all-star competition cheerleading squads. The physical demands of cheerleading contribute to cheerleading-related injuries to the ankle, wrist, shoulder, knee, back, neck, and head. Physical therapists can help cheerleaders not only safely heal from an injury sustained during cheerleading, but also can help prevent injury through a targeted conditioning and strengthening program. Check out our 10 tips to prevent injury during cheerleading!

Common Cheerleading Injuries

Over the past 40 years, cheerleading has evolved from school-based squads that cheer, clap, and toe jump to year-round competitive cheering that involves gymnastic tumbling, partner stunts, lifts, pyramids, and tosses. Cheerleading is incredibly popular with 3.8 million cheerleaders in the United States as of 2017, ages 6 and up; 97% of cheerleaders are female.

Injuries can occur due to performing skills too difficult for the cheerleader’s current skill level or on hard or uneven surfaces, poor conditioning or training, limited flexibility, lack of proper training or equipment to perform stunts, general overuse, poor nutrition, or due to lack of core strength or arm or shoulder strength.

One study assessed 412 U.S. cheerleading teams with 9,022 cheerleaders over a one-year period to assess prevalence and type of injury incurred. Throughout the course of the study, 567 cheerleading injuries were reports, 83% of which occurred during practice. Researchers found that 52% of injuries occurred when a cheerleader was performing a stunt, 26% when tumbling, and 24% when a cheerleader was basing or spotting one or more cheerleaders. Lower extremity injuries were the most common injuries, particularly sprains and strains in the ankle and knee. The other three top injured areas were the neck, lower back, and head. 

The most common cheerleading injuries include:

  • Ankle Sprains: Ankle sprains are common, especially in competitive cheerleading, when running, jumping, and flipping. Multiple practices during the week can put stress on the ankles and lead to a sprain, especially in younger kids.

  • Knee Injuries: A strain or tear of a knee ligament, such as the ACL, MCL, or meniscus, can occur due to the stress on the knees from a tumbling pass or jumping and landing from a pyramid formation.

  • Concussions: A concussion is a mild traumatic brain injury that occurs due to either trauma to the head from whiplash or a direct blow to the head. Concussions are fairly common among cheerleaders, whether in those at the base of stunts if the cheerleader they are supporting falls on them or in the flyer (the cheerleader performing the stunt) if they are dropped or fall.

  • Wrist and Shoulder Injuries: Injuries to the wrist or shoulders can occur during a tumbling pass, when supporting as a base in a stunt, or if you fall and extend the arm to brace yourself. Injuries can include a wrist sprain, dislocation or break or shoulder dislocation, separation, rotator cuff injury, or overuse tendinitis.

  • Back Pain: A back injury can occur due to strenuous movement, a bad landing, or hyperextension of the back during tumbling sequences. Spondylolisthesis can occur in which one of the bones of the spine slips under the vertebra below it in the low back causing low back pain.

Cheerleading Injury Prevention Tips

Should an injury occur, physical therapists can help cheerleaders recover safely through a customized exercise and strengthening program tailored to the specific injury. Physical therapists prescribe exercise to address any muscle imbalances or improper body mechanics and improve flexibility, strength, coordination, and stability. Physical therapists also can perform musculoskeletal evaluations and screens to identify any areas of muscle weakness before the cheer season and address them through exercise, manual therapy, and strengthening to prevent future injury.

For ACL rehabilitation and concussion recovery, the therapist follows a specific protocol to gradually rebuild strength and mobility in the knee and restore function and balance after a concussion through a gradual graded therapeutic exercise and strengthening program.

Here are 10 tips to prevent cheerleading-related injury:

  1. Always engage in a dynamic warm-up, which increases the temperature of your muscles by moving through motions and stretches to prepare for cheerleading. A dynamic warm-up prepares your major muscle groups and joints for the demands of tumbling, stunts, and cheering.

  2. Use floor mats during practice and when possible, during competition, particularly when practicing or performing new skills and routines. Avoid stunts if cheering outdoors in inclement weather that causes wet ground from rain or snow.

  3. Ensure proper training for spotting and bases during stunts or pyramid formations. Proper hand placement during a stunt is critical to prevent ankle injuries in the flyers and protect those at the bottom of the stunt from wrist or shoulder injuries.

  4. Be mindful of the surface on which you are cheering as each surface has varying degrees of levelness or cushioning. Practice tumbling and stunts on every surface safely using floor mats. When transitioning to harder surfaces, such as the indoor basketball court, decrease training intensity to allow the body to adjust to the firmer surface.

  5. Follow safety guidelines for the safe execution of stunts, pyramids, and basket tosses that outline the height restrictions in human pyramids (two body lengths for high school), thrower-flyer ratio, and the number of spotters that must be present for each person that is lifted above shoulder level (four throwers and one thrower must be behind the flyer at all times during the toss).

  6. Improve hip stability as strong hip muscles help to prevent ankle and knee injuries. The gluteus medius (side of the hips) and gluteus maximus (back of hips) help to stabilize the body’s position in space, specifically the legs.

  7. Build core strength as a strong trunk, abdominals, and low back provide a stable base for movement. A strong core provides stability when landing a tumbling pass or as a flyer or base supporter during a stunt.

  8. Stabilize the shoulder through targeted shoulder and upper back strengthening exercises. A strong, stable shoulder provides you strength and power when completing stunts or tumbling.

  9. Improve flexibility through stretching at the end of practice as your muscles are fully warmed up and are as flexible as possible at that time. Hold stretches for 90 seconds or 3 sets of 30 seconds each to make long-term changes in flexibility

  10. Maintain healthy nutrition and sufficient sleep to support your body’s optimal health and functioning.

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