American Journal of Emergency Medicine
Volume 29, Issue 9 , Pages 1003-1012, November 2011

Epidemiology of strain/sprain injuries among cheerleaders in the United States

  • Brenda J. Shields, MS

      Affiliations

    • Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 614 722 2400; fax: +1 614 722 2448.
  • ,
  • Gary A. Smith, MD, DrPH

      Affiliations

    • Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
    • The Ohio State University, College of Medicine, Columbus, OH, USA

Received 7 April 2010; received in revised form 21 May 2010; accepted 23 May 2010. published online 16 August 2010.

Abstract 

Objective

The aim of this study is to describe the epidemiology of cheerleading-related strain/sprain injuries by type of cheerleading team and type of event.

Methods

Athlete exposure (AE) and injury data were collected from 412 United States cheerleading teams via the Cheerleading Reporting Information Online surveillance tool, and injury rates were calculated.

Results

Strains/Sprains were the most common injury (53%; 0.5 injuries per 1000 AEs) sustained by cheerleaders during our 1-year study. The lower extremities (42%), particularly the ankles (28%), were injured most often. Most injuries occurred during practice (82%); however, the rate of injury was higher during competition (0.8 injuries per 1000 AEs; 95% confidence interval [CI], 0.6-1.0) than during practice (0.6 injuries per 1000 AEs; 95% CI, 0.5-0.6) for all team types. Injuries were sustained most frequently by high school cheerleaders (51%), although college cheerleaders had the highest injury rate (1.2 injuries per 1000 AEs). Strains/Sprains occurred most frequently while attempting a stunt (34%) or while tumbling (32%). Spotting/Basing other cheerleaders (19%) was the most common mechanism of injury and was more likely to result in a lower back strain/sprain than other mechanisms of injury (odds ratio, 3.38; 95% CI, 1.41-8.09; P < .01).

Conclusions

Cheerleaders should increase their focus on conditioning and strength-building training, which may help to prevent strain/sprain injuries. Spotters and bases should additionally focus on proper lifting technique to help avoid back injury. Guidelines may need to be developed for return-to-play after cheerleading-related strain/sprain injuries.

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 Funding for this study was provided by The Research Institute at Nationwide Children's Hospital.

PII: S0735-6757(10)00237-8

doi:10.1016/j.ajem.2010.05.014

American Journal of Emergency Medicine
Volume 29, Issue 9 , Pages 1003-1012, November 2011