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Health & Exercise Forum

Prevention of Cheerleading Injuries: Part II of II

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Mar 28, 2009

Dr. Mackarey's Health & Exercise ForumGuest Columnist - Janet M. Caputo, PT, OCS

“Ashley’s Law,”named for Ashley Burns who died from a cheerleading stunt, would require EMTs and protective gear at games, competitions, and practices. In response to safety concerns, some schools are prohibiting stunts and keeping cheerleaders grounded.

Cheerleading includes gymnastics, tosses, partner stunts, and pyramid building. These challenges pose increased risk of injury. Injury prevention and safety precautions are essential help prevent injuries.

Here are several key points for injury prevention in cheerleading:

Adhere to all rules and regulations

Complete rules can be found at


Pre-season physicals identify chronic injuries to be treated or conditioning deficiencies to be remedied. Non-musculoskeletal health issues are addressed: cardiac arrhythmias, dizziness, and seizures. If present an aggressive work up should be done before participation is allowed.

Identifying eating disorders

Women participating in aesthetic sports are at increased risk for eating disorders. Carefully evaluate daily eating patterns and menstrual irregularities. Any athlete with a new stress fracture or overuse injury should also undergo screening. Abnormalities addressed immediately!

Identify and treat injuries early with appropriate rehabilitation

Any injury should be promptly evaluated and diagnosed to determine the extent of damage. Performing any sport with an injury can cause further trauma and long term complications.

Knowledgeable coach

  • Attends training camps with the squad
  • Participates in local, state, or national coaches’ conferences
  • Completes Safety Certification Courses
  • Educated and certified in first aid and CPR


Coaches must understand the risks of each maneuver. Safe performance is emphasized. Educating athletes about safe practice patterns will reduce injuries.


Gradually increase intensity of practice. Riskier maneuvers must be approached gradually with emphasis on mastery of the preceding skill.

Strengthening and conditioning

Poor overall conditioning plays a huge role in injuries. Cheerleaders should participate in a year round conditioning program that consists of strength training, aerobic conditioning, and enhancing flexibility. “Base” athletes should concentrate on strengthening the shoulder and rotator cuff. All athletes should concentrate on strengthening the lower back and abdomen.

Proper technique / good form

The best form of injury prevention is proper technique when executing skills. Proper landing technique helps in the prevention of knee and ankle injuries. Good form during routines promotes safety for all athletes involved in the performance.

Environment and equipment

Practicing on hard floors without mats leads to overuse injuries, and to more severe injuries when falls occur. If mats are unavailable, practicing outdoors on the grass or using well-cushioned shoes can reduce impact. Adequate space and height and access to athletic trainers should be provided.

Shoes should be well-fitted and comfortable.  Broad soles may reduce the risk of ankle sprains. Cross-trainers or running shoes are excellent choices. Shoes should be chosen for function, not solely for aesthetics.

Proper spotting technique

Spotters assist in the development of new skills and decrease risk of injury. Spotters correct body position and form and develop confidence in performance.


Most injuries occur in practice. Loss of concentration contributes to injuries. Focus is essential especially during the execution of skills.

Skill and ability

Athletes should work within their level of ability. Advanced skills require time to master. There is a progression to developing new skills. Athletes should acknowledge their limitations in order to prevent injury.

Preparation for emergencies

Finally, emergency procedures and plans should be carefully outlined prior to any practice and performance. Coaches and supervisors should know first aid and the location of the nearest telephone. Emergency transportation should be available.

Cheerleading carries some unavoidable risk. Participants must take responsibility for their own safety and that of their fellow squad members. Nonetheless, safety precautions can reduce the severity and frequency of injuries.

Visit your doctor regularly, and listen to your body.