Cheerleading injury statistics vary widely by outcome: routine injuries are much more common than catastrophic cases, while surveillance studies measure different age groups, settings, and exposure denominators. Across the available research, practice, falls, sprains, and stunt-related events are recurring themes, but long-term trends are not uniform across all measures.
Contents
- How common are cheerleading injuries?
- Concussion and injury-rate comparisons
- Trends in emergency-department injuries
- Catastrophic injury statistics
- Where and how injuries happen
- Common injury types and affected areas
How common are cheerleading injuries?
The clearest way to interpret cheerleading injury numbers is to separate all reported injuries from rare catastrophic events. In high school surveillance from 2009–2014, researchers recorded 793 cheerleading injuries across more than 1.1 million athlete exposures (PubMed 26729538). That study’s high school injury rate was 0.71 injuries per 1,000 athlete exposures (PMC systematic review / high school surveillance).
Cheerleading represented 1.2% of annual sport-related injuries in one review (PMC 8785319). Among 22 high school sports, it ranked 18th for injury rate per 1,000 athlete exposures (PMC 8785319). These figures describe overall injury frequency, not the severity of every case.
Self-reported research captures a different part of the picture. High school cheerleaders reported an average of 3.8 injuries over their careers, compared with 3.5 among collegiate cheerleaders (PMC narrative review). In the same narrative review, 41.2% of high school cheerleaders reported an injury during the previous 12 months, and 39.7% of collegiate cheerleaders did so (PMC narrative review).
Missed participation was also common in those survey findings. High school cheerleaders with at least one missed day represented 41.3% of respondents, while the corresponding collegiate figure was 46.7% (PMC narrative review). The measures are not interchangeable with emergency-department counts: surveys can include injuries that never reach formal medical care.
Participation in cheerleading increased by approximately 18% per year in the United States in the research summarized by the narrative review (PMC narrative review). A growing participant base can affect total injury counts even when the rate per participant moves in the opposite direction.
Concussion and injury-rate comparisons
Concussion was a major component of the 2009–2014 high school surveillance data. Concussions accounted for 31.1% of the 793 reported cheerleading injuries (PubMed 26729538). The cheerleading concussion rate was 2.21 per 10,000 athlete exposures (PubMed 26729538).
For context, the same comparison used an all-sports-combined concussion rate of 3.78 per 10,000 athlete exposures and a girls-sports-combined rate of 2.70 per 10,000 athlete exposures (PubMed 26729538). These are exposure-based comparisons from the same reported research, so they should not be read as a count of all concussions in every cheerleading setting.
Cheerleading’s share of severe outcomes was much larger than its share of routine annual sport injuries. Cheerleading accounted for 54% of all direct catastrophic injuries to female high school athletes and 56% of all direct catastrophic injuries to female collegiate athletes in the review cited as PMC 8785319. The same review reported that cheerleading represented 1.2% of annual sport-related injuries (PMC 8785319). This contrast reflects the difference between total injury frequency and the distribution of rare, severe events.
Trends in emergency-department injuries
National emergency-department data for 2010–2019 showed a mixed pattern. Annual cheerleading injuries declined by 15% over that period, falling from an estimated 35,000 cases to an estimated 30,000 cases (SAGE J Athl Train 2021). The 35,000 estimate had a 95% confidence interval of 27,000 to 44,000, while the 30,000 estimate had a 95% confidence interval of 18,000 to 42,000 (SAGE J Athl Train 2021). These are estimates from emergency-department data, not a complete census of every injury.
The injury rate per 100,000 cheerleaders declined by 27% from 2010 to 2019 (SAGE J Athl Train 2021). At the same time, the annual number of patients admitted or transferred to a hospital increased by 118%, and the admission rate per 100,000 cheerleaders increased by 9.0% (SAGE J Athl Train 2021). In other words, fewer estimated injuries overall coexisted with a larger hospital-care burden in the reported data.
| Measure | Finding | Period or population |
|---|---|---|
| Estimated annual injuries | 35,000 to 30,000 | 2010–2019 |
| Annual injury change | Down 15% | 2010–2019 |
| Injury-rate change | Down 27% per 100,000 cheerleaders | 2010–2019 |
| Hospital admission or transfer count | Up 118% | 2010–2019 |
| Admission-rate change | Up 9.0% per 100,000 cheerleaders | 2010–2019 |
The age distribution in that emergency-department dataset was concentrated among adolescents: 80% of cheerleading injury patients were aged 12–18 (SAGE J Athl Train 2021). Practice accounted for 52% of injuries, school locations accounted for 31%, and homes accounted for 1.1% (SAGE J Athl Train 2021). The narratives also involved two athletes in 19% of cases (SAGE J Athl Train 2021).
Catastrophic injury statistics
The National Center for Catastrophic Sports Injury Research recorded 76 direct catastrophic injuries in high school cheerleaders and 34 in collegiate cheerleaders from 1982–2009 (AAP Pediatrics, 2011). Cheerleading catastrophic injuries increased from an average of 1.5 per year in 1982–1992 to 4.8 per year in 2003–2009 (AAP Pediatrics, 2011). In 2011, only 29 state high school athletic associations recognized cheerleading as a sport, and the NCAA did not include competitive cheerleading on its list of sponsored sports (AAP Pediatrics, 2011). Those institutional details help explain why older surveillance systems may have classified cheerleading differently from conventional sports.
A separate catastrophic injury series covering 2002–2017 recorded 54 cheerleading injuries, averaging 3.6 per year (PMC 6299346). The overall catastrophic injury rate was 2.12 per 1,000,000 participants. The high school rate was 2.32 per 1,000,000 participants, and the college rate was 1.88 per 1,000,000 participants (PMC 6299346).
The annual high school catastrophic injury rate ranged from 0.00 to 7.48 per 1,000,000 cheerleaders, while the collegiate rate ranged from 0.00 to 7.39 per 1,000,000 (PMC 6299346). The wide ranges show why a single year can be misleading when events are rare.
The severity profile was concentrated around the head and neck. Head or cervical-spine injuries made up 84% of the 2002–2017 catastrophic series (PMC systematic review / NCCSIR). Basket tosses accounted for 35% and pyramids for 23% of those injuries (PMC systematic review / NCCSIR). Practice was the setting for 69% (PMC systematic review / NCCSIR).
An earlier 1982–2002 series included 17 severe head injuries, 13 skull fractures, 2 deaths, 8 cervical fractures or major ligament injuries, 3 spinal-cord contusions, and 1 combined head-and-cervical fracture case (SAGE 2003). These legacy figures describe that historical series and should not be treated as current estimates.
Where and how injuries happen
The catastrophic data point toward stunts and practice as important contexts. Basket tosses were the highest-proportion stunt causing injuries in the rule-change study, accounting for 35% of catastrophic injuries recorded from July 2002 through June 2017 (PMC 6299346). Pyramids accounted for 23% in the same series (PMC systematic review / NCCSIR).
Broader fall-related research recorded 77 injured cheerleaders across 56 of 412 teams, meaning 14% of the teams studied had at least one reported fall-related injury (PMC 2775358). The injured athletes ranged from 6 to 27 years old; the mean age was 15.5 years and the median age was 16 years (PMC 2775358). Females represented 96% of those fall-related cases (PMC 2775358).
Strains and sprains accounted for 54% of fall-related injuries, and the lower extremity was injured in 30% (PMC 2775358). In the same body of research, 43.5% of cheer-related injuries kept an athlete out for at least a week, while 28.3% resulted in an emergency-department visit (PMC narrative review). These outcomes show why injury burden cannot be judged only by whether a case was catastrophic.
Common injury types and affected areas
The ankle was the most commonly injured area in the summarized research, with a prevalence of 44.9% (PMC narrative review). The most common injury type was a sprain (PMC narrative review). The fall-related study likewise found that strains and sprains made up 54% of cases, reinforcing the prominence of soft-tissue and lower-extremity injuries in noncatastrophic reports (PMC 2775358).
Treatment location data from the 2006–2007 RIO study show that care occurred across several levels. Thirty-two percent of injured cheerleaders were treated at the scene, 23% in a hospital emergency department, 21% in a doctor’s office, 19% in an athletic trainer’s office, and 5% in urgent care (NATA J Athl Train). In that same study, 50% resumed participation at the next practice or performance (NATA J Athl Train).
These treatment figures are specific to the 2006–2007 study and should not be combined with the later 2010–2019 emergency-department estimates. Together, however, they illustrate the range of injury presentations: some cases are managed immediately or in an athletic trainer’s office, while others require emergency or hospital care.
The overall pattern is therefore uneven. Exposure-based high school injury rates were low relative to many sports, but cheerleading contributed a disproportionately large share of direct catastrophic injuries among female athletes in the cited review. Routine injury estimates declined from 2010 to 2019, while hospital admissions and transfers rose. Practice, falls, basket tosses, and pyramids appear repeatedly in the available surveillance, with ankles, sprains, the head, and the cervical spine representing important injury locations or categories.