All Star cheerleading combines club-based training with competitive routines, and the available research gives a clearer picture of participation and safety than a single injury total can provide. The figures below cover U.S. emergency-department studies, surveillance research, systematic reviews, and USASF organizational rules. Measurement periods and populations differ, so each statistic is identified by its source and scope.
Contents
- Participation and the All Star format
- Emergency-department comparisons
- Injury surveillance among cheerleaders
- Ten-year injury trends
- Craniofacial injuries and hospital care
- What the research evidence includes
- USASF divisions and age structure
Participation and the All Star format
The 2024 American Academy of Pediatrics policy statement reported that more than 3.5 million young people currently participate in cheerleading. The statement also said the vast majority of participants are female and that most are between 6 and 17 years old. These are participation figures for cheerleading overall, not a separate count of All Star athletes. Source: PubMed 39429001.
USASF describes All Star Cheer as primarily competitive and organized through clubs, distinguishing it from traditional school cheer teams. Its routines are 2.5 minutes long, and teams are categorized from Novice to Elite. Source: USASF All Star Tiers.
USASF says All Star Cheer and All Star Dance have been guided by the organization since its founding in 2003. It also describes itself as the largest membership organization for All Star cheer and dance. Its member directory verifies current membership or affiliation, background screening, and abuse-prevention training for adult participants. Sources: USASF About and USASF Home.
The structure matters when interpreting injury research. A study of cheerleading as a whole can include school, collegiate, and All Star participants, while a rule or age-grid statistic can describe only a particular competitive division. The available figures therefore support comparisons, but they should not be treated as a single census of All Star athletes.
Emergency-department comparisons
USA Cheer’s safety research, citing the CPSC National Electronic Injury Surveillance System, reported 22,313 emergency-room visits among girls ages 12–18 for cheerleading in 2024. In the same age band and year, girls’ basketball accounted for 46,795 visits, girls’ soccer for 39,085, girls’ volleyball for 29,706, and girls’ softball for 29,052. USA Cheer says cheerleading was lower than each of those sports in that comparison. Source: USA Cheer safety research.
| Activity | 2024 emergency-room visits, girls ages 12–18 |
|---|---|
| Girls’ basketball | 46,795 |
| Girls’ soccer | 39,085 |
| Girls’ volleyball | 29,706 |
| Girls’ softball | 29,052 |
| Cheerleading | 22,313 |
An additional NEISS prevalence comparison reported by USA Cheer used females ages 14–18. It listed 7,457 cheerleading emergency-room visits, compared with 27,097 for girls’ basketball, 16,159 for girls’ soccer, 11,248 for girls’ volleyball, and 11,176 for girls’ softball. Because the age band differs from the 12–18 comparison, these values should be read as a separate comparison rather than combined with the 2024 figures above. Source: USA Cheer safety research.
The 2023–24 High School RIO study ranked cheerleading 17th out of 20 high school sports for overall injuries, according to USA Cheer’s safety research. USA Cheer also says cheerleading injuries in 2023–24 were lower than those of the 17 sports ranked above it for overall injuries. This ranking is specific to the high-school study and should not be generalized to all club or All Star participation. Source: USA Cheer safety research.
Injury surveillance among cheerleaders
A prospective surveillance study followed 9,022 cheerleaders from 412 U.S. teams for one year and recorded 567 injuries. Practice accounted for 83% of injuries, while 52% occurred during an attempted stunt. Another 24% occurred while an athlete was basing or spotting one or more cheerleaders. Source: PubMed 19911082.
Lower-extremity injuries represented 30% of injuries in that study, and strains and sprains represented 53%. The study reported a practice injury rate of 1.0 injuries per 1,000 athlete-exposures. The rate was 0.6 per 1,000 athlete-exposures at pep rallies and 0.6 at athletic events, while cheerleading competitions had a rate of 1.4.
The same research found a difference in injury type by participation setting. All Star cheerleaders were more likely to sustain a fracture or dislocation, with a relative risk of 1.76 and a 95% confidence interval of 1.16 to 2.66. Collegiate cheerleaders were more likely to sustain a concussion, with a relative risk of 2.98 and a 95% confidence interval of 1.34 to 6.59. These are comparisons reported by the study; they do not establish that every All Star or collegiate athlete has the same risk.
Ten-year injury trends
A 2010–2019 emergency-department study counted 9,868 athletes presenting for cheerleading injuries and estimated 350,000 cheerleading injuries in U.S. emergency departments over the decade. It reported that annual injuries decreased 15%, with the annual count falling from 982 at the beginning of the period to 897 at the end. The corresponding injury rate per 100,000 cheerleaders declined 27%. Source: PubMed 34676270.
Stunt-caused injuries decreased 24% during the same period, falling from 240 to 216. The stunt-injury rate per 100,000 cheerleaders declined 36%. Those trends describe the study’s U.S. emergency-department estimates and are not a direct measure of the number of stunts performed or of competition-only injuries.
Not every outcome moved downward. Concussions and closed-head injuries increased 44%, from 128 to 171 between the start and end years, while hospital admissions increased 118%, from 18 to 24. The hospital admission rate increased 9.0% over 2010–2019. These counts and rates come from the same study and use its definitions and estimation method. Source: PubMed 34676270.
Catastrophic-injury reporting shows a separate long-term pattern. USA Cheer’s safety research, citing the National Center for Catastrophic Sport Injury Research, reported 42 catastrophic cheerleading injuries in 2003–2014 and 6 in 2014–2023, an 85% fall between those periods. The most recent 2023 NCCSIR annual report showed no direct fatal cheerleading injuries and no permanently disabling cheerleading injuries in the previous two years. Source: USA Cheer safety research.
Craniofacial injuries and hospital care
A study covering 2014–2023 estimated 85,102 cheerleading craniofacial injuries requiring emergency-department visits. Females represented 98.2% of cases, and athletes ages 15–19 accounted for 56.0%. Internal-organ injuries made up 30.3% of craniofacial cases, concussions 25.9%, and fractures 3.5%. Source: PubMed 40622298.
The same study reported a 5.5% hospitalization rate for fractures. That percentage applies to fractures within the study’s craniofacial-injury population; it is not a hospitalization rate for all cheerleading injuries. The age and sex distributions also describe the cases captured in that study, rather than the demographic composition of every All Star program.
Taken together with the surveillance study, the craniofacial findings show why totals need context. A broad emergency-department estimate can include many injury types, whereas a craniofacial study narrows the body region and then reports the proportions of internal-organ injuries, concussions, and fractures within that narrower group.
What the research evidence includes
A systematic review identified 372 cheerleading injury studies before screening and included 14 after applying its criteria. The included studies pooled 28,998 cheerleaders and captured 239,361 injuries. The pooled cohort was 96.5% female, with a mean age of 16.0 years. Source: PubMed 41673905.
A separate global meta-analysis reviewed 40 articles covering 175,739 athletes. Source: PubMed 41661157. The existence of different review sizes is important: a pooled count depends on which studies qualify, which countries and settings are represented, and how an injury is defined.
USA Cheer’s safety dashboard compares 2024 visits, 2015–2024 visits, 2023–24 injury rates, and 2023–24 concussion rates. Those comparison windows are not interchangeable. A 2024 emergency-room count is a calendar-year measure, while a 2023–24 high-school injury rate covers a school year and a 2015–2024 comparison covers a longer period. Source: USA Cheer safety research.
USASF divisions and age structure
The USASF 2025–26 Cheer Age Grid lists the member term as June 1, 2025, through May 31, 2026. It defines adult athletes as those born on or before May 31, 2007, who are 18 or older before June 1 in that member term. Source: USASF 2025–26 Cheer Age Grid.
The same age grid lists the CheerABILITIES Unified division for athletes ages 12 and older, with teams of five or more members. It requires 50% or more of the athletes to have disabilities and allows 50% or fewer Unified Partners. These percentages describe the division’s eligibility structure, not the share of all cheerleaders with disabilities.
For the 2025–26 grid, the Novice division begins at birth year 2019 and before, equivalent to ages 6 and older. One restricted Elite level shown in the grid also begins at birth year 2019 and before, equivalent to ages 6 and older. Source: USASF 2025–26 Cheer Age Grid.
These division details help put the research population in perspective. Most cheerleaders in the AAP statement were ages 6–17, while the pooled systematic-review cohort had a mean age of 16.0 years. All Star programs span multiple age and ability divisions, so a statistic from a teenage injury study should be labeled by its study population rather than presented as a universal All Star rate.