Cheerleading safety statistics show a relatively low overall injury rate compared with many high school sports, but the consequences can be serious when falls occur from elevated stunts or pyramids. The available U.S. research describes injury frequency, common diagnoses, practice risks, and changes in catastrophic injuries across different periods and age groups.
Contents
- Overall injury frequency
- What injuries occur most often
- Stunts, falls, and practice exposure
- Concussion and head-injury comparisons
- Fall height, surfaces, and serious injuries
- Catastrophic injuries and long-term outcomes
Overall injury frequency
A U.S. high school surveillance study published in Pediatrics ranked cheerleading 18th among 22 sports by injury rate. Its overall rate was 0.71 injuries per 1,000 athlete-exposures. In the same surveillance period, U.S. high schools recorded 793 cheerleading injuries across about 1.1 million practices or competitions with potential for injury. Concussions represented 31% of those 793 injuries.
The time-summary source for the Pediatrics study reported that cheerleading’s injury rate was 63% lower than the rate for all other high school sports combined. That comparison describes the study’s high school surveillance population and period; it should not be treated as a rate for every cheerleading program or every type of participation.
The fall-related injury study reported 79 falls in one year, 2006–2007. Those 79 falls represented 14% of the 567 injuries reported to Cheerleading RIO by U.S. cheerleading teams. The denominator and reporting system differ from the high school surveillance study, so these figures describe different slices of injury activity rather than one combined national rate.
Older figures in the sources also describe a rise in reported emergency-department visits. Cheerleading Injuries and Safety reported 26,786 cheerleading emergency-department visits in 2007, compared with approximately 5,000 annual injuries reported in 1980. The 2007 total was about five times the 1980 figure. These are historical reported counts, and the source set does not independently verify the legacy figures.
What injuries occur most often
Sprains and strains are the leading broad injury category in the American Academy of Pediatrics review, accounting for 53% of all cheerleading injuries. Abrasions, contusions, and hematomas made up 13% to 18%. Fractures and dislocations accounted for 10% to 16%, while lacerations and punctures accounted for 4%.
Head and neck injuries represented about 15% of cheerleading injuries seen in U.S. emergency departments in the AAP policy source. Within that review, concussion and head injuries made up 3.5% to 4% of all cheerleading injuries. A separate AAP summary stated that concussions and other closed-head injuries accounted for 4% to 6%.
The Pediatrics high school surveillance study found a different distribution: concussion was the most common injury, accounting for 31.1% of all injuries in that sample. The difference between 31.1% in the surveillance study and the lower AAP ranges reflects differences in source, population, case definitions, and measurement setting. Those percentages should not be averaged.
The systematic review of cheerleading injuries reported that 96.8% of cheerleaders in its surveillance sample were female. It also found that 53.2% of injuries were stunt-related. That sample composition helps describe the population represented by the review, but it is not a claim that every cheerleading group has the same gender distribution.
Stunts, falls, and practice exposure
Stunt-related injury rates varied by participation level in the AAP cheerleading injuries policy. Collegiate cheerleaders had a rate of 1.59 stunt-related injuries per 1,000 athlete-exposures. The corresponding rate was 0.59 per 1,000 athlete-exposures for high school cheerleaders and 0.23 per 1,000 athlete-exposures for middle school cheerleaders.
The cheerleading injuries narrative review reported a stunt-related injury rate of 0.57 per 1,000 athlete-exposures. It also reported that the first concussion study in cheerleading found a rate of 11.32 concussions per 100,000 athlete-exposures. Because these results come from different studies, the rates should be read with their source labels and not treated as a single time series.
In the U.S. fall-related injury study, the fall injury rate was 13.3 per 100,000 athlete-exposures. Stunts or pyramids were involved in 89% of falls. Single-leg stunts accounted for 28% of fall injuries, and 85% of fall injuries occurred during practice. High school cheerleaders sustained 51% of the fall injuries in that study.
The injury types in the fall study were also unevenly distributed. Strains and sprains made up 54% of fall injuries, while concussions or closed head injuries made up 6%. Collegiate cheerleaders had a relative risk of 15.8 for concussion or closed head injury compared with other team types, and a relative risk of 7.9 for dislocation compared with other team types.
Concussion and head-injury comparisons
The Pediatrics study measured a cheerleading concussion rate of 2.21 per 10,000 athlete-exposures. The rate for all other sports combined was 3.78 per 10,000 athlete-exposures, while the rate for all other girls’ sports was 2.70 per 10,000 athlete-exposures.
| Comparison group | Concussion rate | Measurement unit |
|---|---|---|
| Cheerleading | 2.21 | per 10,000 athlete-exposures |
| All other sports combined | 3.78 | per 10,000 athlete-exposures |
| All other girls’ sports | 2.70 | per 10,000 athlete-exposures |
These rates are from the same Pediatrics high school surveillance study, making the comparison more direct than comparisons across unrelated reviews. Even so, an exposure-based rate does not indicate the severity of an individual concussion, and a lower group rate does not mean that a specific stunt or fall is low risk.
The fall-related study provides a different perspective on severity. Among the most serious injuries examined, 100% of concussions or closed head injuries occurred at or above the surface’s critical height threshold. The same was true for 100% of ACL tears. The corresponding shares were 67% for dislocations and 50% for fractures.
Fall height, surfaces, and serious injuries
Average fall height varied by the body region injured. The fall-related injury study reported an average height of 4.0 feet for upper-extremity injuries and 5.3 feet for head and face injuries. Those averages describe the injuries in that study; they are not a recommended stunt height or a safety threshold.
The surface findings were concentrated in the small serious-injury subset. Of the 15 most serious injuries, 87% occurred on artificial turf, grass, a traditional foam floor, or a wood floor. In that same subset, 80% occurred at or above the surface’s critical height threshold. The threshold comparison is therefore a feature of the study’s surface analysis, not a universal rule for every venue.
The pattern matters because most reported falls occurred during stunts or pyramids, and practice accounted for 85% of fall injuries. The figures point to elevated skills and routine practice as important contexts for safety planning, while the data itself does not quantify the effect of any specific prevention measure.
Catastrophic injuries and long-term outcomes
The catastrophic-injury sources cover longer historical periods and use narrower definitions than general injury surveillance. One orthopedic-patient review reported mean catastrophic injury counts of 3.6 per year from 2002 to 2017 and 1.95 per year from 1982 to 2002. Approximately 54% of catastrophic cheerleading injuries led to permanent disability. The cervical spine accounted for 32% of catastrophic injuries, and 29% of cervical-spine catastrophic injuries resulted in permanent disability.
In a 1982–2002 catastrophic cheerleading injury series, 17 injuries were classified as severe head injuries. Those included 13 skull fractures. The same series recorded two deaths, eight cervical fractures or major ligament injuries, three spinal cord contusions, and one combined head injury with a cervical fracture.
More recent figures cited by USA Cheer safety research, drawing on the National Center for Catastrophic Sport Injury Research, show a decline in catastrophic injuries. The count fell from 42 injuries in 2003–2014 to six injuries in 2014–2023, an 85% drop. The most recent NCCSIR annual report cited by that source showed no direct fatal or permanently disabling cheerleading injuries in the past two years.
Participation also changed in the period covered by a catastrophic-injury rule-change study. Cheerleading participants aged 12 to 24 declined from 1.9 million in 2001 to 1.8 million in 2016. That change in participation should be kept separate from the injury-count trend because the supplied sources do not provide a common exposure calculation for both series.
The historical and recent catastrophic figures should be read as source-specific findings rather than as one continuous, independently verified record. Together with the injury-rate studies, they show why cheerleading safety statistics need both frequency measures—such as injuries per athlete-exposure—and outcome measures, such as permanent disability, deaths, fractures, and severe head injuries.