High school cheerleading participation has grown substantially in recent reporting, while injury research shows that practice settings and stunts deserve particular attention. The National Federation of State High School Associations (NFHS) counted 206,262 girls in competitive spirit in 2024-25, and earlier studies provide context on injuries, participants, and exposure rates.
Contents
- Participation at a glance
- Girls and boys in competitive spirit
- How competitive spirit compares with other sports
- Where participation is largest
- Cheerleading injury rates
- Practice, stunts, and injury patterns
- Injury types and concussion findings
Participation at a glance
NFHS participation surveys show a sharp rise in competitive spirit over the three school years with detailed girls-and-boys counts. Overall participation increased from 144,209 in 2021-22 to 186,151 in 2023-24. The 2024-25 survey then reported 206,262 girls participants and described competitive spirit as the No. 6 girls sport, with participation nearly 14% higher than the previous year. These are national school-sports participation counts, not estimates of every cheerleader in every program.
| School year | Girls participants | Boys participants | Total participants | Schools reported |
|---|---|---|---|---|
| 2021-22 | 140,552 | 3,657 | 144,209 | 7,236 girls; 755 boys |
| 2022-23 | 149,694 | 4,126 | 153,820 | 7,216 girls; 852 boys |
| 2023-24 | 181,023 | 5,128 | 186,151 | 7,827 girls; 1,074 boys |
Source: NFHS 2021-22, 2022-23, and 2023-24 Participation Surveys.
The 2023-24 total of 186,151 was part of a broader national high school sports participation count of 8,062,302 athletes. That wider total included 4,638,785 boys and 3,423,517 girls across sports. In 2024-25, total high school sports participation climbed to 8,266,244: 4,726,648 boys and 3,539,596 girls. NFHS reported the one-year increase as 203,942 athletes and said the latest total was more than 645,000 higher than three years earlier.
Those broad totals help put competitive spirit in context. Cheerleading is one activity within a very large high school sports system, but its recent participation change was notable: the 2024-25 NFHS survey reported nearly 14% year-over-year growth for competitive spirit.
Girls and boys in competitive spirit
Competitive spirit participation remains predominantly female in the NFHS counts. Girls participants numbered 140,552 in 2021-22, 149,694 in 2022-23, and 181,023 in 2023-24. Boys participants numbered 3,657, 4,126, and 5,128 in those same school years. In 2024-25, NFHS reported 206,262 girls participants, but the supplied survey result does not provide a corresponding boys total for that year.
The school counts moved differently from the participant counts. Girls programs were reported at 7,236 schools in 2021-22, 7,216 in 2022-23, and 7,827 in 2023-24. Boys programs were reported at 755, 852, and 1,074 schools, respectively. Because these are reported school counts by participation category, they should not be read as a count of unique schools across all categories.
Earlier sources also described the activity’s gender distribution. The American Academy of Pediatrics (AAP) reported in its policy statement that girls represented 96% of cheerleading participants. A 2025 systematic review reported that participants in its included studies were 96.5% female, with a mean age of 16.0 years and most injuries occurring among high school athletes. The two figures come from different sources and periods, so they describe study populations rather than a single unified national census.
The AAP policy statement also said approximately 400,000 students participated in U.S. high school cheerleading annually in 2009, including approximately 123,000 on competitive spirit squads. That 2009 estimate should be kept separate from the more recent NFHS survey counts because the definitions, measurement period, and reporting systems differ.
How competitive spirit compares with other sports
In 2023-24, NFHS ranked competitive spirit as the No. 9 girls sport with 181,023 participants. In 2024-25, the survey listed it as the No. 6 girls sport and reported 206,262 girls participants. The rank changed alongside the participation count, but rankings depend on the survey’s sport categories and the same-year counts.
For comparison, the 2024-25 girls participation totals included 513,808 in track and field, 492,799 in volleyball, 393,048 in soccer, 356,240 in basketball, and 331,306 in fast-pitch softball. Competitive spirit’s 206,262 girls participants were below each of those listed totals.
The same NFHS survey counted 1,029,588 boys in 11-player football, 644,235 in track and field, 540,704 in basketball, 484,908 in soccer, 472,598 in baseball, and 300,214 in wrestling. Other boys totals included 241,565 in cross country, 162,357 in golf, 158,667 in tennis, and 119,102 in swimming and diving.
NFHS also reported 68,847 girls flag football participants in 2024-25, a 60% year-over-year increase; 70,006 participants across 15 unified sports; and 30,440 esports participants. These figures show how the participation landscape includes both established sports and newer or differently structured activities.
Where participation is largest
The 2024-25 NFHS Participation Survey reported the largest state totals across all high school sports in Texas and California. Texas led with 879,403 athletes, followed by California with 852,575. The next reported totals were Ohio at 335,808, Pennsylvania at 333,123, Illinois at 328,362, and New York at 327,068.
| State | 2024-25 athletes |
|---|---|
| Texas | 879,403 |
| California | 852,575 |
| Ohio | 335,808 |
| Pennsylvania | 333,123 |
| Illinois | 328,362 |
| New York | 327,068 |
| Florida | 308,396 |
| Michigan | 298,246 |
| New Jersey | 281,971 |
| Minnesota | 232,347 |
Source: NFHS 2024-25 Participation Survey. These are all-sports state totals, not state-by-state cheerleading counts. They indicate the scale of school athletics in each state but cannot establish which states have the most competitive spirit participants.
Cheerleading injury rates
A study by Currie et al. in Pediatrics examined the 2009-10 through 2013-14 period and placed cheerleading’s injury rate 18th among 22 sports, at 0.71 injuries per 1,000 athlete-exposures. Within cheerleading, the competition rate was 0.85 per 1,000 athlete-exposures, the practice rate was 0.76, and the performance rate was 0.49.
The same study reported a higher overall injury rate for boys than girls: 1.33 versus 0.69 injuries per 1,000 athlete-exposures, a boys-to-girls rate ratio of 1.93. It also reported a cheerleading concussion incidence of 2.21 per 10,000 athlete-exposures. That was lower than the 3.78 rate for all other sports combined and lower than the 2.70 rate for all other girls’ sports in the study.
In the Currie et al. findings, 96.8% of injured cheerleaders were girls and concussions accounted for 31.1% of cheerleading injuries. The study’s exposure-based rates are not percentages of participants injured; an athlete-exposure represents one athlete taking part in one practice, competition, or other activity period.
An earlier 2004 high school survey by Jacobson et al. in the Journal of Orthopaedic & Sports Physical Therapy analyzed 425 completed responses from 104 mailed schools. Respondents had a mean age of 16.3 years and an average of 4.1 years of cheerleading experience. In that survey, 61.9% reported at least one career injury and 41.3% reported at least one injury in the previous year. Injured athletes missed an average of 3.4 practice or performance days.
The 2004 survey’s injury locations were ankle injuries at 24.4% of all injuries, back injuries at 16.1%, and wrist or hand injuries at 15.6%. Jacobson et al. also noted that more than 1 million participants were involved in cheerleading at various levels. Because the survey was conducted in 2004, its participant and injury findings should not be treated as current national estimates.
Practice, stunts, and injury patterns
A prospective surveillance study by Shields and Smith reported that 83% of injuries in its broader 9,022-cheerleader cohort occurred during practice. It attributed 52% of injuries to attempted stunts and 24% to basing or spotting. The study reported lower-extremity injuries as 30% of injuries and strains and sprains as 53%.
Its setting-specific rates were 1.0 injuries per 1,000 athlete-exposures in practices, 1.4 in competitions, 0.6 at pep rallies, and 0.6 at athletic events. These results differ from the Currie et al. rates because the studies used different cohorts and surveillance designs. Together, they show why the setting and measurement method matter when comparing cheerleading injury statistics.
The 2025 systematic review of cheerleading injuries included 28,998 cheerleaders and 239,361 injuries across its included studies. It reported that most injuries occurred during practice, that sprains and strains were the most common injury types, and that the ankle was the most common injury location. The review summarized a NEISS 2010-2019 study that found a 15% decrease in emergency visits, a 36% reduction in stunt-related injury rate, a 44% annual increase in concussion or closed-craniocerebral injury, and a 9% rise in hospitalization rate. In that summary, 78% of cases involved ages 10-19 and 62% occurred during practice.
The same 2025 review summarized a pediatric NEISS study covering 23 years and 497,095 injuries. That study reported a 189.1% annual growth rate in injuries, a 290.9% annual increase in concussion or closed-head injury, and falls as the mechanism in 29.4% of cases. These are findings reported by the review’s cited studies, not a forecast of future injury totals.
Injury types and concussion findings
The 2025 review cited a CDC Heads Up poster reporting that 91% of high school cheerleading concussions happened during stunts. That figure aligns with the broader pattern in the supplied surveillance research: stunt attempts account for about half of injuries in one cohort, while practice accounts for most injuries overall.
The Shields and Smith study also found differences by team type. Collegiate cheerleaders were more likely to sustain a concussion than other team types, with a relative risk of 2.98. All Star cheerleaders were more likely to sustain a fracture or dislocation than other team types, with a relative risk of 1.76. Those comparisons involve team categories in that study and should not be generalized to every high school squad.
A narrative review, “Cheerleading injuries: A narrative review,” reported U.S. cheerleading participation increasing about 18% per year and injury rates of about 1 to 2.8 per 1,000 athletic exposures. It reported ankle injuries with a prevalence of 44.9%, and cited a first cheerleading concussion study with a rate of 11.32 per 100,000 athlete-exposures. The review also described one study with 1,115 cheer-related injuries over three years: 43.5% kept a cheerleader out for a week or more and 28.3% resulted in an emergency department visit.
Finally, the AAP policy statement reported that cheerleading accounted for approximately 66% of catastrophic injuries in high school girl athletes over the prior 25 years, cited 4,954 cheerleading-related emergency department visits in 1980, and said only 29 state high school athletic associations recognized cheerleading as a sport at the time. The 2025 review noted that 54% of catastrophic injuries led to permanent disability. These historical and review-based figures describe their stated periods and definitions; they do not replace current injury surveillance.