More than 3.5 million youth athletes participate in cheerleading in the United States, including competition and school teams, according to HealthyChildren.org from the American Academy of Pediatrics (AAP) in 2024. The available figures show a large activity with measurable school participation, distinct injury patterns, and improving catastrophic-injury numbers.
Contents
- How many young athletes participate
- High school participation and program reach
- How cheerleading compares with other sports
- Where and when injuries occur
- Age and team-level injury rates
- Injury types and emergency-department care
- Safety trends and recommended safeguards
How many young athletes participate
The broadest participation estimate is more than 3.5 million youth athletes in the United States. HealthyChildren.org, the AAP’s parent-facing resource, reported that 2024 estimate for cheerleading across competition and school teams. It is a national estimate rather than a count limited to one age group, school level, or competition organization.
School-based data provide a narrower view. The National Federation of State High School Associations (NFHS) High School Athletics Participation Survey for 2023-24 counted 181,023 girls participating in Competitive Spirit. The same survey counted 7,827 schools with girls’ Competitive Spirit programs. Competitive Spirit ranked eighth among girls’ programs by participation and tenth by school count in that survey.
The NFHS table also recorded 5,128 boys participating in Competitive Spirit and 1,074 boys’ schools. Unified Cheer was smaller but included both boys and girls: 218 combined participants, comprising 23 boys and 195 girls, across 8 boys’ schools and 20 girls’ schools. These categories are survey-defined high school programs, so they should not be added to the broader youth estimate as if they measured the same population.
For context, the NFHS survey counted 8,062,302 total high school sports participants in 2023-24. Of that total, 4,638,785 were boys and 3,423,517 were girls. The previous year’s reported totals were 7,851,833 overall, 4,529,795 boys, and 3,318,184 girls. NFHS reported that total high school sports participation increased by 210,469 from the previous year.
High school participation and program reach
Cheerleading’s participation system extends beyond the annual school survey. UCA says it trains over 180,000 cheerleaders every summer and runs over 3,200 sessions across the country. It also stages over 50 regional events across the country. These are organizational reach figures from the UCA About page, not an estimate of unique youth athletes nationwide; one athlete could be represented in more than one activity.
UCA says its events reach over 100 million homes each year and are shown in 32 countries nationwide each year. The wording describes the reach of UCA events and broadcasts, not the number of participants or the number of households that watched a particular event.
UCA also says it has instilled leadership skills and personal confidence in more than four million athletes. That cumulative figure is different from the annual summer-training figure. The UCA National High School Cheerleading Championship first took place in 1980. In 2020, the NHSCC hosted over 20,000 athletes, 950 teams, and 50,000 attendees. Those 2020 event figures describe one championship year and should not be treated as current annual totals.
How cheerleading compares with other sports
Emergency-department counts help put cheerleading injuries in context, although an emergency visit is not the same as an injury rate. USA Cheer safety research using CPSC NEISS data reported 22,313 cheerleading emergency-room visits among girls ages 12-18 in 2024. In that same age-and-year comparison, girls’ basketball had 46,795 visits, soccer had 39,085, volleyball had 29,706, and softball had 29,052.
| Activity | Emergency-room visits | Population and period |
|---|---|---|
| Basketball | 46,795 | Girls ages 12-18, 2024 |
| Soccer | 39,085 | Girls ages 12-18, 2024 |
| Volleyball | 29,706 | Girls ages 12-18, 2024 |
| Softball | 29,052 | Girls ages 12-18, 2024 |
| Cheerleading | 22,313 | Girls ages 12-18, 2024 |
USA Cheer safety research also cited a separate CPSC NEISS prevalence comparison for females ages 14-18. In that comparison, cheerleading accounted for 7,457 emergency-room visits. The corresponding counts were 27,097 for girls’ basketball, 16,159 for girls’ soccer, 11,248 for girls’ volleyball, and 11,176 for girls’ softball. Because the age range and reporting context differ from the 2024 comparison, these figures should be read as a separate data point rather than combined with it.
USA Cheer said cheerleading ranked 17th out of 20 high school sports for overall injuries in the 2023-24 High School RIO study. The ranking is a study result for high school sports and is not a ranking of every youth cheerleading setting.
Where and when injuries occur
A prospective cheerleading surveillance study indexed as PubMed 19911082 found that 83% of injuries occurred during practice. It reported that 52% occurred while attempting a stunt and 24% while basing or spotting. The study also found that lower-extremity injuries made up 30% of injuries and that strains and sprains made up 53%.
The same study reported different injury rates by setting. Practice had a rate of 1.0 injuries per 1,000 athlete-exposures, while competition had 1.4 per 1,000 athlete-exposures. Pep rallies and athletic events each had a rate of 0.6 per 1,000 athlete-exposures. An athlete-exposure is a participation occasion for one athlete, so these rates are not interchangeable with annual participant rates.
The study also identified differences between cheerleading groups. Collegiate cheerleaders were more likely to sustain a concussion, with a relative risk of 2.98. All Star cheerleaders were more likely to sustain a fracture or dislocation, with a relative risk of 1.76. A relative risk compares the likelihood between groups in that study; it does not state the number of injuries by itself.
The practice findings matter for families and coaches because the largest share of observed injuries occurred away from competition. They also show why stunt progression, basing, spotting, landing technique, and supervision are relevant to safety discussions. The percentages describe the study population and period, not a universal distribution for every current program.
Age and team-level injury rates
Youth age was strongly associated with injury frequency in the study indexed as PubMed 16396869. Participants ages 12-17 had 8.1 injuries per 1,000 participants per year, compared with 1.2 injuries per 1,000 participants per year among ages 6-11. The age-based injury risk ratio for 12-17-year-olds versus 6-11-year-olds was 6.49. The study reported higher rates for 12-17-year-olds across all body-part and injury-type groupings.
A separate fall-injury study covering the 2006-2007 period, indexed as PubMed PMC2775358, reported substantial differences by team level. Its fall-related injury rates were measured per 100,000 athlete-exposures:
| Team level | Fall-related injuries per 100,000 athlete-exposures |
|---|---|
| Elementary school | 146.2 |
| College | 29.0 |
| High school | 14.7 |
| All Star | 9.3 |
| Middle school | 7.6 |
| Overall | 13.3 |
These are fall-related rates from the 2006-2007 study, not all-injury rates and not current national estimates. The elementary-school figure was the highest among the listed team levels, while the overall rate was 13.3 per 100,000 athlete-exposures. Differences in study design, exposure measurement, team structure, and injury definition can affect comparisons across studies.
Injury types and emergency-department care
The CDC NCHS Reports 133 report, covering 2010-2016, grouped gymnastics or cheerleading together and found that this category caused 11.8% of sports-injury emergency-department visits among patients ages 5-24. Other leading activity categories in that report included playground activities at 9.2%, pedal cycling at 9.1%, basketball at 8.9%, and other or unspecified activities at 8.8%.
The same CDC report described the injuries and care associated with sports-injury emergency-department visits. Sprains, strains, or dislocations accounted for 28.1% of visits; other or unspecified injuries accounted for 22.6%; and fractures accounted for 18.0%.
Imaging or procedures were common in the report. X-rays were ordered or provided in 67.0% of sports-injury emergency-department visits. CT scans were ordered or provided in 11.8%, including head CT scans in 8.7% and non-head CT scans in 4.2%. Any imaging was ordered or provided in 75.5% of visits, while at least one procedure was performed in 62.1%.
Treatment categories included casts, splints, or wraps in 41.2% of visits, suturing or staples in 8.1%, and intravenous fluids in 5.7%. No medications were given or prescribed in 25.7% of sports-injury emergency-department visits. Because the CDC category combines gymnastics or cheerleading for the activity measure and covers sports injuries broadly for the care measures, these percentages should not be presented as cheerleading-only treatment rates.
Safety trends and recommended safeguards
USA Cheer safety research citing the National Center for Catastrophic Sport Injury Research (NCCSIR) reported an 85% decline in catastrophic cheerleading injuries between two comparison periods: 42 injuries from 2003-2014 and 6 from 2014-2023. The two period totals are the basis for the reported decline. USA Cheer also reported no direct fatal or permanently disabling cheerleading injuries in the past two years covered by the 2023 NCCSIR annual report. These are historical and report-specific findings, not a guarantee that future injuries will not occur.
HealthyChildren.org reported that a basket-toss rule change led to a 74% reduction in catastrophic injuries over a 10-year period. The AAP also reported that concussion incidents accounted for 31% of cheerleading injuries from 2010 to 2019, compared with 4% to 6% from 2006 to 2009. The different periods are important when interpreting the change in concussion share.
The AAP recommends that scholastic cheerleading be overseen in all 50 states. It recommends that short pyramids not exceed the height of two people and that written emergency action plans be in every gym and facility used for practices and competitions. These are recommendations, not participation or injury measurements, but they identify concrete safety controls alongside the injury data.