A group of U.S. pediatricians last week recommended that
cheerleading be designated an official sport, mainly to help prevent injuries,
which the doctors say can be catastrophic.
Some of the group's other recommendations include requiring
cheerleaders to pass pre-season physicals, to have access to strength and
conditioning coaches and to be removed from competing or performing if they
have a head injury.
"We felt that there needed to be some guidelines out
there on how to make it safer for these girls," said Dr. Cynthia LaBella,
co-author of the recommendations that were issued by the American Academy of
Pediatrics (AAP).
In the realm of high school athletics, cheerleading accounts
for less than 1 injury per 1,000 "athletic exposures" in girls,
according to the AAP. That's far less than the 8.5 injuries per 1,000 exposures
for gymnastics or the 5.3 per 1,000 exposures for soccer.
However, research has shown that cheerleaders are at a
disproportionately high risk for catastrophic injuries, which include skull
fractures and spine injuries.
According to the AAP, cheerleading accounted for 65 percent
of all catastrophic injuries in high school girl athletes and about 71 percent
in college women between 1982 and 2009.
"In many states and at the college level, cheerleading
isn't officially recognized as a sport. And because of that there are quite a
few safety mechanisms they miss out on," said LaBella, an associate
professor at Northwestern University's Feinberg School of Medicine in Chicago.
Those safety mechanisms, according to the AAP, include
access to trainers and medical care, better facilities and practice times and
certified coaches. [1]
Most of us have an image of cheerleaders as possessing high
energy and bright smile and glowing personality. While this is for the most part true these qualities may
also serve to mask the fact that these young ladies (I know males do cheer but
96% of participants are female) beat their still developing bodies up pretty
good.
Scan the sidelines of your local high school football team
and you will undoubtedly see girls with their knees, ankles, and wrists taped or
braced. What we can’t see is that
they are also very likely to suffer from some sort of lower back pain.
My 13-year old niece competes in competitive cheer and I
always ask how she’s feeling because I have a pretty good sense her body is
banged up. She tells me that her
knees hurt all the time and her lower back hurts most of the time. Last week I worked with a high school girl’s
gymnastics team. After watching
them perform their routine and observing similar issues with cheerleading I
felt compelled to highlight these two populations particularly in light of the
recommendations above.
For the most part girls don’t train to play/participate in
their sport. They use the sport to
prepare them to play. This would
be akin to trying to prepare a meal and serve it at the same time; you’re
always going to be behind. However
if you do the work ahead of time (prepare the meal) when it comes time to
perform (serve the meal) you are set up for success. Then it’s just a matter of whether or not the judges (diners)
like your routine (food). The
foundation of general fitness and strength does not exist in this population
yet they are still called upon to hoist each other up and do hand springs off a
vault and stick a high velocity landing.
These activities are just as demanding as anything you will find in most
boys sports but the level of commitment by girls to strength and conditioning
falls far short of what should be required to minimize the risk of injury and
to ensure optimal performance.
Another issue is strictly due to the competitive demands of
these activities. Form, the way
movement or the routine looks is very important in cheerleading and
gymnastics. Due to this nature the
girls are required to have tremendous “flexibility.” As a result these young athletes spend a disproportionate
amount of time taking their joints to end range of motion and holding a stretch
for long periods of time to improve muscle length. In the essence of time I won’t get into whether or not this
method of stretching is having the intended affect but this extreme stretching
definitely has negative implications.
These athletes also perform high velocity movements with extreme joint
range of motion such as a back bend to handstand. If you’ve ever seen that move it will make you cringe just
watching it (ugh that poor spine).
Our muscles provide our bodies with active restraints. When our muscles fire they not only
provide movement but also help to stabilize and control joints. Joints and ligaments are more passive
in nature; they provide stability when the muscle fails for whatever
reason. When a muscle is stretched
to it’s full capacity repeatedly and over a long duration it begins to lose
it’s resiliency and their protective nature is delayed. Imagine a rubber band that is stretched
maximally and held at that length for long periods of time. Eventually it becomes very loose and
loses its elasticity. When the muscles aren’t providing adequate stability
these young athletes have to find it somewhere and it very often results in
hanging on a passive restraint like a joint.
Young athletes will lockout their knees and/or hyperextend
their lower back to create stability to support their bodies while executing
the required movements or routines.
In this case imagine a credit card that is repeatedly being flexed back
and forth so that both ends touch.
Eventually the card snaps in half, analogous to a stress fracture for a
young athlete.
And while I use cheerleading and gymnastics as examples it
should also be understood that in all sports there are certain competitive
demands inherent within them that can lead to pain and injury if it’s not
counteracted. For example
basketball players often get their ankles taped and/or wear hi-top sneakers for
added support of the ankle joint.
While on the surface this seems logical it can also be problematic. The ankle is a very mobile joint and if
some sort of brace restricts it the body will compensate in an attempt to find
that lost mobility somewhere else.
Frequently that movement will come from the less mobile knee joint and
this is likely why serious knee injuries are fairly common in basketball
players while catastrophic ankle injuries strangely enough are pretty
rare. That said, I wouldn’t advise
basketball players to throw away the hi-tops or stop taping, it clearly proves
advantageous in the prevention of ankle sprains. What I am saying is that training must be adapted with the
knowledge that ankle mobility must be maintained while concurrently improving
knee stability and hip mobility (hip mobility is a very good thing) to prevent
injury and ensure optimal performance.
The message that should not be missed within all of these
examples is the importance off some type of pre-competition training program to
improve athlete safety and injury reduction. The main benefit of safe, healthy athletes is that they
perform better and when they perform better it’s more fun. The most effective tool to prevent
youth sport injuries is a balanced athletic development foundation. This used to be easy to attain through
free play and seasonal sport participation. Now due to the rise of sport specialization and travel teams
kids lack that broad foundation that will ensure their durability. Sensible and
anti-specific training programs have become a necessity for the current youth
sport culture. The sooner this
approach is adopted the better off our young athletes will be.
Cheerleading Injury Prevention Resource
Gymnastics Injury Prevention Resource
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