{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T02:13:18Z","timestamp":1773972798705,"version":"3.50.1"},"reference-count":40,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,1,1]]},"abstract":"<jats:p>OBJECTIVE. To describe the epidemiology of cheerleading-related injuries among children in the United States.<\/jats:p>\n               <jats:p>DESIGN. A retrospective analysis of data for children 5 to 18 years old from the National Electronic Injury Surveillance System (NEISS) of the US Consumer Product Safety Commission, 1990\u20132002.<\/jats:p>\n               <jats:p>METHODS. Sample weights provided by the NEISS were used to make national estimates of cheerleading-related injuries. Injury rates were calculated for the most frequently occurring types of injury using cheerleading participation data.<\/jats:p>\n               <jats:p>RESULTS. An estimated 208 800 children (95% confidence interval [CI]: 166 620\u2013250 980) 5 to 18 years of age were treated in US hospital emergency departments for cheerleading-related injuries during the 13-year period of 1990\u20132002. The number of injuries increased by 110% from 10 900 in 1990 to 22 900 in 2002, with an average of 16 100 (95% CI: 12 848\u201319 352) injuries per year (P &amp;lt; .01). The average age of injured children was 14.4 years (median: 15.0 years); 97% were female; and 85% of injuries occurred to children 12 to 17 years old. The number of injuries per 1000 participants per year was greater for 12- to 17-year-olds (8.1) than for 6- to 11-year-olds (1.2) for all cheerleading-related injuries combined (P &amp;lt; .01; relative risk [RR]: 6.49; 95% CI: 6.40\u20136.58), as well as for injuries grouped by body part injured and type of injury. The body parts injured were lower extremity (37.2%), upper extremity (26.4%), head\/neck (18.8%), trunk (16.8%), and other (0.8%). Injury diagnoses were strains\/sprains (52.4%), soft tissue injuries (18.4%), fractures\/dislocations (16.4%), lacerations\/avulsions (3.8%), concussions\/closed head injuries (3.5%), and other (5.5%). Children in the 12- to 18-year age group were more likely to sustain strains or sprains to the lower extremity than 5- to 11-year-olds (P &amp;lt; .01; RR: 1.62; 95% CI: 1.50\u20131.88). The majority of patients with cheerleading-related injuries was treated and released from the emergency department (98.7%). Patients sustaining fractures or dislocations were more likely to be admitted to the hospital than those sustaining other types of injury (P &amp;lt; .01; RR: 5.30; 95% CI: 3.29\u20136.43).<\/jats:p>\n               <jats:p>CONCLUSIONS. To our knowledge, this study is the first to report numbers, rates, and trends of cheerleading-related injuries to children using a nationally representative sample. Cheerleading is an important source of injury to girls. The number of cheerleading-related injuries more than doubled during the 13-year study period. A set of uniform rules and regulations directed at increasing the safety of cheerleading, that are universally enforced, should be implemented. Mandatory completion of a safety training and certification program should be required of all cheerleading coaches. Establishment of a national database for cheerleading-related injuries would facilitate the development and evaluation of injury-prevention strategies based on epidemiologic evidence.<\/jats:p>","DOI":"10.1542\/peds.2005-1139","type":"journal-article","created":{"date-parts":[[2006,1,5]],"date-time":"2006-01-05T02:28:34Z","timestamp":1136428114000},"page":"122-129","source":"Crossref","is-referenced-by-count":52,"title":["Cheerleading-Related Injuries to Children 5 to 18 Years of Age: United States, 1990\u20132002"],"prefix":"10.1542","volume":"117","author":[{"given":"Brenda J.","family":"Shields","sequence":"first","affiliation":[{"name":"Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, Columbus, Ohio"},{"name":"Department of Pediatrics, the Ohio State University College of Medicine and Public Health, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2006,1,1]]},"reference":[{"key":"2021120819431729400_R1","unstructured":"American Association of Cheerleading Coaches and Advisors. An American Association of Cheerleading Coaches and Advisors position paper addressing the issue of cheerleading as a sport. Available at: www.aacca.org\/sportposition.html. Accessed April 27, 2005"},{"key":"2021120819431729400_R2","doi-asserted-by":"crossref","unstructured":"Boden BP, Tacchetti R, Mueller FO. Catastrophic cheerleading injuries. Am J Sports Med.\u20082003;31:881\u2013888","DOI":"10.1177\/03635465030310062501"},{"key":"2021120819431729400_R3","doi-asserted-by":"crossref","unstructured":"Luckstead EF, Satran AL, Patel DR. Sport injury profiles, training and rehabilitation issues in American sports. Pediatr Clin North Am.\u20082002;49:753\u2013767","DOI":"10.1016\/S0031-3955(02)00017-2"},{"key":"2021120819431729400_R4","unstructured":"American Sports Data, Inc. The Superstudy of Sports Participation: Volume II\u2014Recreational Sports 2003. Hartsdale, NY: American Sports Data, Inc; 2004"},{"key":"2021120819431729400_R5","unstructured":"Mueller FO, Cantu RC. Special section on cheerleading. In: National Center for Catastrophic Sports Injury Research: twenty-first annual report: fall 1982\u2013spring 2003. Available at: www.unc.edu\/depts\/nccsi. Accessed April 27, 2005"},{"key":"2021120819431729400_R6","doi-asserted-by":"crossref","unstructured":"Luckstead EF, Patel DR. Catastrophic pediatric sports injuries. Pediatr Clin North Am.\u20082002;49:581\u2013591","DOI":"10.1016\/S0031-3955(02)00006-8"},{"key":"2021120819431729400_R7","doi-asserted-by":"crossref","unstructured":"Hutchinson MR. Cheerleading injuries: patterns, prevention, case reports. Phys Sportsmed.\u20081997;25:83\u201396","DOI":"10.3810\/psm.1997.09.1508"},{"key":"2021120819431729400_R8","unstructured":"Axe MJ, Newcomb WA, Warner D. Sports injuries and adolescent athletes. Del Med J.\u20081991;63:359\u2013363"},{"key":"2021120819431729400_R9","doi-asserted-by":"crossref","unstructured":"Sinha AK, Kaeding CC, Wadley GM. Upper extremity stress fractures in athletes: clinical features of 44 cases. Clin J Sport Med.\u20081999;9:199\u2013202","DOI":"10.1097\/00042752-199910000-00003"},{"key":"2021120819431729400_R10","doi-asserted-by":"crossref","unstructured":"Schulz MR, Marshall SW, Mueller FO, et al. Incidence and risk factors for concussion in high school athletes, North Carolina, 1996\u20131999. Am J Epidemiol.\u20082004;160:937\u2013944","DOI":"10.1093\/aje\/kwh304"},{"key":"2021120819431729400_R11","doi-asserted-by":"crossref","unstructured":"Simon TD, Bublitz C, Hambidge SJ. External causes of pediatric injury-related emergency department visits in the United States. Acad Emerg Med.\u20082004;11:1042\u20131048","DOI":"10.1197\/j.aem.2004.04.013"},{"key":"2021120819431729400_R12","unstructured":"Hage P. Cheerleaders suffer few serious injuries. Phys Sportsmed.\u20081983;11:25\u201326"},{"key":"2021120819431729400_R13","unstructured":"Shields RW Jr, Jacobs IB. Median palmar digital neuropathy in a cheerleader. Arch Phys Med Rehabil.\u20081986;67:824\u2013826"},{"key":"2021120819431729400_R14","doi-asserted-by":"crossref","unstructured":"Cantu RC, Mueller FO. Cheerleading. Clin J Sport Med.\u20081994;4:75\u201376","DOI":"10.1097\/00042752-199404000-00001"},{"key":"2021120819431729400_R15","doi-asserted-by":"crossref","unstructured":"Fort GG, Fort FG. Cheerleading as a cause of splenic rupture. Am J Emerg Med.\u20081999;17:432\u2013433","DOI":"10.1016\/S0735-6757(99)90107-9"},{"key":"2021120819431729400_R16","unstructured":"Kessler E, Schroeder T. The NEISS Sample (Design and Implementation). Washington DC: US Consumer Product Safety Commission; 1999"},{"key":"2021120819431729400_R17","doi-asserted-by":"crossref","unstructured":"Hopkins RS. Consumer product-related injuries in Athens, Ohio, 1980\u20131985: assessment of emergency room-based surveillance. Am J Prev Med.\u20081989;5:104\u2013112","DOI":"10.1016\/S0749-3797(18)31112-7"},{"key":"2021120819431729400_R18","doi-asserted-by":"crossref","unstructured":"Annest JL, Mercy JA, Gibson DR, Ryan GW. National estimates of nonfatal firearm-related injuries: beyond the tip of the iceberg. JAMA.\u20081995;273:1749\u20131754","DOI":"10.1001\/jama.273.22.1749"},{"key":"2021120819431729400_R19","doi-asserted-by":"crossref","unstructured":"Davis Y, Annest JL, Powell KE, Mercy JA. An evaluation of the National Electronic Injury Surveillance System for use in monitoring nonfatal firearm injuries and obtaining national estimates. J Safety Res.\u20081996;27:83\u201391","DOI":"10.1016\/0022-4375(96)00002-3"},{"key":"2021120819431729400_R20","doi-asserted-by":"crossref","unstructured":"McNeill AM, Annest JL. The ongoing hazard of BB and pellet gun\u2013related injuries in the United States. Ann Emerg Med.\u20081995;26:187\u2013194","DOI":"10.1016\/S0196-0644(95)70150-8"},{"key":"2021120819431729400_R21","unstructured":"World Cheerleading Association. Open Challenge Series. Divisions for 2005\u20132006. Available at: http:\/\/cheerwca.com\/Divisions.htm. Accessed April 26, 2005"},{"key":"2021120819431729400_R22","unstructured":"The Champion Cup Nationals. Divisions & guidelines. Available at: www.championcupnationals.com\/competition.html. Accessed April 26, 2005"},{"key":"2021120819431729400_R23","doi-asserted-by":"crossref","unstructured":"SPSS for Windows [computer program]. Version 12.0.1. Chicago IL: SPSS, Inc; 2003","DOI":"10.1007\/978-3-663-05757-4_1"},{"key":"2021120819431729400_R24","doi-asserted-by":"crossref","unstructured":"Jacobson BH, Hubbard M, Redus B, et al. An assessment of high school cheerleading: injury distribution, frequency, and associated factors. J Orthop Sports Phys Ther.\u20082004;34:261\u2013265","DOI":"10.2519\/jospt.2004.34.5.261"},{"key":"2021120819431729400_R25","doi-asserted-by":"crossref","unstructured":"Jacobson BJ, Redus B, Palmer T. An assessment of injuries in college cheerleading: distribution, frequency, and associated factors. Br J Sports Med.\u20082005;39:237\u2013240","DOI":"10.1136\/bjsm.2004.014605"},{"key":"2021120819431729400_R26","doi-asserted-by":"crossref","unstructured":"Smith GA. Injuries to children in the United States related to trampolines, 1990\u20131995: a national epidemic. Pediatrics.\u20081998;101:406\u2013412","DOI":"10.1542\/peds.101.3.406"},{"key":"2021120819431729400_R27","doi-asserted-by":"crossref","unstructured":"Smith GA, Shields BJ. Trampoline-related injuries to children. Arch Pediatr Adolesc Med.\u20081998;152:694\u2013699","DOI":"10.1001\/archpedi.152.7.694"},{"key":"2021120819431729400_R28","doi-asserted-by":"crossref","unstructured":"McGeehan J, Shields BJ, Smith GA. Children should wear helmets while ice-skating: a comparison of skating-related injuries. Pediatrics.\u20082004;114:124\u2013128","DOI":"10.1542\/peds.114.1.124"},{"key":"2021120819431729400_R29","doi-asserted-by":"crossref","unstructured":"Ortega HW, Shields BJ, Smith GA. Bicycle-related injuries to children and parental attitudes regarding bicycle safety. Clin Pediatr (Phila).\u20082004;43:251\u2013259","DOI":"10.1177\/000992280404300306"},{"key":"2021120819431729400_R30","unstructured":"Mueller FO. Catastrophic head injuries in high school and collegiate sports. J Athl Train.\u20082001;36:312\u2013315"},{"key":"2021120819431729400_R31","unstructured":"Roenigk, A. Cheer safety: setting the record straight. Am Cheerleader.\u20082002;8:46\u201348, 159"},{"key":"2021120819431729400_R32","unstructured":"Ninemire V. Huskers' cheerleaders held to the ground. Available at: http:\/\/cheerleading.about.com\/library\/weekly\/aa040702a.htm. Accessed May 2, 2005"},{"key":"2021120819431729400_R33","unstructured":"Anonymous. UNL right to allow stunts by cheerleaders. Available at: www.theindependent.com\/stories\/041503\/opi_edit15.shtml. Accessed May 2, 2005"},{"key":"2021120819431729400_R34","doi-asserted-by":"crossref","unstructured":"Hage P. Cheerleading: new problems in a changing sport. Phys Sportsmed.\u20081981;9:140\u2013145","DOI":"10.1080\/00913847.1981.11711019"},{"key":"2021120819431729400_R35","doi-asserted-by":"crossref","unstructured":"Xiang H, Kelleher K, Shields BJ, Brown KJ, Smith GA. Skiing- and snowboarding-related injuries treated in U.S. emergency departments, 2002. J Trauma.\u20082005;58:112\u2013118","DOI":"10.1097\/01.TA.0000151270.26634.DD"},{"key":"2021120819431729400_R36","doi-asserted-by":"crossref","unstructured":"McDonald AK. Limitations of NEISS child injury data. Inj Prev.\u20081996;2:77","DOI":"10.1136\/ip.2.1.77"},{"key":"2021120819431729400_R37","doi-asserted-by":"crossref","unstructured":"Weiss HB. Limitations of child injury data from the CPSC's National Electronic Injury Surveillance System: the case of baby walker related data. Inj Prev.\u20081996;2:61\u201366","DOI":"10.1136\/ip.2.1.61"},{"key":"2021120819431729400_R38","doi-asserted-by":"crossref","unstructured":"Weiss HB. NEISS and child injury data. Inj Prev.\u20081996;2:166","DOI":"10.1136\/ip.2.2.166"},{"key":"2021120819431729400_R39","unstructured":"Schroeder T, Ault K. The NEISS Sample (Design and Implementation) From 1979 to 1996. Washington DC: US Consumer Product Safety Commission; 2001"},{"key":"2021120819431729400_R40","unstructured":"Schroeder T, Ault K. The NEISS Sample (Design and Implementation) 1997 to Present. Washington DC: US Consumer Product Safety Commission; 2001"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/117\/1\/122\/1010141\/zpe00106000122.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/117\/1\/122\/1010141\/zpe00106000122.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T22:21:03Z","timestamp":1639002063000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/117\/1\/122\/67934\/Cheerleading-Related-Injuries-to-Children-5-to-18"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,1,1]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2006,1,1]]},"published-print":{"date-parts":[[2006,1,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2005-1139","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,1,1]]}}}