Health Day News — In efforts to increase the safety of cheerleading as the complexity and popularity of the sport increases, the American Academy of Pediatrics has issued new guidelines to aid in the prevention of cheerleading-related injuries.

“We are seeing more children and adolescents participating in cheerleading and we are seeing the complexity of the stunts and routines increase. Given both of these factors, we are seeing more injuries,” Jeffrey Mjaanes, MD, member of the AAP Council on Sports Medicine and Fitness and coauthor of the new guidelines, said at the Amercian Academy of Pediatrics National Conference.

From 1980 to 2007, the prevalence of cheerleading injuries increased more than 400%, with more than 26,000 cheerleading-related injuries documented in the United States in 2007 alone. The incorporation of difficult tumbling and acrobatics are two factors that have contributed to these increases, according to Mjaanes.

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“Cheerleading is often not considered a sanctioned sport at many schools and colleges or by many states. We would like cheerleading to be designated as a sport across the country in order to improve access to quality coaches, facilities, and medical care, and to allow better injury data collection,” he said.

The new AAP guidelines recommend limiting pyramid stunts to two-people high and using trained spotters for all stunts. In addition, cheerleaders should not move on to complex stunts until they have demonstrated appropriate skill progression from simpler stunts.

Uniform training for coaches to ensure they know how to detect and prevent injuries, and a requirement that all cheerleaders have a pre-participation physical to detect any conditions that might predispose the participant to injury, were also suggested. Other key points in the recommendations, include:

  • Written emergency plans be provided to coaches, parents and athletes, and whenever possible, a certified athletic trainer or physician should be present at practices and competitions.
  • A standard policy to remove any cheerleader with signs of a head injury from practice or competition until they have received written clearance to return to practice from a qualified health-care provider.

“Our goal is to make cheerleading as safe an activity as possible for the millions of participants. We hope this policy statement serves as a means to achieve this goal,” Mjaanes said.


  1. Council on Sports Medicine and Fitness. Pediatrics 2012; doi: 10.1542/peds.2012-2480.