For as long as there have been sports leagues for children and teens, there have been concerns about the effects of injuries on young athletes’ developing bodies. In recent years there has been more awareness about the possible long-term effects of concussions on athletes at every age and skill level. Some parents are so concerned that they are rethinking their children’s participation in certain sports. But if you ask American parents which sport has the highest rate of catastrophic injuries, the right answer would not even occur to most of them.

Cheerleaders at the Greatest Risk for Catastrophic Sports Injuries

According to the American Academy of Pediatrics (AAP), cheerleading caused more catastrophic injuries to female high school and college athletes during the period from 1982 to 2009 than all other sports combined. The study found a total of 110 closed head injuries, skull fractures and spinal injuries that resulted in permanent brain injury, paralysis and death during this period – not a large number, if you consider that some 3.6 million girls participating in cheerleading programs during the same period. But the proportion of the most severe type of injuries is striking when you compare cheerleading to other sports, leading the National Center for Catastrophic Sports Injury Research to call cheerleading “without a doubt, the most dangerous female sport.” (While about 4 percent of cheerleaders are male, the study did not address the incidence of injury in male participants.)

President Obama has remarked that if he had a son, he would think twice about allowing him to play football, but he has not been asked how he would feel if one of his daughters wanted to cheer. If he were asked, he might well not realize that cheerleading has changed significantly in recent decades. Today, it is not unusual to see girls who are too young to drive being thrown tens of feet into the air, with nothing but other participants of the same age between the “flyer” and a life-changing injury.

The AAP did find that the incidence of catastrophic injury has been falling ever since 2005, partly due to new recommendations that certain higher-level skills only be performed on mats, a ban on one particular trick in high school programs, and requirement that cheerleaders master more basic tricks before they attempt more dangerous ones. The recommendations seem like common sense, but many coaches for school teams are not specifically trained to teach young athletes, a problem that extends far beyond cheerleading. While the sport’s governing body has emphasized increased training for coaches, cheer programs sometimes are victims of a Catch-22 situation. Only 29 states recognize cheerleading as a sport, and the NCAA does not include competitive cheerleading in its list of sponsored sports. The lack of agreement on treating cheerleading as a sport can lead to more lax attitude toward required physical exams, access to a trainer, and documented emergency plans.

Parents know that good sports programs can confer a wide variety of benefits to children and teens that last far longer than the playing season. But parents have to ask the right questions and not blindly trust a school or a private gym to protect their children from injury. Don’t be afraid to ask about the coach’s training and experience, and refuse to allow your child to participate if you are not comfortable with the answers.

If your child has suffered an injury while participating in any sports program, you should make sure to take the child to the doctor, even if he protests that he is fine. Do not allow the child to return to practice until the doctor has certified that the injury has fully healed. If your child has suffered an injury to their head or spine or another type of serious injury that may lead to permanent disability, you should discuss the situation with an experienced sports injury attorney. A mistake in this area can cost your child not only their sports career, but also their health and in some cases, could even threaten their life.