Cheerleading Safety Data and Research

According to the Consumer Products Safety Commission NEISS, in 2024 there were fewer emergency room visits for girls ages 12-18 for cheerleading (22,313) than girls’ basketball (46,795), soccer (39,085), volleyball (29,706), and softball (29,052). (See chart 1 and 1a.)

Chart 1: 2024 Emergency Room Visits, Females Age 12 – 18

Chart 1a: 2015-2024 Emergency Room Visits, Females Age 12 – 18

The 2023-24 High School RIO Study shows that cheerleading again ranks as the lowest 17th out of 20 high school sports studied for overall injuries.

Chart 2: 2023-24 High School Sports Injury Rates per 1,000 Athletic Exposures

Concussion rates for cheerleading in the 2023-24 High School RIO report did increase compared to previous years. The NFHS/USA Cheer Rules Committee and USA Cheer Safety Council have reviewed the available material, and although there doesn’t appear to be a specific rule change pointing to the increase, we will continue to monitor the data actively. While some of the increase can be attributed to better concussion awareness and adherence to concussion reporting protocols, addressing and minimizing head injury remains a priority in the cheer community. As practice settings make up the majority of concussion incidents, increased vigilance in following skill progressions and monitoring fatigue during practice is strongly recommended.

Chart 3: 2023-24 High School Concussion Rates per 1,000 Athletic Exposures

According to the National Center for Catastrophic Sport Injury Research (NCCSIR), catastrophic injuries in cheerleading have dropped significantly, resulting in a decrease of 85% in the total number of catastrophic injuries from 42 in 2003-2014 to 6 in 2014-2023. The most recent 2023 NCCSIR Annual Report shows no direct fatal or permanently disabling injuries in cheerleading in the past two years. In fact, the number of catastrophic injuries from cheerleading over the past 10 years are similar to other girls’ high school sports and are lower than those for football, baseball, boys’ wrestling, and boys’ and girls’ soccer. (See charts 4, 5 & 6.)

Chart 4: Female Cheerleading Direct Catastrophic Injuries, 2001-02 to 2022-2023

Chart 5: Female High School and College Direct Catastrophic Injuries, 2014-2023

Chart 5: All Sports Direct Catastrophic Injuries, 2014 to 2023

National High School Sports-Related Injury Surveillance Study
Christy L. Collins, MA, Natalie M. McIlvain, BS
This annual study of 20 High School sports, conducted for the National Federation of High Schools, includes reporting by Athletic Trainers at the high school level assigned to each sport. Injuries which result in a loss of at least one day of playing time are reported along with number of daily exposures to injury. Results demonstrate that cheerleading has a significantly lower risk of injury, 17th out of 20, than most other sports in the survey.

National Electronic Injury Surveillance System (ER Visits)
This report estimates total injuries based on a sample of approximately 100 emergency rooms across the U.S. based on data given when someone is admitted to the ER. This is a prevalence report that shows cheerleading has a lower total number of ER visits (7,457) than girls’ basketball (27,097), soccer (16,159), volleyball (11,248), and softball (11,176) for females age range of 14 – 18 yrs.

National Center for Catastrophic Sport Injury Research
Kristen L Kucera, MSPH PhD ATC LAT and Robert Cantu, MD
This report on college and high school sports catastrophic injuries is often cited regarding the prevalence (total number) of injuries dating back to 1982. What is not often reported is that the incidence (rate per 100,000 athletes) for cheerleading is lower than many other male and female sports, including girls’ ice hockey, girls’ gymnastics and girls’ soccer. The report also shows a significant decline in serious injuries in cheerleading since 2005-06.

Catastrophic High School and Collegiate Cheerleading Injuries in the United States: An Examination of the 2006-2007 Basket Toss Rule Change
Yau RK, Dennis SG, Boden BP, Cantu RC, Lord JA 3rd
Catastrophic injury rates in cheerleading decreased dramatically after the 2006-2007 rule change banning basket tosses from being performed on any hard surfaces. In particular, there was a nearly 4-fold reduction in the rate of catastrophic basket toss injuries.

Progress in Cheerleading Safety: Update on the Epidemiology of Cheerleading Injuries Presenting to US Emergency Departments, 2010-2019
Xu AL, Suresh KV, Lee RJ. Progress in Cheerleading Safety: Update on the Epidemiology of Cheerleading Injuries Presenting to US Emergency Departments, 2010-2019. Orthop J Sports Med. 2021 Oct 13;9(10):23259671211038895. doi: 10.1177/23259671211038895. PMID: 34676270; PMCID: PMC8524718.

Cheerleading Injuries in United States High Schools
Currie DW, Fields SK, Patterson MJ, Comstock RD. Cheerleading Injuries in United States High Schools. Pediatrics. 2016 Jan;137(1). doi: 10.1542/peds.2015-2447. Epub 2015 Dec 10. PMID: 26729538.
Although safety remains a concern among cheerleaders, overall injury rates are lower than most other high school sports. Although overall injury rates are relatively low, cheerleading injuries may be more severe when they do occur. A detailed knowledge of cheerleading injury patterns relative to other sports is needed to drive targeted, evidence-based prevention efforts.

Trends in Concussion Incidence in High School Sports: A Prospective 11-Year Study
Andrew E. Lincoln, ScD; Shane V. Caswell, PhD, ATC; Jon L. Almquist, VATL, ATC; Reginald E. Dunn, BA; Joseph B. Norris, MD and Richard Y. Hinton, MD, MPH, PT
This 10-year study of 12 sports in 25 Virginia high schools reported that cheerleading is tied with baseball as the sports with the lowest concussion rates (.06 per AE), as compared with the three highest sports, boys’ football (.60), girls’ soccer (.35) and boys’ lacrosse (.30)

Incidence and Risk Factors for Concussion in High School Athletes, North Carolina, 1996–1999
Mark R. Schulz, Stephen W. Marshall, Frederick O. Mueller,Jingzhen Yang, Nancy L. Weaver, William D. Kalsbeek and Michael Bowling
This study evaluated 15,802 high school athletes over a 3-year period with reporting by the Athletic Trainer. This study demonstrates that the rate of concussion in cheerleading is significantly less than other high school sports. In this study, cheerleading tied with wrestling as the two sports with the lowest concussion rates.