What Parents Should Know About Cheerleading & Gymnastics Injuries

An indoor facility with neatly laid out mats, platforms, and beams. Coaches oversee a structured two-hour practice. Athletes stretch in matching uniforms while parents watch from the bleachers. Every detail signals that the sport is being managed, that the risks are accounted for, and that young athletes are in a controlled environment.

Cheerleading and gymnastics offer real benefits. They build athletic skill, discipline, confidence, and the kind of teamwork that follows kids into adulthood. Millions of children participate in this sport each year, and most finish their seasons without any serious harm. Years of safety reforms have made measurable progress, particularly in reducing catastrophic injuries.

But the structured appearance can also mask where injury risks actually live. Cheerleading and gymnastics rank among the leading sources of catastrophic injuries in young female athletes. They can produce significant rates of concussions, fractures, and overuse injuries that build over months of training. And they often operate within a regulatory framework that, in many places, treats these as activities rather than sports, with all the differences in oversight that classification brings.

This isn’t about pulling kids out of cheer or gymnastics. It’s about giving parents the information they need to ask better questions and recognize warning signs.

What the Data Says About Cheerleading Injury Rates

According to the American Academy of Pediatrics, more than 3.5 million children currently cheerlead in the U.S., mostly girls who are 6 to 17 years old. This includes cheerleading competitions as well as sideline cheerleading that supports another sport during games.

For many parents, watching their kid try out for cheer (or gymnastics) comes with a quiet undercurrent of worry. The flips, the heights, the pyramids: it can be hard to shake the sense that something could go wrong. Cheerleading in particular can get a bad rap for being prone to catastrophic injuries, so the data for cheer injuries in particular is worth examining.

That said, the data on cheer safety can be hard to come by. The NCAA does not classify cheerleading as a sport, and only about half of states track cheer injury data the way that they track injuries in other competitive sports. But the good news is that the data tells a reassuring story.

Any kind of progress like this doesn’t happen by accident. It reflects years of work by governing bodies, coaches, and safety researchers who pushed for changes that made the sport measurably safer. The most consequential of those reforms came between 2006 and 2007, when new rules limited basket tosses to mats, grass, and rubber tracks. The change meant that athletes could no longer be thrown high into the air on basketball courts or other hard surfaces. In the decade that followed, basket-toss-related catastrophic injuries dropped by 74%, according to the American Academy of Pediatrics (AAP).

But progress is not the same as elimination, and a national decline in catastrophic injuries does not guarantee that every coach or facility will follow safety measures. Documented incidents from recent years offers a window into how things still go wrong.

A college cheerleader was hospitalized after what news reports described as a freak tumbling accident, a reminder that even at elite levels and with experienced coaching, performing on hard surfaces like a basketball court is still dangerous. A gymnastics facility in Arizona faces a lawsuit that alleges the coach failed to provide a spotter during a stunt, a safeguard that must be in place regardless of how confident a coach feels in an athlete’s ability. Recently, a 17-year-old high school cheerleader was hospitalized and now uses a wheelchair because of head and spinal injuries sustained during practice, after a trainer allegedly sent her home instead of taking her to the hospital right away.

None of these risks are inherent to the sport, not if everyone does their part. Each injury represents a choice that could have been made differently by those overseeing the athletes.

Where Cheerleading Fits Among Other Sports

A study using the National Electronic Injury Surveillance System (NEISS) found that between 2010 and 2019, around 350,000 patients between the ages of 5 and 25 were treated in emergency departments for cheerleading injuries. That meant roughly 35,000 such patients each year, most of whom were between the ages of 12 and 18. While 98% of patients were female, the share of male cheerleaders treated rose during that decade, from 1.4% to 3.4%. Data on male cheerleaders remains more limited overall, but the injury patterns and prevention strategies that follow apply to male and female athletes alike.

That same data showed that cheerleading injuries most consistently occurred at gyms or sports clubs (52% of injuries), schools (31%), and homes (1.1%). About 2.3% of these emergency room visits resulted in hospitalization, either for treatment, observation, or transfer to another facility. Most of those hospitalizations involved upper-body fractures or head and spinal cord injuries.

Other research, drawn from the High School Reporting Information Online (RIO) database, compared overall injury rates in cheerleading to other girls’ high school sports across multiple years, including gymnastics.

Cheerleading’s overall injury rate of 0.71 per 1,000 athletic exposures is less than a third of soccer’s and roughly half of volleyball’s. An “athletic exposure”, or AE, refers to a single instance of one athlete participating in one practice or competition. For example, 10 practices with 10 athletes each equals 100 athletic exposures. A rate of 0.71 injuries per 1,000 AEs means that across many thousands of practice hours, the typical cheerleader is far less likely to be injured than a soccer or basketball player. While that’s just barely true for gymnastics as well, the point remains.

Numbers like these don’t mean injuries don’t happen, but they do offer parents a useful frame of reference. The routine risks of cheer and gymnastics are lower than they are for some sports that parents will sign their kids up for without a second thought.

How Cheer Injuries Happen

The RIO data also showed that most cheer injuries occurred during practice or competition, not during sideline or halftime performances at games. Even though cheerleading’s overall rate is lower than most other girls’ sports, the average severity of an injury tends to be higher. Across all cheer injuries in the database, 31% were concussions, a lower share than in other sports, but still a substantial number.

Most of these concussions came from:

• Stunting (69%)
• Pyramids (16%)
• Tumbling (9%)

Of these concussions, 206 were reported from a practice, 21 happened during performance, and 18 happened in competition. Concussions were also the main reason that any cheer injury took an athlete out for three weeks or more.

A separate study of clinic visits found that overuse injuries were the most common type of cheer-related medical visit, accounting for more than 65% of cases.

Looking at all cheer injuries (not just concussions), stunting accounted for 53% and tumbling for 21% of these injuries, far and away the most prominent injury risks. Within stunting injuries specifically, 64% involved dismounts to a cradle, and 36% involved dismounts to the floor.

Lower overall injury rates do not mean that cheer injuries are minor when they happen. Of all cheer injuries, 43% affected the head or neck, 12% the ankle, 9% the hand or wrist, and 8% the trunk.

Three out of four cheerleaders are back within three weeks of an injury, but a meaningful share (about 1 in 6) lose three or more weeks, and one in 20 are out for the season. The injuries behind those longer absences are also the ones with the most lasting consequences. Concussions account for more than a third of injuries that keep cheerleaders out for three weeks or more, and concussion effects can extend well beyond the recovery window. A single concussion can affect a young athlete’s school performance, sleep, and emotional health for months. Multiple concussions raise the risk of long-term cognitive issues that may not appear until adulthood.

The Risks That Build Over Time

Not every cheer or gymnastics injury comes from one bad fall. Some of the most common injuries build slowly, through repetition, insufficient rest, and progression that outpaces what a young body is ready for.

Specialization is one of the largest known risk factors for such overuse injuries. Athletes who specialize in a single sport before the age of 15, particularly when participation runs year-round, tend to experience lower-extremity injuries at rates 60% higher than athletes who play multiple sports. The risk is not unique to cheer or gymnastics, but it shows up in these disciplines the same way it shows up in any single-sport focus.

The injuries that come from overuse include:

• Stress fractures
• Tendinitis
• Knee pain
• Spinal stress fractures

These rarely announce themselves in one dramatic moment. They accumulate as small aches, are often dismissed as soreness, and become serious when the body can no longer compensate.

Burnout is the mental version of the same problem.

Signs that a young athlete may be heading toward burnout include:

• Heightened anxiety or stress around cheer
• Recurring headaches and stomach aches
• Frequent illness
• Fatigue from inadequate sleep
• Social isolation from friends outside the sport
• The sense that an activity that once felt fun (cheer) has become a chore

Coaches and loved ones sometimes contribute to burnout without intending to. Some of the pressure stems from a belief that early specialization will lead to long-term success. The evidence points the other way. Athletes who play multiple sports through middle school and into the early high school years tend to have longer careers, fewer injuries, and stronger overall athleticism. The NFHS describes multisport participation as “a natural form of injury prevention.” Many high school coaches openly prefer athletes who play more than one sport for exactly this reason.

What Parents Can Ask & Look Out For

The most important thing parents can do is to be informed and engaged. The following topics are worth raising with any cheer or gymnastics program before the season begins, and revisiting if anything changes.

Preparticipation Physical Examinations

The AAP recommends a preparticipation physical exam for every young cheerleader. This includes a review of medical history, a physical health assessment, and a medical eligibility form. One of the most important things these evaluations can catch is disordered eating or restrictive caloric intake, which sharply increases the risk of bone stress injuries.

The AAP urges both parents and coaches to use language that does not pressure cheerleaders to maintain a particular body type, and to choose uniforms that fit a range of body types (specifically recommending uniforms that don’t expose the midriff). Doctors and parents can also use this opportunity to talk with kids about nutrition that supports strong bones, sustained energy, and healthy growth.

Qualified Coaches & Spotters

Cheerleaders and gymnasts should always train under coaches who know how to prevent injuries and how to respond when one occurs. Spotters in particular play a crucial role. A qualified spotter is positioned to catch a falling athlete, has clear sight lines to the stunt being performed, has the strength and training to actually intervene during a fall, and knows when a stunt is being attempted before the team is ready for it. Coaches and spotters also have a part to play in ensuring safe equipment and progression, and in having a written emergency plan.

Safe Equipment & Progression

Stunts should only be performed on appropriate surfaces. Rubber mats, sprung floors, grass, or other impact-absorbing surfaces are essential for any skill that involves height or rotation. Concrete, asphalt, gym floors without proper matting, and uneven or slick surfaces are dangerous for performing stunts where athletes might fall.

Progression matters as much as the surface. Skills should only be attempted when athletes have mastered every prerequisite skill. The NFHS publishes detailed stunt and tumbling progressions that move from basic skills to more advanced ones. For partner stunts, the recommended sequence begins with step-up drills and double-base thigh stands, then progresses through shoulder stands, extension preps, and cradle drills, with basket tosses reserved for the most advanced level.

The principle is simple. No skill should be attempted before an athlete has every prerequisite down pat, and no stunt should be attempted until every individual involved has mastered the preceding skills. When parents see a coach pushing an athlete to skip steps, that is a moment to ask questions.

Written Emergency Action Plans

Every school, gym, and coach should have a written emergency action plan, and the plan should be different for events (where medical staff are typically present) than for practices (where they typically are not). USA Cheer publishes templates for such scenarios. Parents can ask to see the plan or simply ask whether one exists.

A written plan covers things like:

• Who calls emergency services
• Who provides initial care
• How to direct EMS to your location
• How to keep unnecessary personnel away from the scene

It is also critical that someone on hand, whether a coach or someone else on staff, be CPR certified and know Sports First Aid. Staff should also know where an AED device is located at every venue.

Recognizing a Concussion

Of all the injuries that cheerleaders and gymnasts can sustain, concussions are among the most serious, and unfortunately, the easiest to miss. Symptoms aren’t always obvious right after a hit, and young athletes often downplay how they feel because they don’t want to come out of practice or a competition. Knowing what to watch for, and what to do when something seems off, is one of the most important things that parents can carry into the season.

All 50 states have passed laws that require written medical clearance before young athletes return to play after a suspected concussion. But laws don’t enforce themselves, and parents may find themselves having to advocate for their children and make sure the protocol is followed. If a coach, teammate, or athlete pushes for a return to practice before clearance is in hand, the right answer is always to resist that push and wait. There is no game, competition, or practice worth permanent harm to a developing brain. And if a coach can’t see that, it may be time to start asking more questions.

Preventing Overuse & Burnout

The injuries that quietly accumulate over a long season have less to do with any single fall and more to do with how much time an athlete spends in their sport, how little time they spend away from it, and how young they were when they specialized. The National Athletic Trainers’ Association (NATA) has spent years building evidence-based guidance for parents on exactly these issues.

None of these are absolute rules, and most athletes who occasionally exceed them won’t be hurt as a result. But the pattern in the data is consistent. Kids who specialize before they turn 15 or 16, train more hours per week than is healthy for their age, who skip rest days, or never take a real off-season are more likely to be sidelined by overuse injuries. They are also more likely to burn out and walk away from the sport entirely. The aim of these guidelines isn’t to limit ambition. It is to make a long, healthy athletic career possible.

Reporting Injuries & Advocating for Change

If a child is injured, immediate medical care comes first. After that, parents have an opportunity to contribute to a system that protects future athletes, Catastrophic injuries can be reported to the National Center for Catastrophic Sports Injury Research. These reports help researchers identify patterns and evaluate whether existing rule changes are working.

Where rules need updating, or where coaches or programs need to be held accountable, the people closest to the situation are usually the ones who can drive change. That can mean raising concerns directly with the program, working with safety advocates to enforce changes, and working with legal professionals when serious harm has occurred. The same principles apply across every type of cheerleading and gymnastics program, school-based or club, traditional or stunt-focused, recreational or elite.

How Cheer Gets Safer

Cheerleading and gymnastics, at their best, give children some of the most rewarding experiences of their childhood. The friendships, the discipline, the confidence that comes from mastering a skill that once seemed impossible: these are real, and they matter. The data shows that catastrophic injuries are less common than they used to be, and that overall injury rates in cheer are lower than in many other sports.

For parents, the goal isn’t to monitor every practice or to second-guess every coach. The goal is to know what good safety looks like, to ask the questions that distinguish a careful program from a rushed one, and to back the athlete up when they say something hurts. A long, healthy career in cheer or gymnastics is possible. It just isn’t automatic.