title: Epidemiology of strain/sprain injuries among cheerleaders in the United States.
abstract: OBJECTIVE
  The aim of this study is to describe the epidemiology of cheerleading-related strain/sprain injuries by type of cheerleading team and type of event.
  
  
  METHODS
  Athlete exposure (AE) and injury data were collected from 412 United States cheerleading teams via the Cheerleading Reporting Information Online surveillance tool, and injury rates were calculated.
  
  
  RESULTS
  Strains/Sprains were the most common injury (53%; 0.5 injuries per 1000 AEs) sustained by cheerleaders during our 1-year study. The lower extremities (42%), particularly the ankles (28%), were injured most often. Most injuries occurred during practice (82%); however, the rate of injury was higher during competition (0.8 injuries per 1000 AEs; 95% confidence interval [CI], 0.6-1.0) than during practice (0.6 injuries per 1000 AEs; 95% CI, 0.5-0.6) for all team types. Injuries were sustained most frequently by high school cheerleaders (51%), although college cheerleaders had the highest injury rate (1.2 injuries per 1000 AEs). Strains/Sprains occurred most frequently while attempting a stunt (34%) or while tumbling (32%). Spotting/Basing other cheerleaders (19%) was the most common mechanism of injury and was more likely to result in a lower back strain/sprain than other mechanisms of injury (odds ratio, 3.38; 95% CI, 1.41-8.09; P < .01).
  
  
  CONCLUSIONS
  Cheerleaders should increase their focus on conditioning and strength-building training, which may help to prevent strain/sprain injuries. Spotters and bases should additionally focus on proper lifting technique to help avoid back injury. Guidelines may need to be developed for return-to-play after cheerleading-related strain/sprain injuries.
authors: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA. brenda.shileds@nationwidechildrens.org
authors: Brenda J
authors: BJ
authors: Shields
authors: Gary A
authors: GA
authors: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology* / Q000209:etiology; D016009:Chi-Square Distribution; D002648:Child; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012008:Recurrence; D012574:Schools / Q000706:statistics & numerical data; D013177:Sports / Q000706:statistics & numerical data; D013180:Sprains and Strains / Q000453:epidemiology* / Q000209:etiology; D018709:Statistics, Nonparametric; D014481:United States / Q000453:epidemiology; D014495:Universities / Q000706:statistics & numerical data; D055815:Young Adult