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Cheerleading is now a competitive sport that continues to gain popularity all over the world, not just in the United States.1 As the sport evolves to include a higher number of participants and more complex routines, incorporating increasingly risky maneuvers, there is potential for a higher incidence of injury in athletes participating in this sport.2

From pom-poms, chants, and fight songs led by male-dominated squads to the cradles, back handsprings, and stunts of primarily female teams, cheerleading has progressed into an extremely acrobatic and physically demanding sport.3 Since the addition of Title IX, female participation in athletics has skyrocketed.4 As a result, frequency and severity of injury, as well as the incidence of catastrophic injury in female athletes, has dramatically increased.4 In response to higher injury rates, possibly from performing riskier and more physically demanding stunts, the American Association of Cheerleading Coaches and Administrators (AACCA) was organized, and the group was responsible for creating the Cheerleading Safety Standards in 1987.3 The rules and regulations for the safety of cheerleaders need to continue to expand based on the statistical data gathered on injury type as well as the intensity and extreme level of athletic demands of the progressing sport.1 As cheerleading continues to grow and evolve, it is necessary for clinicians and practitioners to better understand the biomechanics of cheerleading and the mechanisms of injury in order to prevent and treat these athletes properly.

Competitive Cheerleading Categories

Competitive cheerleading is scored in different categories including stunts, pyramids, and jumps.5 Stunts are when one or more cheerleaders support one or more cheerleaders, who are lifted off of the ground.6,7,8 Pyramids require partners that are connected while performing a stunt.6,7,8 Jumps are usually performed with a preparatory phase, where the athlete squats with their arms down by their side and then rises explosively while swinging the arms upward and jumping.9

There are many variations and types of jumps. It can be speculated that because these categories require more athleticism, the risk of injury has increased for cheerleaders.


Cheerleading is an extremely complex sport and can involve a neverending list of various stunts, jumps, dances, and cheers that incorporate a number of different movements. Three main cheerleading positions exist: base, partner, and spotter. These positions are all included in performing stunts, the aspect of cheerleading that has the highest risk for injury.10


The first position that will be explored is the spotter (Fig. 20.1). Spotters have one main goal: to make sure that the partner completes their stunt safely.11 Spotters must be used during stunts where the base is required to extend their arms above their head. The spotter provides ...

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