Injury Prevention


Long-term studies open our eyes to changes in the adult body as we age. As those studies get published, our knowledge of how to prevent injuries and maintain healthy bodies into old age increases significantly, and gives you the power to control your own life years before the risks increase. 


Hip fractures in older adults can be severely debilitating and can lead to significant medical expenses, but a study published in the American Journal of Public Health (“Physical Activity and Inactivity and Risk of Hip Fractures in Men” – April 2014) suggests that 4 hours of walking each week can significantly reduce hip fracture risk later in life.

Data from a study of nearly 36,000 men, conducted over a 24-year period, revealed that men who walked 4 or more hours a week at a brisk pace had a 62% lower risk of hip fracture than men who walked fewer than 4 hours a week, and that even men who walked 4 or more hours a week at a slower pace experienced a 43% lower risk of fracture than men who walked fewer than 4 hours a week.


According to the APTA, among high school athletes, girls are at greater risk for overuse injuries than boys, according to a recent national study published in the Journal of Pediatrics (“Epidemiology of Overuse Injuries among High-School Athletes in the United States” – March 2015).

In analyzing 3,000 male and female high school athletes participating in 20 different sports, researchers found that overuse injuries represented 7.7% of injuries overall, but rates among girls and boys differed significantly, with overuse injuries representing 13.3% of all injuries for girls compared to only 5.5% for boys.

Girls and boys also differed in terms of when the injuries were likely to occur, with the proportion of overuse injuries decreasing in females from freshman to senior year, while it increased in males.

The highest overuse injury rates for girls were seen in track and field, field hockey, and lacrosse.

"This finding may be solely due to differences between males and females or that these girls’ sports have larger teams with younger, skeletally immature girls who were not physically ready to handle the repetitive motion associated with these sports," the researchers summarized. "Athletes in these sports may benefit most from overuse injury assessment and prevention."

In a video produced by Ohio State University, lead author Thomas Best, MD, also theorized that single-sport specialization could be a contributing factor.

"Many of these youngsters are playing a single sport, and that may in fact be a major risk factor for these overuse injuries because their bodies are seeing the same repetitive blows with one sport," Best said.

What can you do? Preventative measures are your best option. Although there's no guarantee, you can make a significant impact on yourself by working against nature to prevent it. 


Legend has it that cheerleading started with a University of Minnesota student standing up in the stands and leading his fellow students in "cheering" for their team during a football game. Cheerleading has morphed drastically since then. Today, it's considered an athletic activity that incorporates elements of dance and gymnastics along with stunts and pyramid formations. In 2002, an estimated 3.5 million people in the United States participated as cheerleaders, from six-year-olds to adults who cheerlead for professional athletic teams. While cheerleading is meant to support an athletic team, its intense competitions at the high school and collegiate levels have created a whole new dynamic, including increased risk for injury.


The U.S. Consumer Product Safety Commission (CPSC) estimates that cheerleading led to 16,000 emergency room visits in 2002 (the latest year for data). While not as frequent as injuries in other sports, cheerleading injuries tend to be more severe, making up more than half of the catastrophic injuries in female athletes. Cheerleading injuries affect all areas of the body — most commonly the wrists, shoulders, ankles, head, and neck.


Stunt Restrictions

In an attempt to curb the amount of catastrophic injuries in cheerleading, restrictions have been placed on stunts. They range from height restrictions in human pyramids, to the thrower-flyer ratio, to the number of spotters that must be present for each person lifted above shoulder level.

For example, the limit for pyramids is two body lengths for the high school level and 2.5 body lengths for the college level, with the base cheerleader in direct contact with the performing surface. Base supporters must remain stationary and the suspended person is not allowed to be inverted or rotate on dismount.

Basket toss stunts in which a cheerleader is thrown into the air (sometimes as high as 20 feet) are only allowed to have four throwers. The person being tossed (flyer) is not allowed to drop the head below a horizontal plane with the torso. One of the throwers must remain behind the flyer at all times during the toss.

Mats should be used during practice sessions and as much as possible during competitions. Cheerleaders should not attempt a stunt if they are tired, injured, or ill, as this may disrupt their focus and cause the stunt to be performed in an unsafe manner.


The importance of a qualified coach is also critical. Coaching certification is encouraged. Precautions should always be taken during inclement weather for all stunts. Also, a stunt should not be attempted without proper training, and not until the cheerleader is confident and comfortable with performing the stunt.  Supervision should be provided at all times during stunt routines.

As with any sport, proper conditioning and training are important to minimize injury, including:

  • Resistance exercises to gain strength in the lower back, stomach, and shoulders
  • Regular stretching, yoga, or pilates instruction to improve flexibility
  • Speaking with a sports medicine professional or athletic trainer if you have any concerns about injuries or cheerleading injury prevention strategies
  • Returning to play only when clearance is granted by a healthcare professional


One of the most common injuries cheerleaders suffer is an ankle or wrist sprain or strain. For treatment of a sprain or strain, remember RICE:

  •  Rest the injured site for at least 24 hours
  •  Ice the injury at least every hour for 10-20 minutes during the initial four hours after injury. Icing then can be done 10-20 minutes four times a day for two days
  •  Compress the injured site with a snug, elastic bandage for 48 hours
  •  Elevate the injured limb for at least 24 hours Immediate medical attention is required for any cheerleader with a suspected head or neck injury.


Campbell, John D, and Barry P. Boden. Cheerleading Injuries. Sports Medicine Update. September/October 2008.

Boden BP, R Tacchetti, FO Mueller. Catastrophic cheerleading injuries. Am Journal of Sports Med. 31:881-888, 2003.

Shields BJ, GA Smith. Cheerleading related injuries to children 5 to 18 years of age: United States, 1990- 2002. Pediatrics. 117:122-129, 2006.

The following expert consultants contributed to the tip sheet:
John D Campbell, MD
Barry P. Boden, MD