Inside Cheerleading: The Most Dangerous Sport for Women

The Risks, the Rigors and the Role of Chiropractic Care

By Brenda Duran

On a warm evening in 2003, Krista Parks was beaming with pride on a football field as a cheerleader at the University of Memphis. This was her moment - her squad was practicing for the national cheer championship in Orlando, Fla.

Parks was to pull off an ambitious stunt - a high front flip in the air from the top of the pyramid, landing in the arms of her squad; instead, she lost her momentum and fell head first onto a 2-inch foam mat on concrete. The result: a broken neck, a blood clot in her brain and multiple fractures.

"I couldn't feel or move anything," Parks recalled. "I was pretty miserable."

Following the incident Parks underwent three surgeries, had to wear a neck brace, and then had to deal with years of physical therapy. A permanent shunt was placed in her spine to help drain fluid from her brain because her body can no longer do it.

Today, she is also dealing with life-altering changes to her cognitive abilities - loss of memory, delayed comprehension and mental fogginess.

Inside Cheerleading - Copyright – Stock Photo / Register Mark "It's not just throwing around pom poms, it is a real, dangerous athletic activity that comes with risks," said Parks, now executive director for the National Cheer Safety Foundation. "There is a lot that needs to be done to make it safer."

And one of the things that can make it much safer - and healing faster - is consistent chiropractic care, she said.

"Chiropractic care has helped me with pain management, I can sleep better and not have to finish my day in agonizing pain," said Parks, who also works as a physical therapy assistant at Spinal Healthcare Associates in Memphis, Tenn. "It's an approach to pain management I really love."

Since she started chiropractic care for her catastrophic injuries a few years ago, Parks said her pain level has decreased to the point where she can function much better on a daily basis.

The Most Dangerous Female Sport

In a 2009 report, the National Center for Catastrophic Sports Injury (NCCSI) Research at the University of North Carolina at Chapel Hill, N.C., declared cheerleading the "most dangerous female sport in the United States" based on injury data they obtained from 1982-2008 that showed approximately two-thirds of severe school sports injuries over the past 25 years were from cheerleading.

The reason is quite straightforward: At many high schools and colleges, and at the professional level, it is no longer enough for the cheer squad to simply coordinate chants and perform dance routines.

Today, highly demanding acrobatic moves have become the norm, experts say. National competitions have upped the ante, by fomenting a "can you top this" attitude that pushes kids to do even riskier stunts.

As a result, their jumps, splits, and acrobatic tumbles have become to cheerleaders what the blindside hits, collisions and flying tackles are to the football players out on the field. The jolts to their bodies are serious.

But while injuries have made cheerleading the most dangerous sport for young American women, experts say that the risk and severity of injury can be kept to a minimum with chiropractic care. Chiropractors identify injuries early and properly manage them before they progress to something more serious, which is the key to people like Parks who has had to ensure her body heals properly.

Natural Healing

Inside Cheerleading - Copyright – Stock Photo / Register Mark Krista Parks (in photo) was a University of Memphis cheerleader in 2003 when an ambitious front-flip maneuver during practice turned disastrous, ending her career and necessitating years of rehabilitation. With cheerleading calling for ever-higher degrees of athleticism, chiropractors say they are able to provide a unique understanding of the rigorous training and physical toll that the sport has on the body, unlike any other type of physician.

"Doctors of chiropractic are the only healthcare professionals who specialize in the process of correcting spinal misalignments with adjustments," said Dr. Steve Goninan, a chiropractor at Integrity Chiropractic in Georgia. "These adjustments re-energize the nervous system, reduce biomechanical stress, optimize the athlete's agility without the athlete having to overcome the side effects of drugs or irreversible surgeries."

Dr. Goninan, who has written about the benefits of chiropractic care for cheerleading, notes that chiropractic works with the nervous system, which controls and coordinates the functions of all other bodily systems. When injury occurs to the spine - one of the key structures that surrounds and protects the nervous system it can impede the nervous system's ability to govern the body and maintain a balance necessary for health, he said.

Some of the most common injuries for cheerleading these days include overuse of the shoulders, wrists, and elbows, neck injuries, head traumas, fractured wrists and dislocations. These tend to happen from falls onto hard gym floors and tracks.

Other factors such as the length of the cheerleading season, which lasts from the fall to spring also sets up much more potential for nagging injuries that are never fully allowed to heal, said Dr. Goninan. "Like all athletes there has to be some down time to in order to allow the body to recover," he said.

Dr. Goninan also said cheerleaders need to take occasional breaks of 3-4 days during the year when there are no games or practices. They should also do more weight training to strengthen their shoulders and upper body and implement nutritional supplements like all other athletes to boost performance. "This helps reduce the risk of injuries and helps manage the wear and tear that the never-ending season causes."

Dr. Enrico Esposito, a chiropractor who has treated various cheerleaders in Alabama, said it is the younger cheerleaders who tend to suffer from repetitive motion injuries like patellar tendonitis, ankle sprains, stress fractures, hip strains, and inflammation around the hips. There are also low-back injuries that can become chronic without proper care. But chiropractic care for younger cheerleaders can help reduce the risk of even more serious injuries in the future, he said.

"Any injury at a young age that is not rehabbed properly will undoubtedly result in residual problems later on," said Dr. Esposito. "A lot of injuries can prevent kids from excelling as good athletes down the line. Chiropractic care can decrease inflammation, re-strengthen and rehabilitate by balancing the body."

Dr. Gonina agrees, noting chiropractors are able to mitigate future injuries while healing prevent mishaps. "I have seen athletes fail to complete a rehabilitation regimen that led to reinjury down the road that was as bad, if not worse, than the original injury," he said. "I have learned how valuable chiropractic is for an athlete, both as a means of treating an injury and preventing future injuries."

Inside Cheerleading - Copyright – Stock Photo / Register Mark The Washington Redskins cheerleaders are supporting the nonprofit Foundation for Chiropractic Progress, sharing their positive experiences with chiropractic care and how it helps keep them at the top of their game. Dr. Goninan recommends all cheerleaders have their spines checked and their muscle strength tested at least once a week during the season to detect and prevent all types of lingering injuries.

"To perform some of the athletic gymnastic moves required in cheerleading, it is absolutely essential that all muscles be firing on all cylinders," said Goninan.

Prevention Is Key

For many cheerleaders who go on to professional teams, chiropractic care becomes even more critical to maintain healthy joints and a spine, said Dr. Jay Greenstein, chiropractor for the Washington Redskins cheerleaders.

"What's interesting about cheerleaders is that they are true athletes; they endure a tremendous amount of physical stress," he said. "They practice hard, there is a lot of demands on them when it comes to performance and they are doing chronic repetitive motions that put significant strain on their bodies, so they are perfect candidates for chiropractic care."

Dr. Greenstein's clients have been so pleased with the results of their care they recently assumed the role of being the latest ambassadors for chiropractic care by teaming up with the Foundation for Chiropractic Progress to promote chiropractic and the benefits of a healthy lifestyle.

Amanda Mitchell, who has been in the sport since high school and a professional for the last two seasons on the Redskins cheer squad, credits chiropractic care for making it possible for her to perform through a 16-game season. In fact, without it, she says, she wouldn't have made it through her first season.

"This is a sport, we're athletes, and cheerleading can take a very heavy toll on your body," she said in a recent interview. "Without chiropractic it would not have been possible to stay in this."

Mitchell said her flexibility and pain from subtle injuries have dramatically been reduced through chiropractic care. "People don't view it as a competitive sport, but you have to try out every single year in this industry and its extremely cutthroat," she said.

Denise Medina, a first-year member of the Redskins cheer squad, said that while the team devotes more time to dance routines than a high school or college team, "cheerleading will just tear your body up if your aren't well-prepared."

Diet and Stretching Matter, Too

Both Medina and Mitchell have also learned a lot of useful tips to avoid injuries. Medina said that regular exercise outside of practice and good eating habits are at least as important as warm-ups and cool-downs at practice and events. And Mitchell pointed out that while parents may not be able to control what happens at practice or a game, they can take control in the kitchen.

Inside Cheerleading - Copyright – Stock Photo / Register Mark "It all begins with a healthy diet," said Mitchell. "I believe staying in shape is 80 percent diet, 10 percent genetic and 10 percent workout." She believes part of the reason why she has avoided serious injury is because she's learned to eat the right foods at the right time of day. Training, proper warm-up and cool down, as well as practice are important too, of course, but she strongly believes that it's her diet that has been the ultimate factor.

"It's a cliche, but you really are what you eat," she said. "Parents who have kids in cheerleading have to understand that poor eating habits are poor preparation and poor preparation greatly increases the risks of injury."

On a typical day, Mitchell said she has five small meals of between 200 and 300 calories each. Breakfast often includes oatmeal and egg whites. Her morning snack is a protein shake or protein bar. Lunch is a spinach or broccoli salad, often mixed with chicken. Afternoon snack is again a shake or protein bar, usually with some almonds for "finger food." Fish is her favorite for dinner.

"Parents have control over three of those meals, and they can help their kids get through the day by adding in healthy snacks," she said. "If they don't do that the kids will grab for whatever is available in the vending machine."

Mitchell said that at practice and before a performance, stretching is also critical. "If you don't warm up, all the jolts and tumbles are much more likely to cause an injury," she said. "I can't stress enough how important stretching is, because this sport can tear your body up."

Dr. Greenstein also recommends cheerleaders also do dynamic warm-ups - a warm up activity that includes upper body and lower body movements to warm up the muscles and dynamic stretches for better flexibility two hours prior to an event. He also recommends if a cheerleader is getting their technique wrong, its best to adjust it to prevent any other injuries.

If a cheerleader does end up getting hurt, he said, with chiropractic care there are always plenty of solutions. "The goal is to decrease pain that can be done naturally through chiropractic care and also improving overall function, which also is a huge component of what chiropractors do," he said.


Inside Cheerleading - Copyright – Stock Photo / Register Mark 10 Tips for Cheerleader Safety

  1. Make sure your athlete's team has rehearsed their catastrophic emergency plan before going out on the field.

  2. Obtain a pre-participation physical for your athlete to ensure they are healthy and prepared.

  3. Look for a mature, qualified coach that knows proper technique, progressions and spotting.

  4. Find a safe environment to practice and learn.

  5. Have automatic external defibrillators available at all time in case of an emergency.

  6. Report injuries to www.cheerinjuryreport.com for research purposes.

  7. Make sure you are aware of head injuries and the signs of concussion.

  8. Keep your athlete hydrated and make sure they know how they prevent heat illness.

  9. Only allow your athlete to return to play after injury when released by a qualified health professional.

  10. Check that the coach has had a background check.

Source: The National Cheerleading Safety Foundation. For more information, visit www.nationalcheersafety.com.



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