Once upon a time, cheerleading meant waving pom-poms on the sidelines of a football game to get the crowd going. Not anymore. Cheerleading today is a competitive and demanding sport. It requires as much (or more) athletic ability and intricate skills as any other high school or college sport.

Cheerleading is a great group activity and an excellent way to stay fit. But it's not without its risks. Injuries, some of them extremely serious, are a threat, particularly for "flyers," the young women who are tossed into the air in certain cheerleading maneuvers. Pressure to stay thin can lead to body image problems that also affect gymnasts and dancers.

To learn how to keep things as safe as possible, follow the tips below.

Why Is Cheerleading Safety Important?

Cheerleading has been called "the world's most dangerous sport." Although that nickname is a bit dramatic, cheerleading is a leading cause of sports injuries. The most common injuries — to feet, ankles, and legs — are usually not serious.

But cheerleaders also can get neck and back injuries. These types of injuries can lead to permanent disabilities, so practicing and competing in a safe way can really protect you.

The rise in popularity of cheerleading in recent years has led to an increased number of injuries. The gymnastic-type maneuvers involved in cheerleading are largely responsible for most of these.

Until recently, cheerleading wasn't recognized as an official sport. So it wasn't subject to the same safety regulations. Fortunately, that's starting to change. As a result, severe injuries among cheerleaders in 2007 were at their lowest level since 2001.

Choose a Safe Place to Practice

Most cheerleading injuries happen during practice. When you're working on your maneuvers and skills, it's super important to have a safe place to practice. Find a facility with floors that absorb impact well — like spring floors or 4-inch-thick landing mats on top of foam floors.

Never practice on a basketball court or other hard surface. Also, always check out the space where you'll be practicing to ensure it's smooth, level, dry, and clear of any objects that might interfere with your performance.

Find a Qualified Coach

Before you enroll in any cheerleading program, whether through your school or a club, make sure the coach or program director is qualified.

Cheerleading coaches should be certified by the American Association of Cheerleading Coaches and Administrators (AACCA) or a similar organization. A qualified coach will be up to date on the latest safety measures and regulations governing the sport of cheerleading.

Before You Practice or Compete

Cheerleading requires a tremendous amount of strength and coordination. Given this, it makes sense to stay in the best shape possible (eating a healthy diet and getting regular exercise) year-round.

Start getting in shape a few months before the cheerleading season begins. That way, you'll be ready to go when the time comes — and less at risk of getting sidelined with injuries, especially overuse injuries like tendonitis. Many coaches recommend an off-season strength training program for cheerleaders.

Consider enrolling in a gymnastics program or taking gymnastics lessons. Given that cheerleading at its highest levels requires difficult gymnastics-type skills, having a solid gymnastics background not only will make you a better cheerleader, it also will make you more confident in your abilities. That all adds up to a good way to help prevent injuries.

Always warm up before any cheerleading practice or competition. Do some jumping jacks or jog in place for a few minutes to get the blood flowing, and then do some .

Make sure you have properly fitting, rubber-soled shoes with adequate cushioning and support. Flyers also might want to consider wearing a lightweight cheer vest while practicing to protect themselves from bruising and injuries.

While Competing or Practicing

Almost all cheerleading-related concussions happen during stunts. When learning stunts, take the time to perfect lower-level and less complicated skills before moving on to more difficult ones. It might sound boring, but having a solid skill base to work from will make you more confident in your movements and less likely to get injured. It goes without saying not to attempt a stunt that's beyond your skill level.

During practices, any time you attempt a stunt or maneuver that is difficult or dangerous, have a coach or teammate spotting you and ready to catch you in case you fall. This not only reduces your chances of injury, it also helps you to maximize the benefit you get from practicing. If you are assigned to spot a teammate, take the job seriously. Don't divert your attention from the person you're assigned to spot.

Be sure a coach is on hand to supervise all practices and competitions. If you don't feel comfortable doing a stunt, let your coach know. Cheerleading is supposed to be fun. Doing something that you're not comfortable with or sure about will make you more likely to get hurt and also put your teammates at greater risk. If your coach isn't supportive when you voice your concerns, talk to your parents or an administrator.

During competitions and performances, don't attempt a stunt that you and your teammates haven't worked on over and over again in practice. Trying to do something unfamiliar will put everyone involved at risk.

If you feel any pain or discomfort while practicing or competing, let your coach know right away. Don't continue cheerleading until the pain subsides or you've had the injury looked at by a doctor and have been cleared to start practicing again. "Playing through the pain" can make some injuries more severe and ultimately keep you sidelined even longer.

"Playing through" an injury is especially dangerous when it's a head injury. The brain needs time to heal after a concussion. So it's absolutely essential to follow a doctor's advice and wait until all symptoms are gone before returning to normal activities.

A Few Other Reminders

• There's lots of pressure to stay thin in cheerleading, so the sport carries a risk of eating disorders. Body image issues, anorexia, bulimia, and other eating disorders can lead to serious health problems down the road. Teen cheerleaders are at a point in life when it's essential to maintain a healthy diet in order to develop and grow properly. If you think a friend or teammate might have an eating disorder, don't be afraid to tell a coach or parent. The best way to fight eating disorders is to catch them early. Telling doesn't mean you're a snitch; it means you're a true friend.
• Your coach or someone present at all practices and performances should know how to do CPR. Likewise, first aid should be readily available anywhere you practice or compete.
• Find out if your team has a plan for emergencies and be sure you are familiar with it. If someone does suffer a serious injury, being prepared can make a big difference.

Reviewed by: Kate M. Cronan, MD
Date reviewed: September 2011