Cheerleading Injuries

Strength Training Is Part of the Solution

Last year there were 30,000 incidents of cheerleading injuries in the U.S. severe enough to require emergency room visits and treatment. This is six times greater than in 1980. From 1982 to the spring of 2008 the number of catastrophic injuries (including two deaths) suffered by high school cheerleaders in this country was 73. This is the highest number attributed to any female athletic activity. Number 2 was gymnastics with NINE. Furthermore the NCAA reported that in the 2005 stats their insurance arm spent 25% of its liability claims budget on cheerleading injuries while spending 57% on football. The number of football players covered by the NCAA is 10 times greater than the number of cheerleaders.

Clearly there is a problem here and concerned parents should be involved in the proposed solutions.

There is general agreement that cheerleading has developed into an activity that is quite different than it was 30 years ago. The movements are more acrobatic and gymnastic in nature with many moves borrowed from the discipline known as handbalancing. Apparently the practitioners are more athletic, more daring and there is a considerable motive to remain competitive between schools what with cheerleading competitions becoming stand alone activities.

Because cheerleading is not recognized as a school sport in most states (Florida being a notable exception), there is less oversight provided by the school districts and consequently many of the sponsors are merely roll book carriers with little expertise in coaching an athletic activity. What little training is available is meager and insufficient. Cheerleaders performing tumbling movements should be supervised by adults with experience in spotting as is a prerequisite for coaching gymnastics.

Moreover the people running cheerleading programs have been advised by the football community that requiring safety equipment would indicate an assumption of danger and hence liability should any claims go to litigation. Subsequently there is no oversight procedure requiring the use of safety mats or spring loaded surfaces for either practices, performances or competitions.

In all of the proposed solutions I've encountered, nowhere is strength training mentioned as a part of the answer. This is not surprising since the topic never comes up in the female athletes' torn ACL discussions.

Much of what the modern day cheerleaders are performing is very similar to the ancient art of hand balancing in which one person (the top mounter) performs acrobatic or gymnastic maneuvers while being supported by another person (the understander). Circuses used to regularly feature hand balancing acts and in fact, Burt Lancaster was a circus hand balancer before becoming an actor. Practitioners of this art used to perform strength training exercises to improve their performances and to minimize injuries. Why should cheerleaders be any different?

Not only will properly designed strength training improve the durability of the muscles and connective tissues that would lessen the severity of an injury, it would delay the onset of fatigue. Muscular fatigue late in a performance or competition may well be the cause of miscues and non-support on the part of the bottoms that lead to injuries.

A couple of training session a week of power snatches, power cleans, presses and squats should be enough to significantly improve the performance and durability of cheerleaders and head off some of the injuries and lessen the severity of others.

The movement to minimize the danger of cheerleading must include all of the aforementioned factors. Official oversight, acceptable standards of technical proficiency, sophisticated adult instruction and supervision, appropriate safety equipment and well designed strength and conditioning all figure into raising the bar of safety standards.

I'm convinced that parent booster groups will have to be the ones that lead the way on this one by getting involved with school district administration, providing input on supervisory personnel, funding safety equipment and campaigning for inclusion of cheerleading into the strength and conditioning program. I know that most strength and conditioning coaches are probably overloaded as is, but there is a disproportionate injury rate in this activity and providing services might provide some leverage for increasing the strength and conditioning program.

As a society we believe in solving problems through litigation, legislation, diplomacy, administration, education, good intentions, psychology, financing and pharmacology. Injuries happen to tissues and their component cells and molecules. Strength and conditioning professionals can improve the tissues.

Chiropractic Intervention Helps Female Athletes Avoid Injuries

Professional ball players have traditionally used chiropractic intervention to improve performance and reduce the risk of injury. Studies are prevalent showing the positive effects of chiropractic intervention in male athletes.

Now female athletes are receiving the same attention by researchers. A 2011 study in the "Journal of Manipulative and Physiological Therapeutics" reported on the results of a chiropractic intervention used with professional football cheerleaders during the 2010 season. The study focused on hamstring injury prevention, a common injury among cheerleaders, gymnasts, and other female athletes.

Doctors of Chiropractic provided the study participants with a "closed-chain, eccentric hamstring exercise protocol" for the season. Hamstring injury was assessed before and after the season. The protocol consisted of two specific exercises performed with an elastic band, two to five times per week. The results showed a statistically significant difference in successfully reducing hamstring injuries and related pain in the participants.1

The study is good news for female athletes across the board, including dancers, skaters, gymnasts, runners, and others who are prone to overuse and hamstring injuries. Now, traditional, best practice methods for preventing a hamstring injury--proper strength training of the hamstring muscles to ensure that they are equally balanced with the quadriceps muscles, and ample warm-up and stretching of the muscles before beginning exercise and training--can be combined with a specific intervention protocol designed to reduce hamstring injuries in females.

Chiropractors naturally advocate taking a proactive stance. Injury prevention is much preferred to injury rehabilitation. Proactive chiropractic care not only helps reduce the risk of injuries in athletes but can also help improve strength, balance, speed, agility, and flexibility.

Chiropractors are whole body practitioners and while they may provide a site-specific training program focused on a certain area of the body, generally this is only a piece of the puzzle. Chiropractors are physicians trained to look at the biomechanics of the body as a whole. Further, Certified Chiropractic Sports Physicians (CCSP) are Doctors of Chiropractic with a special certification in treating sports injuries and optimizing physical fitness. They regularly provide integrative whole body training programs for the athletes they treat, using protocols to help minimize the risk of injury and enhance sports performance.

Athletes under the care of a chiropractor or a CCSP are typically less prone to painful, frustrating injuries and recover more quickly when they do experience an injury. And because chiropractors are natural, hands-on healers, athletes under their care are often able to avoid surgery. Heat and ice therapy, electric stimulation, ultrasound, massage, rehabilitative exercises, and mobilizations or manipulations (adjustments) can often restore balance, alignment, and proper range of motion following an injury, without the need for more invasive treatment such as surgery.

Ultimately, prevention is the best medicine.

References
1. Greenstein JS, Bishop B, Edward J, Topp R. The Effects of a Closed-Chain, Eccentric Training Program on Hamstring Injuries of a Professional Football Cheerleading Team. J Manipulative Physiol Ther. 2011 Mar-Apr;34(3):195-200.

Spinal Cord Injuries During Football Season

Football is a violent sport. For many fans, this is part of its appeal. For the players, however, the violence inherent in the game poses a serious health risk. With this year's football season already begun, there's no time like the present to focus on the potential for spinal cord injury, measures for prevention, and methods of treatment.

Spinal Cord Injuries

The spinal cord is a bundle of nerves that carries messages between the brain and the rest of the body. It is protected by the vertebrae and extends into the lumbar spine. The signals that pass between the brain and the body via the spinal cord are responsible for regulating our most essential functions: bowel and bladder control, blood pressure, body temperature regulation and sensation.

Injury to the spinal cord can occur as the result of tumors, developmental disorders, disease, and - what I'll be focusing on in this article - trauma. A physical trauma can cause strain on the spinal cord, compression of the spinal cord, or fracture of the vertebrae surrounding the spinal cord, resulting in damage to the cord itself. Oftentimes, when the spinal cord is injured, the messages cannot pass between the brain and the body. When this is the case, essential bodily functions can fail - causing paralysis or even death.

Football Injuries

Head, neck, and spine injuries are common in football; this stands to reason as falls and hard hits are an everyday occurrence for all players - no matter what position they play or level of play (high school, college, or the NFL). If the angle and velocity of these impacts are just right, spinal cord injury is a natural result. Various sources offer statistics regarding football-related injuries. Although the exact figures in these reports may vary, all sources agree that even just a single severe spinal cord injury is too many.

To be fair, I believe equal attention should be paid to the athletes on the sidelines: cheerleaders. These men and women have progressed to complex acrobatics that send them hurtling through the air. Stunts like these can result in cheerleaders falling on their heads or backs, or with other cheerleaders landing on top of them. Clearly, these scenarios can result in head trauma or spinal cord injury, and these types of injuries are also an unfortunate reality of the sport of cheer leading.

Treatment

At my practice, we use several methods for treating our patients with spinal cord injuries on Long Island. The ultimate goal of these therapies is to decompress the spinal cord and stabilize the spinal column.

After surgery, most of our spinal cord injury patients in the NYC metro also undergo physical therapy and other ancillary therapies. Thanks to advanced treatment methods, life expectancy and quality of life for these patients may be significantly improved. Victims of these injuries can go on to lead full lives, even if they have lost the use of their arms and legs.

Prevention While improving treatment for football-related injuries is a worthy goal, equal emphasis needs to be placed on preventing the injuries from occurring in the first place. I can offer several suggestions.

Coaches and trainers: Perform thorough physical exams to ensure that no athletes are playing injured. Encourage training for coaches and staff so that they are prepared to respond to a spine injury. Coach players to use methods of blocking and tackling that do not use the head as a "battering ram." Arrange for a physician to be on the field during practice or a game in case of emergencies. Make sure that helmets are well-fitted and that straps are tight.
Officials: Continue to enforce penalties against helmet-to-helmet contact.
Players: Focus on keeping the head up, even when blocking and tackling. Trainers should work with players to strengthen neck muscles so that they can maintain proper posture during the game. Players need to immediately report "warning signs" of an injury (such as numbness or tingling, pain or pressure in the head/neck/back, weakness or uncoordination, and difficulty breathing) - and should not return to the game.

Measures can also be taken to prevent cheer leading injuries. Experts suggest improving the facilities where stunts are performed (for example, requiring floor mats and avoiding wet surfaces), limiting the participants who can perform more dangerous stunts to those with more experience, and requiring coaches to undergo specialized safety training. It's important to note that cheer leading is not considered a sport by some schools, and thus is not as heavily-regulated as other athletics. Many have suggested that, until cheer leading is sufficiently regulated by all schools, sufficient safety improvements cannot be made.