A prospective cohort study of injury incidence and risk factors in North Carolina High School competitive cheerleaders

Background: Cheerleaders suffer nearly half of catastrophic injuries observed in female scholastic athletes in the United States. However, incidence of noncatastrophic injury in this population has not been described. Hypothesis: Coach, athlete, and injury circumstance variables may predict the injury rate among cheerleaders. Study Design: Prospective cohort. Methods: The authors investigated injury incidence in a sample of North Carolina female cheerleaders who competed interscholastically from 1996 to 1999. Injury, exposure, and demographic data were collected from squads that participated in the North Carolina High School Athletic Injury Study. Results: Cheerleaders suffered 133 injuries during 1701 athlete seasons. More than 21% of the injuries were ankle sprains. The injury rate was 8.7; the 95% confidence interval (CI) was 6.5 to 11.7 per 10,000 athlete exposures. In a multivariate Poisson regression model, cheerleaders supervised by coaches with the most education, qualifications, and training (coach EQT) had a nearly 50% reduction in injury risk (rate ratio [RR], 0.5; 95% Cl, 0.3-0.9), and cheerleaders supervised by coaches with medium coach EQT had a nearly 40% reduction in injury risk (RR = 0.6; 95% Cl, 0.3-1.2) compared to cheerleaders supervised by coaches with low coach EQT.