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 inter-scholastically 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% CI, 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% CI, 0.3-1.2) compared to cheerleaders supervised by coaches with low coach EQT.