Dr Cantu was chief of the Neurosurgery Service at Emerson Hospital in Concord, Massachusetts. Statistics in his report — The Physician and Sportsmedicine: Fatalities and Catastrophic Injuries in High School and College Sports, 1982-1997 — are sobering.

We can quibble with this survey. But not with the bottom line. Competitive Artistic Gymnastics competition in schools and Universities is dangerous. And Cheer far more dangerous.
With Cheer booming, and the lack of any real coach education program in the USA, I suspect the statistics are even worse in the States from 1998 – 2007.
What to do?
Many state high school associations have responded to these changes and the increase in injuries by banning stunts such as pyramid building and the tossing of cheerleaders. Others have designated cheerleading as a sport. The American Association of Cheerleading Coaches and Advisors implemented a Safety Certification Program, which has certified over 500 coaches and been adopted by some states and some college conferences.
Safety initiatives have resulted in a number of recommendations, including the following:
* Coaches should supervise all practices and be safety certified;
* Cheerleaders should have a preparticipation exam, be trained in gymnastics, spotting, and conditioning, and participate only in stunts that they have mastered;
* Stunts should be limited; eg, pyramids should be limited to two levels and performed on mats;
* Emergency procedures should be written and available; and
* Cheerleaders who have signs of head trauma should receive immediate medical attention and return to cheerleading only with permission from a physician.
I’d like to get more Cheer competitors and their coaches into gym clubs that have proper matting, trampoline and tumbling equipment, pits and expert spotters.
I’ve met many superb cheer coaches, just as skilled as top Artistic coaches. But there are very many more volunteer beginner coaches who need training and experience in a safe facility.
