Kathryn Coxe had performed the full-extension liberty hundreds of times.
It was a simple enough stunt: A male teammate held her aloft while she
raised both arms and one leg skyward. But one day in practice, a new
partner lost his grip on her ankle.
The sophomore at Wheaton College in Illinois plunged 8 feet to the concrete floor of the gymnasium. She landed on her head.
“Immediately, my ears were buzzing and I saw bursts of light,” Coxe, now 23, recalled of her injury. “Never, ever have I been in that much pain.”
As she lay on the ground, coaches handed Coxe an ice pack, called a campus nurse and resumed practice.
“I didn’t make it to the emergency room until two hours later,” Coxe said. There, she was diagnosed with a grade 3 concussion — the most severe classification.
Concern over the long-term dangers of sports-induced concussions has amplified in recent years, thanks to high-profile studies on brain injuries and testimonials of former athletes, particularly NFL players. Lifelong symptoms can include depression, difficulty focusing and early-onset dementia.
But as hundreds of cheerleaders break out their most jaw-dropping moves for March Madness, experts warn that the national discussion has generally skipped over a leading, if unlikely, culprit.
Cheerleading is the fourth most common cause of sports-related concussions in youth, according to a study presented in December at the annual meeting of the American Public Health Association.
Despite eight years as a cheerleader, Coxe had never been warned about the frequency of brain injuries in her chosen sport. Wheaton’s coaches, themselves former cheerleaders, weren’t certified in safety protocol. Elaborate stunts were routinely performed by novice athletes and without padded mats.
Coxe is far from the only young cheerleader whose life changed permanently after a stunt went wrong.
The activity is more popular than ever: 3 million young women participate, and 500,000 — some as young as 5 — enroll in cheering camps each summer. Just 2 percent of cheerleaders are male. Compounding cheering’s brain injury crisis is the fact that females are more vulnerable to concussions.
Take the case of a high school cheerleader who was hospitalized not because of a hard fall, but after being repeatedly bumped by a teammate’s elbow during pyramid routines.
“It was this small bang to the head, over and over and over, that led to a diagnosis of concussion,” recounted Jim Lord, director of the American Association of Cheerleading Coaches and Administrators. “A concussion doesn’t mean you’ve fallen 10 feet onto a gym floor.”
Often difficult to diagnose and treat, concussions afflicted around 400,000 student-athletes last year.
And because concussions tend to be associated with contact sports, the risks are often overlooked among cheerleaders.
Symptoms can be easy to brush off. Difficulty concentrating, headaches, fatigue and irritability might indicate a stressed-out sophomore — or one suffering a traumatic brain injury.
Serious concussions, like Coxe’s, can have life-changing effects.
“It would take an hour to get through two pages of a biology textbook,” she said. “I’d finally finish, and have no idea what I’d just read about.”
Coxe also found herself stuttering, repeating sentences and unable to finish assignments. signments. She was depressed and anxious. Her grades plummeted and she stopped going to class.
Six months of occupational therapy yielded significant improvements, and Coxe graduated with a degree in psychology last spring. Still, she suffers chronic head, jaw and arm pain.
“I have scarring in my brain,” she said. “My brain actually degraded a bit.”
She’s far from alone in navigating the long-term neurological effects of a cheering injury.
“If I laugh too hard, the back of my skull will start to burn, and I hear high-pitched ringing noises once a week or so,” Amy Davis, now 29, said of symptoms that persist nearly a decade after she suffered a concussion as a student at Weber State University.
Doctors anticipate that both symptoms are permanent.
Between 1982 and 2007, cheerleading caused 65 percent of serious sports injuries among high school females and 67 percent among college females, according to a report released in 2008 by the National Center for Catastrophic Sports Injury Research.
That’s not to say that adults charged with cheerleader safety have stood idly on the sidelines: Leaders at the AACCA have been hustling to tighten regulations since the start of the decade, when reports of serious, widespread injury first trickled out.
The NCAA unveiled new regulations in 2006, including mandatory training for coaches, an array of safety rules created by the AACCA, and an anonymous Web forum for cheerleaders to report unsafe coaching.
While dramatically reducing life-threatening injuries among college cheerleaders, the new safety measures are far from perfect. Most school teams rely on self-reported symptoms, while others use a computerized diagnostic test with a high rate of false positives.
Safety standards for high school cheerleaders continue to be much less well-defined.
Sydney Cassamasima, a 14-year-old in East Brunswick, N.J., fell headfirst onto a running track at a school football game in October.
“I had to substitute for a teammate, and I didn’t know the stunt,” she said of the one-legged flying twist that caused her injury. “The person behind didn’t catch me.”
School officials didn’t call an ambulance, so Cassamasima was driven to a hospital by a family friend.
“She shouldn’t have stood up, or been touched, or allowed into a car,” said Cassamasima’s mom, Tracey. “The doctors at the hospital were absolutely fuming.”
Currently, only 12 states mandate safety training for high school cheerleading coaches.
The national cheerleading association has banned a handful of stunts that pose particularly high risks, but “there’s no referee, no police, no penalty,” said Gwen Holtsclaw, founder of the National Council of Spirit Safety and Education.
Lord, director of the cheerleading association, has said more states will institute safety training and formal protocol, with one major exception. “California is a death zone for cheerleading injuries,” he said.
“Without question, injuries are underreported across the board,” Lord said. “Promising statistics are only so reassuring, when anecdotally you’re aware of this ‘code of silence’ around warning signs."
Coxe experienced that code firsthand. Wheaton College coaches asked her not to tell classmates about the injury, let alone go to the media.
Holtsclaw sees a groundswell of recognition around the hazards of cheerleading, along with fewer uncertified coaches than ever. But stretched state and local budgets might prevent athletic associations from implementing widespread training and regulations.
For Cassamasima, who started cheering in fourth grade, the risk of another concussion is worth the thrill of conquering a new athletic challenge. “They don’t scare me,” she said of the aerial maneuvers that caused her injury, “I’m back to doing those same stunts, and I’m getting even better.”
Tracey doesn’t attend her daughter’s games, because she can’t watch without cringing. “I worry, absolutely all the time,” she said. “But any sport would come with risks, and this just happens to be the one she loves.”
The sophomore at Wheaton College in Illinois plunged 8 feet to the concrete floor of the gymnasium. She landed on her head.
“Immediately, my ears were buzzing and I saw bursts of light,” Coxe, now 23, recalled of her injury. “Never, ever have I been in that much pain.”
As she lay on the ground, coaches handed Coxe an ice pack, called a campus nurse and resumed practice.
“I didn’t make it to the emergency room until two hours later,” Coxe said. There, she was diagnosed with a grade 3 concussion — the most severe classification.
Concern over the long-term dangers of sports-induced concussions has amplified in recent years, thanks to high-profile studies on brain injuries and testimonials of former athletes, particularly NFL players. Lifelong symptoms can include depression, difficulty focusing and early-onset dementia.
But as hundreds of cheerleaders break out their most jaw-dropping moves for March Madness, experts warn that the national discussion has generally skipped over a leading, if unlikely, culprit.
Cheerleading is the fourth most common cause of sports-related concussions in youth, according to a study presented in December at the annual meeting of the American Public Health Association.
Despite eight years as a cheerleader, Coxe had never been warned about the frequency of brain injuries in her chosen sport. Wheaton’s coaches, themselves former cheerleaders, weren’t certified in safety protocol. Elaborate stunts were routinely performed by novice athletes and without padded mats.
Coxe is far from the only young cheerleader whose life changed permanently after a stunt went wrong.
The activity is more popular than ever: 3 million young women participate, and 500,000 — some as young as 5 — enroll in cheering camps each summer. Just 2 percent of cheerleaders are male. Compounding cheering’s brain injury crisis is the fact that females are more vulnerable to concussions.
Take the case of a high school cheerleader who was hospitalized not because of a hard fall, but after being repeatedly bumped by a teammate’s elbow during pyramid routines.
“It was this small bang to the head, over and over and over, that led to a diagnosis of concussion,” recounted Jim Lord, director of the American Association of Cheerleading Coaches and Administrators. “A concussion doesn’t mean you’ve fallen 10 feet onto a gym floor.”
Often difficult to diagnose and treat, concussions afflicted around 400,000 student-athletes last year.
And because concussions tend to be associated with contact sports, the risks are often overlooked among cheerleaders.
Symptoms can be easy to brush off. Difficulty concentrating, headaches, fatigue and irritability might indicate a stressed-out sophomore — or one suffering a traumatic brain injury.
Serious concussions, like Coxe’s, can have life-changing effects.
“It would take an hour to get through two pages of a biology textbook,” she said. “I’d finally finish, and have no idea what I’d just read about.”
Coxe also found herself stuttering, repeating sentences and unable to finish assignments. signments. She was depressed and anxious. Her grades plummeted and she stopped going to class.
Six months of occupational therapy yielded significant improvements, and Coxe graduated with a degree in psychology last spring. Still, she suffers chronic head, jaw and arm pain.
“I have scarring in my brain,” she said. “My brain actually degraded a bit.”
She’s far from alone in navigating the long-term neurological effects of a cheering injury.
“If I laugh too hard, the back of my skull will start to burn, and I hear high-pitched ringing noises once a week or so,” Amy Davis, now 29, said of symptoms that persist nearly a decade after she suffered a concussion as a student at Weber State University.
Doctors anticipate that both symptoms are permanent.
Between 1982 and 2007, cheerleading caused 65 percent of serious sports injuries among high school females and 67 percent among college females, according to a report released in 2008 by the National Center for Catastrophic Sports Injury Research.
That’s not to say that adults charged with cheerleader safety have stood idly on the sidelines: Leaders at the AACCA have been hustling to tighten regulations since the start of the decade, when reports of serious, widespread injury first trickled out.
The NCAA unveiled new regulations in 2006, including mandatory training for coaches, an array of safety rules created by the AACCA, and an anonymous Web forum for cheerleaders to report unsafe coaching.
While dramatically reducing life-threatening injuries among college cheerleaders, the new safety measures are far from perfect. Most school teams rely on self-reported symptoms, while others use a computerized diagnostic test with a high rate of false positives.
Safety standards for high school cheerleaders continue to be much less well-defined.
Sydney Cassamasima, a 14-year-old in East Brunswick, N.J., fell headfirst onto a running track at a school football game in October.
“I had to substitute for a teammate, and I didn’t know the stunt,” she said of the one-legged flying twist that caused her injury. “The person behind didn’t catch me.”
School officials didn’t call an ambulance, so Cassamasima was driven to a hospital by a family friend.
“She shouldn’t have stood up, or been touched, or allowed into a car,” said Cassamasima’s mom, Tracey. “The doctors at the hospital were absolutely fuming.”
Currently, only 12 states mandate safety training for high school cheerleading coaches.
The national cheerleading association has banned a handful of stunts that pose particularly high risks, but “there’s no referee, no police, no penalty,” said Gwen Holtsclaw, founder of the National Council of Spirit Safety and Education.
Lord, director of the cheerleading association, has said more states will institute safety training and formal protocol, with one major exception. “California is a death zone for cheerleading injuries,” he said.
“Without question, injuries are underreported across the board,” Lord said. “Promising statistics are only so reassuring, when anecdotally you’re aware of this ‘code of silence’ around warning signs."
Coxe experienced that code firsthand. Wheaton College coaches asked her not to tell classmates about the injury, let alone go to the media.
Holtsclaw sees a groundswell of recognition around the hazards of cheerleading, along with fewer uncertified coaches than ever. But stretched state and local budgets might prevent athletic associations from implementing widespread training and regulations.
For Cassamasima, who started cheering in fourth grade, the risk of another concussion is worth the thrill of conquering a new athletic challenge. “They don’t scare me,” she said of the aerial maneuvers that caused her injury, “I’m back to doing those same stunts, and I’m getting even better.”
Tracey doesn’t attend her daughter’s games, because she can’t watch without cringing. “I worry, absolutely all the time,” she said. “But any sport would come with risks, and this just happens to be the one she loves.”
