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What is the World’s Most Dangerous Sport?
(We Bet You’ll NEVER Guess)

© 2022 Health Realizations, Inc. Update


During a period of over 28 years, there were reported over 1,100 catastrophic injuries in high school and college sports, which includes any severe or fatal injury that occurred while participating in the sport. Not including the numbers of many grade school children 1st - 8th grades.

Yet, a great portion of those injuries did not occur during a football, hockey, wrestling or any other type of contact sport, like you might suspect. They did not all occur during a baseball, soccer or basketball game either.

As it turns out, according to the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill, which recently released its 26th annual report on the topic, the sport that causes more serious and deadly injuries among women than any other sport is … cheerleading.

In all, spanning a period of past 26 years, there were 152 fatalities, 379 non-fatal injuries and 374 serious injuries among high school sports, and 22 fatalities, 63 non-fatal injuries and 126 serious injuries among college sports.

Of these, cheerleading accounted for a whopping 65 percent of high school, and 71 percent of college, catastrophic sports injuries among females.

"What's staggering, really, is that the single most dangerous activity in sports in schools is to be a flier [the person thrown into the air during a stunt] in cheerleading," Dr. Robert C. Cantu, clinical professor of neurosurgery at Boston University School of Medicine and chairman of Emerson Hospital's department of surgery, told The Boston Globe. "The chance for catastrophic injury is exponentially higher than for any other sports activity."

Why is Cheerleading So Dangerous?

Decades ago, cheerleading was largely made up of shaking pom-poms, catchy chants and dance moves. Today, cheerleading routines regularly involve tossing teammates 10-20 feet into the air, performing complicated flips and gymnastic moves.

Yet, although cheerleaders use a high level of athletic ability, cheerleading is still not considered a sport by the majority of schools.

Because of this, it is not subject to the same safety regulations as other sports, like football. Meanwhile, cheerleading squads can exist without coaches or with coaches who have no safety certifications or training. Some schools also do not have the proper equipment or space for cheerleaders to practice safely.

"Modern cheerleading mostly closely resembles the sport of gymnastics, only without the mat and safety regulations," state Representative Peter J. Koutoujian, who filed a bill this year to create a committee to help make cheerleading less dangerous, said in The Boston Globe. "These are serious athletes that literally risk their necks to perform high-level stunts."

Is Cheerleading Getting Safer?

The obvious risks involved have not put a damper on cheerleading participation; there are an estimated 3 million cheerleaders in the United States alone. Fortunately, with participation growing the American Association of Cheerleading Coaches & Administrators (AACCA) points out that cheerleading safety standards are getting more stringent. They say:

  • The NCAA’s insurance company, which used to have 25 percent of its claims coming from cheer injuries, has not had a catastrophic injury claim since 2006, when the NCAA started required coaches to get safety training.

  • Emergency room visits among cheerleaders, which had been increasing every year, have leveled off in the last five years and even declined in some years, according to a National Electronic Injury Surveillance System survey by the Consumer Products Safety Commission.

  • Currently, 13 states require training for its high school cheerleading coaches, and many more offer the AACCA safety course at coaches’ conferences.

  • In 2006, AACCA banned basket tosses and 2 1/2 high pyramids from the basketball court for college cheerleading and basket tosses for high school (high school teams are already limited to two persons high for all skills).

  • In 2008, AACCA restricted the use of twisting dismounts and other skills.

What to Watch Out for if Your Child Has Had a Head Injury-Symptoms Complaints of Dizziness or vertigo?

If your child has a head injury while cheerleading, in gym class or during another activity, you should immediately see your doctor who is trained in current concussion protocols & identification. Even if it appears mild, the full extent of a head injury may not develop for days, so you should continue to watch closely for symptoms.

These are symptoms to watch for following a blow to the head:

  • Irritability

  • Depression

  • Problems concentrating

  • Memory loss

  • Difficulty collecting thoughts

  • Trouble walking (balance)

  • Trouble sleeping

  • Dilated pupils

  • Drainage of blood or clear fluids from nose or ears

  • Weakness or numbness in limbs

  • Headaches

  • Lethargy

  • Balance

  • Nausea

  • Fatigue

  • Bad tast in mouth

  • Slurred speech

  • Rining in ears

  • Neck pain

  • Anxiety

If you notice any of these symptoms seek medical help immediately. Further, do not let your child participate in sports if they are showing signs of a head injury.

As for why high school players have a higher rate of catastrophic injury, the researchers suggested younger brains may be more susceptible to injury. Further, there are not as many team physicians on the high school level as the college level, which means it could be that high school athletes are not being properly evaluated or receiving the proper medical attention following an injury, said Barry P. Boden, M.D., from the Orthopedic Center in Rockville, Md., and adjunct associate professor at the Uniform Services University of the Health Science in Bethesda, Md., in Science Daily.

"Having more team physicians for high school and younger sports teams who have training in current concussion protocols and management may prevent long-term consequences and improve healthy return to play levels appropriately", stated Dr. Michael K. Bagnell, Fellow of the American Board of Brain Injury Rehabilitation.

Why Some Experts State: "If Your Child Has a Concussion or Other Head Injury! Do NOT let them continue participating!"

"The single most important piece of advice that I can give is to never let an athlete play football if he has any neurological symptoms whatsoever,” Dr. Boden told Science Daily. This could include amnesia, dizziness, headache, irritability, personality changes or any of the signs listed above.

Cheerleading often like football are a very tough sports. Athletes are taught to continue participating through pain. Dr. Boden continued. "Concussions need to be taken seriously. Many of them are probably being overlooked at the high school level. These injured athletes are allowed to return to play before full recovery, leaving them susceptible to a more significant injury."

Highly Prevalent! Not Just Cheerleading and other Sports!

More than 42 percent of Americans experience dizziness or vertigo during their lifetimes. Many suffer in silence, assuming there is nothing that can be done for the disarming feeling of spinning or falling off balance.

However, in about 20-50 percent of cases dizziness is actually caused by a disorder that’s incredibly easy, and fast, to treat -- once it’s diagnosed. If you or your child currently struggle with dizziness, you owe it to yourself to explore this condition, as it’s actually one of the most common causes of vertigo there is.

What is Benign Paroxysmal Positional Vertigo (BPVV)?

BPPV causes mild to intense dizziness, which is often triggered by changing the position of your head (specifically, tipping your head up or down or lying down, turning over or sitting up in bed). Along with feelings of dizziness, you may also experience spinning sensations (vertigo), loss of balance, blurred vision, unsteadiness, nausea and vomiting. Abnormal rhythmic eye movements, or jumping of the eyes, are also common along with BPPV symptoms.

The Epley Maneuver: A Simple Treatment

A surgical procedure that involves using a bone plug to block a portion of your inner ear is sometimes recommended to treat BPPV, but make sure you do not consent to this treatment until your physician has tried a canalith repositioning procedure known as the Epley maneuver. As the Mayo Clinic states:

“Performed in your doctor's office, the canalith repositioning procedure consists of several simple and slow maneuvers for positioning your head.

The goal is to move particles from the fluid-filled semicircular canals of your inner ear into a tiny bag-like open area (vestibule) that houses one of the otolith organs (utricle) in your ear where these particles don't cause trouble and are more easily reabsorbed.

Each position is held for about 30 seconds after any symptoms or abnormal eye movements stop. This procedure is usually effective after one or two treatments.”

The Epley maneuver takes just 15 minutes for your physician to perform and may offer you relief to a problem that's been plaguing you for years. A recent study published in the journal Physical Therapy even found that the odds of resolving BPPV were 22 times higher among those receiving the canalith repositioning procedure than in people receiving a sham treatment.

Identifying Symptoms

"Symptoms of BPPV are almost always precipitated by a change in head position. Getting out of bed and rolling over in bed are two common "problem" motions. Some people feel dizzy and unsteady when they tip their heads back to look up. An intermittent pattern of these symptoms is usual," states the Vestibular Disorders Association (VEDA).

Because of this, some people with BPPV avoid certain movements and positions for years at a time, not realizing that there is a simple remedy in sight. Lisa Dransfield, director of physical therapy at the Balance and Vestibular Center at Associated Neurologists Physical Therapy in Connecticut tells NewsTimes:

"There are people who come to see me and say they haven't turned their head in a certain direction for ten years or more. The sad thing is many have learned to adapt to this by driving without turning their head, not reaching for things, and not rolling onto their side in bed.

Their world becomes very small and limited, and they increase their risk of getting into accident."

Another consideration for brain trauma recovery is BrainTap RX relaxation

What Causes BPPV?

Structures in your inner ear contain calcium carbonate crystals (sometimes called "ear rocks") that help you perceive movement and gravity. If these crystals become dislodged, they can bounce around your inner ear canals, leading to feelings of spinning, imbalance and vomiting.

BPPV can occur with no known cause, especially in older people, however it is often associated with a head injury. According to VEDA, "The most common cause of BPPV in people under age 50 is head injury." Head injuries that occur from falls, playing sports, car accidents and any other cause may contribute to BPPV.

It is also associated with migraines and viruses of the ear, and any disorder that impacts the balance organs of your ear can also increase your risk of BPPV. The condition has also been occasionally reported following dental or inner ear surgery.

Before an Epley treatment it highly recommended to purchase and bring a padded neck brace to wear immediately following treatment for 24 hours as it is important to not drop your head looking down following treatment as often that will reverse the treatment retuning BPPV symptoms.

The Epley maneuver takes as little as just 15 minutes for your physician to perform and may offer you relief to a problem that's been plaguing you for years. A recent study published in the journal Physical Therapy even found that the odds of resolving BPPV were 22 times higher among those receiving the canalith repositioning procedure than in people receiving a sham treatment.

Following the treatment, your physician will give you home-care instructions to follow. Generally, your ear must not move below shoulder level for the rest of the day, and you cannot lie flat. When you sleep you will need to elevate your head on several pillows or sleep in a recliner.

Again Dr. Bagnell stated "One of the best parts about the Epley maneuver is that your physician can teach you how to do home exercises, so you’ll likely be able to reduce or even possibly correct the problem yourself at home should it reoccur."

Do you know any seniors that complain about being dizzy or vertigo?

Many seniors experience head injuries and live with BPPV dizziness resulting in a poor quality of life condition that can cause dangerous falls and further injuries that are preventable.

If you know of a friend or family member who has complained of unexplained vertigo and dizziness, by forwarding this article on to them you have the power of helping to potentially eliminate their suffering, dramatically changing their lives.

By seeing a health care practitioner who is knowledgeable about BPPV and trained in the Epley maneuver, you may well be able to find relief from chronic dizziness in as little as 15 minutes.

Tips to Reduce the Risk of Head Injury for Cheerleaers and Other Sports Activities

High-quality protective gear, including properly fitted helmets, mouth guards and padding, can help prevent athletes from sustaining sometimes deadly head injuries, however that is only a starting point.

The National Center for Catastrophic Injury Research has compiled the following nine tips for reducing the risk of head and neck injuries among cheerleaders and football players:

  1. Athletes must be given proper conditioning exercises that will strengthen their necks so that participants will be able to hold their heads firmly erect when making contact.

  2. Coaches should drill the athletes in the proper execution of the fundamental football skills, particularly blocking and tackling. Contact should always be made with the head-up and never with the top of the head/helmet. Initial contact should never be made with the head/helmet or facemask.

  3. Coaches and officials should discourage the players from using their heads as battering rams when blocking and tackling. The rules prohibiting spearing should be enforced in practice and in games. The players should be taught to respect the helmet as a protective device and that the helmet should not be used as a weapon.

  4. All coaches, physicians, and trainers should take special care to see that the cheerleaders and player's equipment is properly fitted, particularly the helmet.

  5. When a cheerleader or football player has experienced or shown signs of head trauma (loss of consciousness, visual disturbances, headache, inability to walk correctly, obvious disorientation, memory loss), he should receive immediate medical attention and should not be allowed to return to practice or game without permission from a physician.

  6. A number of the football players associated with brain trauma complained of headaches or had a previous concussion prior to their deaths. The team physician, athletic trainer, or coach should make players aware of these signs. Players should also be encouraged to inform the team physician, athletic trainer, or coach if they are experiencing any of the above mentioned signs of brain trauma.

  7. Coaches should never make the decision whether a cheerleader or player returns to a game or active participation in a practice if that player experiences brain trauma.

  8. The National Federation of State High School Associations stated in a concussion management recommendation the following: no athlete should return to play the same day of a concussion and must receive clearance from a medical professional before resuming practice or games.

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports in a December 2009 meeting recommended that an athlete would be sidelined for at least the rest of the day if he/she loses consciousness or shows other worrisome symptoms during competition.

The panel also recommended sidelining an athlete with less severe concussion-related symptoms until cleared by a doctor.

A major concern is second impact syndrome where an athlete who has not recovered from a concussion is returned to play and receives another severe hit. This situation most often results in death.

  1. Cheerleading coaches should pull cheerleaders out at any sign of a possible head injury and football officials (referees) should call all illegal helmet contact in games. The sooner the better for the child. In football if they call all illegal helmet contact the number of concussions and catastrophic injuries may be reduced. Coaches will no longer teach improper techniques and players will no longer use their helmeted heads if they know a penalty will be called. At the present time officials are not calling all illegal helmet contact.

On a whole-body level, players should also put serious attention to stretching and strengthening their mind and body with the same programs many professional football players use to minimize injuries to their bodies.

According to the President's Council on Physical Fitness & Sports:

  • Stretching is known to relax the muscle and has been advocated for the treatment of various muscle problems.

  • Static stretching is clearly indicated and commonly used for the acute relief of muscle cramps.

  • Stretching is commonly practiced to relieve symptoms of delayed-onset muscle soreness (DOMS).

A Sound, Peaceful Night's Sleep is Also a Crucial Element of Safe Sports Performance.

Researchers at Stanford University found college basketball players who got some extra sleep were able to decrease their sprint times and increase their average free throw percentage. They also reported increased energy and improved mood during their games and practices. What's more, getting extra sleep for as little as two weeks was enough to significantly improve the players' athletic performance.

Power Nap
Studies have found that 20 minutes is just the riht amount of time to de-stress — sleep to much longer and you could end up feeling groggy.

Five Important Cheerleading Safety Tips

If you are a parent with son or daughter in cheerleading, follow these tips to make sure he or she stays safe:

  1. Find out if the coach is qualified. Your child’s cheerleading coach should be certified by an organization like AACCA.

  1. Skills should be taught in the proper sequence. Skill progression training helps cheerleaders to master foundational skills before they move on to more advanced stunts. Spotters should also be used to help catch the top person in a stunt and protect their head, neck and shoulders.

  1. The practice space should be safe. Foam mats should be on the floor and stunts should not be performed on a basketball court or other hard surface.

  1. Make sure your child doesn’t go beyond their skill limit. Don’t allow your child to perform advanced gymnastics moves unless they have completed supplemental lessons at a certified gymnastics gym.

  1. Find out about the emergency plan. Your child’s cheerleading squad should have an emergency plan in place to help anyone who becomes injured. Talk to your coach about the plan, or insist they put one in place if they haven’t already.

If you are the parent of a high school athlete, please share this important information not only with your child but also with her or his coach and teammates.

As always, knowledge is how to prevent them (which you just learned) and acting on this knowledge (which is up to you) are the main weapons you have in avoiding head injuries.

If you have any concerns or questions you would like to discuss, please contact us for an appointment today.


National Center for Catastrophic Sport Injury Research

National Center for Catastrophic Injury Research, Catastrophic Sport Injury Research 28th Annual Report

The Boston Globe

CrashCourse Concussion Education

New concussion recommendations for kids (AAP)

American Academy of Pediatrics Children Sports-Related Concussions

What’s Causing Your Memory Loss? Concussion care for children and teens: What parents need to know Evaluating MCI (Mild Cognitive Impairment) Are you getting enough B12? How to Improve Your Memory Apolipoprotein e (APOE) ε4 genotype influences memory performance following remote traumatic brain injury in U.S. military service members and veterans

Medical News Today CRT: What is cognitive rehabilitation therapy, and how does it work?

American Academy of Neurology Concussion

Subdural Hematoma

Intensive treatment of blood pressure helps prevent memory decline in older adults

Too little sleep, and too much, affect memory

Headache: When to worry, what to do

Dr. Bernstein's Comments

Important article.  Sad but true.  Cheerleading used to be cartwheels and loudly rooting for your team, (when I was a cheerleader.)  Now there are much higher level acrobatics and formations without safety precautions.  This leads to the risk of serious injuries associated with this sport.

Concussions need to be taken seriously and if the there has been a recent concussion, the person should be closely monitored and not participating in the sport.  A second concussion can be devastating if the first concussion injury is not fully healed.

There are natural treatment approaches that can aid in recovery as well.

For BPPV, the Epley Maneuver can be very helpful and we can refer to a qualified Vestibular Physical Therapist for treatment when indicated.

Let us know how we can be of best support.

Please Note: Above comment statements are not written by Health Realizations, Inc. nor the opinion of

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