Seeking State and National Safety Standards for Competitive Cheer

By Terry Zeigler, EdD, ATC 

Until improved safety regulations for competitive and sideline cheerleading are in place, parents need to take a stand and advocate for change. Closely approaching the two year anniversary of the death of competitive cheer performer Lauren Chang, has the sport of cheerleading made any progress in becoming safer since her death?

Lauren Chang, a 20 year old competitive cheerleader, died of an injury sustained while performing in a cheer competition in Massachusetts April 14, 2008. She was competing on an all-star competitive team when she was reportedly kicked in the chest while performing a stunt.

Lauren died from bilateral pneumothoraces (two collapsed lungs). This is an injury that takes a tremendous amount of force and is usually seen in car accident victims or those who fall from great heights.

Flyers (usually the smallest cheerleaders who are tossed into the air) are regularly tossed 15 – 20 feet into the air while performing high level technical skills. Apparently, this height was sufficient to incur this type of life-threatening injury.

Lauren’s team was performing on a spring-loaded mat (approved safety regulation) and she had been trained on an all-star team (usually better training and resources available as compared to high school teams). In her case, the safety problem may have been the lack of medical personnel on site at the cheerleading competition.

Shortly after her death, her family “immediately began working with Massachusetts Representative Peter Koutoujian, a co-chair of the Joint Committee on Public Health, on a legislative response that may include the regulation of cheerleading safety practices, a requirement that additional medical personnel be available at events, and/or educating the public on the dangers of cheerleading” (, accessed March 19, 2010).

The goal is to make the sport of cheerleading as safe as possible while still recognizing that the athletes are competing in a high-risk sport and are at risk for injuries. Although the sport of cheer will never be without injuries, can catastrophic injuries be reduced with better safety regulations?

In order to move towards improving safety regulations at the high school level, one possible solution is to move competitive cheerleading teams under athletic departments where the sport could be regulated by state athletic federations.

This simple move would place teams under specific state athletic rules and guidelines with a nationally recognized oversight body to ensure the safety of all of the participants. Although there is a rulebook for high school cheer programs to follow (National Federation of State High School Association’s Spirit Rule Book 2009-2010), there is currently no organized body authorized to bring sanctions against coaches or schools that use illegal stunts in their programs or who stunt on unsafe surfaces (i.e., basket tosses on gym wood floors).

Without state or national oversight, it is up to the individual schools to decide what their programs can and cannot perform. Unfortunately, because competitive cheerleading teams are not under the athletic department (in many cases), the oversight of the cheerleading programs is left to a school administrator (not an athletic director) who may not even be familiar with or understand the safety rules of the sport.

Moving Competitive Cheer Teams under Athletic Departments 

Moving competitive cheer teams under athletic departments is one solution to improving safety in the sport of cheer. One issue that is currently a safety problem in one local high school is access to medical care.

Equal access to medical care should be the right of every high school competitive athlete. High school cheer and dance competitors at a local high school were told that the certified athletic trainer hired to treat athletes on campus was not allowed to treat their injuries.

While athletes on traditional sport teams are evaluated, treated, taped, and provided rehabilitation by this sports medicine professional, cheer and dance athletes are not permitted access to care.

Recognizing competitive cheer teams as a sport would improve safety in a number of ways including:

• Direct oversight of the program within each school by an athletic administrator
• Access to medical care through high school certified athletic trainers
• Oversight of coaches ensuring that they are safety certified, first aid and CPR certified, and experienced in tumbling progressions and spotting techniques

Parents can help advocate safety regulations by becoming familiar with the NFHS Spirit Rulebook and challenging coaches and schools that perform illegal stunts or high risk stunts on hard surfaces. Parents can learn about the proper critical heights as well how to be more proactive in cheer safety in the following article.

Preventing Catastrophic Injuries in Cheerleading 

Some of the basic safety rules commonly broken include:

• Section 10. Article 1.d. “In all tosses: the flyer must not become inverted (shoulders below the waist).”
• Section 10. Article 2. “Basket tosses and other similar multi-base tosses are permitted only on appropriate mats, grass, rubberized and soft-yielding surfaces.”

Sign Up for the SportsMD Newsletter