A group of U.S. pediatricians on Monday recommended that cheerleading be designated an official sport, mainly to help prevent injuries, which the doctors say can be catastrophic.

Some of the group's other recommendations include requiring cheerleaders to pass pre-season physicals, to have access to strength and conditioning coaches and to be removed from competing or performing if they have a head injury.

"We felt that there needed to be some guidelines out there on how to make it safer for these girls," said Dr. Cynthia LaBella, co-author of the recommendations that were issued by the American Academy of Pediatrics (AAP).

Girls make up 96 percent of an estimated 3.6 million cheerleaders over the age of six in the U.S. In high school alone, there were 400,000 cheerleaders in 2009, according to the policy statement.

In the realm of high school athletics, cheerleading accounts for less than 1 injury per 1,000 "athletic exposures" in girls, according to the AAP. That's far less than the 8.5 injuries per 1,000 exposures for gymnastics or the 5.3 per 1,000 exposures for soccer.

However, research has shown that cheerleaders are at a disproportionately high risk for catastrophic injuries, which include skull fractures and spine injuries.

According to the AAP, cheerleading accounted for 65 percent of all catastrophic injuries in high school girl athletes and about 71 percent in college women between 1982 and 2009.

"In many states and at the college level, cheerleading isn't officially recognized as a sport. And because of that there are quite a few safety mechanisms they miss out on," said LaBella, an associate professor at Northwestern University's Feinberg School of Medicine in Chicago.

Those safety mechanisms, according to the AAP, include access to trainers and medical care, better facilities and practice times and certified coaches.

Currently, 29 U.S. states recognize cheerleading as a high school sport. The National Collegiate Athletic Association, however, does not recognize it as a sport at the college level.

"The reason we promote having all the states recognizing it as a sport is because it would be a simple way to provide these services for the cheerleaders," said LaBella.


"Most of this is actually stuff we've recommended for quite a while," said Jim Lord, executive director of the American Association of Cheerleading Coaches and Administrators (AACCA) in Memphis.

But Lord told Reuters Health there are sticking points.

Specifically, he does not think cheerleading should be designated a sport because many cheerleaders don't compete on a regular basis, and some states or organizations may require that.

"Regardless of the term, we have to get to the point where they are treated like athletes and it's seen as an athletic activity," he added.

Another sticking point was the AAP's recommendation that pyramids or stunts only be performed on foam or spring floors, which Lord said may interfere with a cheerleader's balance.

"That would actually increase injuries dramatically," he said.

But both Lord and LaBella told Reuters Health that there shouldn't be any problem solving those disagreements.

"We have (the cheerleaders') safety in mind and we know AACCA also has their safety in mind. I think those are easy things to come to agreement on," said LaBella.

"We realize there are some political issues that may not work in every state with these recommendations, but even if cheerleading is not recognized as a sport, there are ways that schools and state organizations can provide these safety mechanisms for them," she added.

The recommendations were published in the journal Pediatrics to coincide with a presentation at AAP's national conference in New Orleans.