U can hold me, u can luv me,

u can kiss me, and u can touch me,

but don't u dare say cheerleading is not a sport!!!

-- From Cheerleading Quotes, by Allie, NJ

At its annual meeting last week, the American Medical Association (AMA) approved designating cheerleading as an official school sport. An official statement said: "The AMA recognizes the potential dangers now associated with cheerleading and believes steps should be taken to ensure the health and safety of individuals who participate in the time-honored tradition."

The AMA hopes to persuade state high school associations and the National Collegiate Athletic Association (NCAA) to make that official declaration so that cheerleading practitioners can "benefit from the same robust safety protocols as other designated sports, including properly trained coaches and adherence to rules for the proper execution of stunts."

Many of us born in the prior century may not automatically equate "cheerleaders" with "athletes," or "cheerleading" with "sport." We grew up regarding cheerleaders as an elite social class of popular and pretty girls -- not a muscular group of revered athletes.


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In fact, in general, it was usually unpopular to be athletic, and female athletes were often derided as "un-lady-like" or "tomboys." Besides, schools didn't routinely provide athletics programs for girls until forced to do so in 1972 with passage of Title IX -- a federal law requiring equal educational and athletic opportunities for men and women.

According to the National Women's Law Center, before Title IX only one in 27 girls played high school sports, college sports scholarships for female athletes were virtually nonexistent, and female athletes overall received a mere 2 percent allocation of college athletics budgets.

Thankfully, times changed. Female athletes now have a sporting chance on the field, in academic opportunities, and in society generally.

Indeed, today's cheerleaders are often full-fledged acrobats and gymnasts. They fly, they tumble, they jump and rumble. They may perform risky athletic routines that demand significant physical strength and coordination. They form human pyramids, fling one another into the stratosphere.

As the diverse and creative athleticism of cheerleading broadened, so did cheerleading's popularity. By 2003 there were more than 3.6 million cheerleaders nationwide, aged 6 and up. And a 2009 survey estimated there were about 400,000 cheerleaders in U.S. high schools -- 96 percent of them girls.

Clearly, modern competitive cheer has evolved into a demanding athletic sport with increasing appeal to students at all academic levels. Consequently, as might be expected, we've also witnessed greater numbers of cheerleading injuries over the last three decades.

And yet, data concerning those injuries remain appallingly scant -- scouring current medical literature provides several anecdotal reports and poorly conducted surveys, but few substantive studies. But that's not surprising when no one's been required to document or report cheer injuries -- a situation that would change if the NCAA were to designate cheer as an official sport.

Obviously, our paucity of data regarding cheer safety stymies our ability to make it any safer. As succinctly stated on CheerSafe.org: "Only in recent years has cheerleading been included in epidemiological studies that properly use participation and exposure data to help determine the actual risks involved in cheerleading as well as provide a detailed analysis that safety experts and rules-writing bodies can use to help minimize risk."

That's why I'm wary of anyone claiming to know the actual score about cheer safety and risk. Additionally, it's evident that cheerleaders -- like other athletes -- sometimes underreport their own injuries for a variety of reasons.

Still, solid evidence reveals that cheerleaders are no strangers to musculoskeletal injuries, especially ankle sprains. And hard data from the U.S. Consumer Product Safety Commission reveals that cheerleading injuries accounted for more than 36,000 hospital emergency room visits in 2010. That same year, cheerleading head injuries were associated with 1,579 concussions, 361 contusions, and 2,292 internal injuries, while neck injuries included 60 fractures and 79 contusions.

In response to burgeoning concerns about the health and well-being of cheer practitioners, the American Academy of Pediatrics (AAP) in 2012 forcefully recommended that cheerleading be designated as a sport. It reasoned that by doing so, cheerleaders would be supervised and protected under more formal safety rules, with improved access to certified trainers and qualified coaches.

Additionally, the AAP wisely recommended that cheerleaders with head injuries be required to obtain medical clearance before returning to practice or competition.

Designating cheerleading as an official sport means that coaches would have to undergo safety training and certification -- as they do for football or baseball. Cheerleaders would benefit from clear and standardized safety protocols, more routine relationships with athletic trainers and team physicians, and greater access to well-maintained and staffed practice facilities.

And all the while, due to mandated reporting of cheer injuries, we'd come to know precisely what must be done to make cheerleading as safe as it can -- and should -- be. To all of that I say: Yea safety! Go safety! Let's go-o-o safety!!

Lastly, placing cheerleading under an athletic department would provide cheerleaders with additional off-the-field benefits assumed in other sports -- including better institutional and academic support, and enhanced opportunities for athletic scholarship.

With 35 states and prominent medical organizations standing up for student safety, it's past due for the NCAA to take a national leadership position by including competitive cheerleading on its list of sponsored sports.

Kate Scannell is a Bay Area physician and the author, most recently, of the novel "Flood Stage."