For Bethany Hancock, senior year of high school was supposed to be filled with memorable events, events that would cap her four years as a cheerleader at Eastmoor Academy in Columbus, Ohio.
But instead of rooting the school's teams to victory, the teenager spent most of the year in and out of the hospital recovering from two surgeries to repair torn ligaments in both of her knees. She was injured when she landed awkwardly on a marble floor while practicing a difficult jump in a school hallway.
"It was the worst pain ever," recalled Hancock, 19. "I bounced off the floor and I could feel shock waves run up my legs, and I lay there and screamed."
Hancock is one of the estimated 16,000 cheerleaders injured seriously every year in accidents involving dramatic stunts and tumbles. Sports medicine researchers at Columbus Children's Hospital warn that the sport has become much more dangerous in the last two decades. In a study published in the January issue of the journal Pediatrics, the authors conclude the number of emergency room visits for cheerleaders between the ages of 5 and 18 increased 110 percent from 1990 to 2002.
"Cheerleading is an important source of injury for girls ... . These injuries doubled during the 13-year period we studied," said Brenda Shields, research coordinator at the Center for Injury Research and Policy at Columbus Children's Hospital.
In the first national analysis of its kind, Shields and her colleagues examined the cases of 209,000 children treated in emergency rooms, as recorded by the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System. They found the increasing emphasis on daring gymnastics and high-flying acrobatics has made cheerleading much more athletically demanding and risky in recent years.
"Ten or 15 years ago, they were basically standing leading cheers on the sidelines. They weren't throwing each other up in the air, and they weren't forming tall pyramids. The injuries that can result are severe," Shields explained.
Researchers have found that the most common injuries among young cheerleaders were strains and sprains, which make up 52 percent of cheerleading injuries. Bruising, fractures, cuts and concussions are also reported, but to a lesser extent.
Hancock, now a freshman at Ohio State University, said she and her cheer team often endured painful wounds.
"I've gotten kicked in the face. I've gotten elbowed in the mouth," she recalled.
But after tearing her anterior cruciate ligaments on that fateful day two summers ago, Hancock had to give up her dreams of cheerleading at the college level. She can no longer play soccer or go for a run, and she says her knees still shake when she takes the stairs.
The Columbus researchers theorize that more injuries like Hancock's could be prevented with better training for coaches and more supervision.
"A set of universally enforced rules and regulations directed at increasing the safety of cheerleading should be implemented," argued Shields. She and her fellow researchers have called on schools to mandate a safety and certification program for all cheerleading coaches. Shields also believes many cheerleaders are practicing in places that are not adequately equipped with mats and other safety gear.
Hancock looks back on her experience with nostalgia and a bit of regret. "I really loved cheerleading. Maybe if anyone had been more aware of what was happening and had been more knowledgeable, then maybe it [my injury] wouldn't have happened. And it would have saved me two surgeries, scars on my legs and missing out," she said, as she reflected on a very different final year of high school than the one she had planned.