"At the high school level, cheerleading is a very varied event," said Comstock.
She noted that in some high schools, the cheerleaders serve as a pep squad, while in others they do the same flips and jumps one might expect in a gymnastics routine.
But while gymnasts may do their acrobatics on a mat, "[cheereladers] frequently perform those types of activities in settings that place them at higher risk than gymnasts," said Comstock.
Additionally, while gymnastics is a solo event, cheerleading has more than one person involved.
"You also have the possibility of person to person contact," said Comstock. "The vast majority of high school sports-related injuries occur in player to player contact."
Kim England, founder of Energized Athletics, agrees that cheerleading is a team sport where more than one person is involved.
"The hardest thing about cheerleading is that they're needed for every piece for that routine," said England, as opposed to other sports where another player from the bench is ready to replace someone who's injured. In cheerleading, when an athlete gets a sprained finger or hurt in some other way, there isn't anyone readily available to take over their position, and so when that happens, a routine may be unperformable until the team member recovers.
England's daughter, Samantha England, has been cheerleading for about 10 years and cheers and coaches for Energized Athletics, as well as cheering for Watertown High School. She has suffered a cyst in her wrist as a result of over-tumbling, as well as floating knee caps.
Samantha has seen her fellow cheerleaders endure the occasional sprained wrist which also occurs due to over-tumbling. However, she insisted that the occurence of injuries during a group stunt is minimized through a group effort.
"If we're doing a stunt, the girl [who's thrown in the air] is caught before she hits the mat," said Samatha. "The basers always catch her."
To prevent injuries from appearing on their team, Dwayne Harmon, all-star director of the Energized All-Star cheerleading team, said that he uses proper progression to teach the girls and boys on his squad. According to Harmon, proper progression involves "teaching the basic fundamentals" before having the cheerleaders try out complicated tricks and stunts.
Also, the skill level of a cheerleader has bearing on the type of injuries they get.
"The higher level of skill [of a cheerleader], the more risk that comes in," said Dannie Halloran, cheerleader for Energized Athletics ad cheerleading coach for Cambridge Ringe and Latin High School in Cambridge, Mass.
For that reason, Mueller believes that better regulation could make the sport safer. "If you look at cheerleading, [the injuries] probably can be reduced," he said.
Despite the high injury rate in cheerleading, Kim England believes the benefits heavily outweigh the risks.
"I got Samantha to cheer for academic reasons, since you need certain grades to continue cheering," England noted. "It's great for fitness [and] keeps her out of trouble. [Also], just to see the bonding and how excited [the cheerleaders] are is amazing."
Halloran agrees with England on the benefits of cheerleading.
"It's an amazing sport to get into," added Halloran. "Not only are you learning great discipline on a mat, putting a routine, but it's a great sport of socialization where you meet great people with the same ambition and get to work on the same goals."