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Cheering for concussion awareness

Concussion awareness continues to be an important component of any youth sports or program activity. Knowing how concussions occur, signs and symptoms, along with precautionary steps, your program can take are vital to a successful concussion management program. Most often, concussions are associated with contact sports such as football, soccer, and basketball. 

Cheer programs also have concussion exposures.

Results of a study provided by the University of Pennsylvania Medical Center (UPMS) found that 78.8% of all cheerleading injuries occurred during practice and that a majority of injuries, approximately 31.1%, involve concussions. The study further identified that the largest proportion of concussion injuries involved:

  • Stunts (69%)
  • Pyramids (15.7%)
  • Tumbling (9.1%)
  • Other (6.2%)

The positions most susceptible to concussions involve:

  • Bases (45.5%)
  • Flyers (36%)
  • Spotters (9.8 %)
  • Other (8.6%)

Finally, the study also found that the most common ways to get a concussion during cheerleading involved:

  • Contact with the playing surface (37.9%)
  • Contact with another person (58.9%). Contact with another person was due to impacts with the other person’s elbow, head, and foot.

Tips for concussion prevention in cheerleading

To recognize if someone suffered a concussion, it is important to understand what is involved. According to the Centers for Disease Control and Prevention (CDC), a concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

As referenced previously, during cheerleading, a concussion can occur because of a fall to a hard underlying surface such as a playing surface, a floor, asphalt, concrete, dirt, and grass. If you desire to practice outside because the weather is nice, it is important to know that the American Society for Testing and Materials (ASTM) has determined that grass and dirt are not proper impact attenuating surfaces to reduce the likelihood of major head trauma.  Therefore, it is recommended that if you do practice elevated stunts or tumbling outdoors, you do so on surfaces that provide adequate fall protection. These include any material tested to ASTM F1292 Standard Specification for Impact Attenuation of Surface Systems Under and Around Playground Equipment such as pea gravel, sand, shredded/recycled rubber mulch, wood mulch, and wood chips. Minimum depth guidelines for these surfaces call for a minimum depth of 9 inches. Impact attenuating gym mats may be used as an alternative, but need to be properly anchored to reduce their movement.

Along with the use of proper matting in a gym setting, you can help reduce the likelihood of a participant experiencing head trauma through proper spotting and safe landing techniques. According to the American Association of Cheerleading Coaches & Administrators, guidelines for spotting in partner stunts and pyramids should include the following:

  1. Always remember that protection of the performer's head, neck and back is the prime safety consideration.
  2. The spotter (s) should be in constant contact with the person being spotted and in a position to break a potential fall and/or catch the performer at any time.
  3. The spotter (s) should stay directly next to the person being spotted. It is easier and more natural to reach up and catch the performer when the spotter is already in the appropriate position and doesn’t have to move in.
  4. “Hands-up” – If the nature of the skill precludes touching the performer initially, the spotter should stand as close to the base as is appropriate, reach up as high as possible toward the performer, and maintain constant visual contact.
  5. The spotter(s) should attempt to catch the performer as soon as is mechanically possible. This will afford them a greater distance through which to apply their stopping force and result in a more effective spot.
  6. Effective spotting requires an assertive “hands-on” approach. Do not hesitate to grasp the performer quite firmly.
  7. During the actual act of spotting, spotters should use their legs. (i.e., flex ankle, knee, and hip joints) to help absorb the performer’s falling force.
  8. Learn to spot the most basic partner stunts and pyramids before progressing to more advanced skills.
  9. Practice spotting from lower heights first and ensure consistent, effective spotting before moving to progressively higher regions.
  10. Make every attempt to anticipate the spot (i.e., a common tendency is being too late in providing the necessary spot).

If you suspect a child (or teenager) has experienced an event that may have caused a concussion, discontinue his/her activities immediately, and contact his/her parent(s) or guardian. Do not allow the person to return to participation until a medical professional has provided an “all clear” to do so.


  • “Be Captain of Your Health Squad: Facts About Cheerleading and Concussions.” 2017. University of Pittsburgh Medical Center.
  • ASTM F1292-18, Standard Specification for Impact Attenuation of Surfacing Materials Within the Use Zone of Playground Equipment, ASTM International, West Conshohocken, PA, 2018,
  • George, Gerald S. AACCA Cheerleading Safety Manual. The UCA Publications Department. Memphis, Tennessee. Revised Edition 2006.