Creating a cheerleading emergency kit: Preventing and treating common cheer-related illnesses and injuries

Like many others, I enjoy spending time with my children and watching them participate in their sporting events and activities! With two daughters on all-star and school cheerleading teams, it’s difficult not to get caught up in the thrill of seeing them learn new cheerleading and tumbling skills, build confidence and self-esteem both individually and as a team, and perform exhilarating, yet exhausting, routines during a game or competition. However, even as I’m mesmerized and amazed by the extreme, fast-paced tumbling, gravity-defying jumps, and spectacular stunts and basket tosses, I’m always conscious and aware of the risk for potential injuries.  

As cheerleading has evolved from a spirit-leading, sideline activity into a competitive, year-round sport, cheerleading injuries have increased in both number and severity. Unsurprisingly, stunting accounts for 42 percent to 62 percent of all cheerleading injuries, and although flyers may seem to be at highest risk for injury, most injuries occur during basing, spotting and tumbling. Previous injury, higher body mass index, cheering on harder surfaces, and supervision by an inexperienced coach with lower-level training may increase a cheerleader’s risk for injury.    

Overall, sprains and strains are the most common types of injuries (which account for more than half of all cheerleading injuries), followed by abrasions/contusions/hematomas, fractures/dislocations, lacerations/punctures, and concussions/head injuries. However, while at a practice, sporting event or competition, parents should be prepared to care for a wide variety of illnesses and injuries. A “C.H.E.E.R” Emergency Kit should be created to prevent and treat the following cheer-related emergencies:

“C” - Colds/Cough/Congestion:  

Most colds are mild and get better on their own! For cheerleaders, cold symptoms, such as congestion and cough, may cause them to feel more tired, less energetic and dehydrated. Cheerleaders with asthma may also develop worsening cough, wheezing, chest tightness and shortness of breath.  

Be sure to include: 

  • Daily medications for allergies (e.g., Claritin, Zyrtec)
  • Rescue medications for asthma (e.g., Albuterol with spacer) 
  • Over-the-counter nasal saline and cold/cough medications (if older than 6 years of age)
  • Over-the-counter fever-reducing medications (e.g., Tylenol and Ibuprofen)
  • Tissues
  • Hand sanitizer 

Coaches and parents should seek immediate medical care (pediatrician, Texas Children’s Urgent Care, emergency center) for cheerleaders with persistent wheezing, shortness of breath and chest tightness (especially after using multiple albuterol treatments)! 

“H”- Heat-related illnesses:  

During outdoor conditioning and sporting events, cheerleaders are at risk for heat-related illnesses, including heat-cramps (intense muscle pain), heat-exhaustion (headaches, dizziness, nausea/vomiting, muscle weakness), and heat-stroke (confusion, hallucinations, seizures). Heat-related illnesses can be prevented with acclimatization, adequate hydration, cool and light-colored clothing, and environmental awareness and schedule flexibility.  

Be sure to include: 

  • Cold water and/or sports drinks (Avoid caffeinated/energy drinks!)
  • Loose/light colored clothing 
  • Spray bottle and hand-held fan 

Heat stroke is a medical emergency! Coaches and parents should call 911 and seek medical care at the closest pediatric emergency center for cheerleaders with hallucinations, loss of consciousness, persistent nausea/vomiting, and/or seizures!

“E”- Eye illnesses/injuries:    

Eye problems can be caused by an allergy (e.g., pollen, dust), irritation (e.g., makeup, hair spray) or trauma (e.g., direct injury to the eye).      

Be sure to include: 

  • Makeup remover 
  • Eye irrigation solution and sterile eye cup
  • Lubricating eye drops (e.g., Visine, Blink Tears)
  • Contact solution and glasses 

Coaches and parents should seek immediate medical care (pediatrician/ophthalmology clinic, urgent care clinic, emergency center) for cheerleaders with significant/persistent eye pain, swelling, redness and drainage! However, cheerleaders with abnormal eye appearance or movement, impaired or double vision, or persistent bleeding should be immediately evaluated in an emergency center.   

“E”- Extremity injuries:

Extremity injuries include sprains, strains, fractures and dislocations. Younger cheerleaders (5- to 11-year-olds) are 1.6 times more likely to suffer a fracture or dislocation compared with older cheerleaders (12- to 18-year-olds), and older cheerleaders are 1.2 times more likely to suffer a sprain or strain than are younger cheerleaders.

Be sure to include: 

  • Cold pack/compress – applied directly to the skin for 20 minutes
  • Elastic (ACE) bandage/splint
  • Over-the-counter, pain-relieving medications (e.g., Tylenol and Ibuprofen)

Most sprains and strains can be treated with R.I.C.E.M (Rest, Ice, Compression, Elevation and Medication/Motrin) therapy. However, coaches and parents should call 911 and go to the closest emergency center for cheerleaders with deformed/angulated injuries, color/temperature changes (pale, blue/purple, cold), or numbness/tingling!

“R”- Rashes:

Cheerleaders can suffer from a wide variety of skin problems and injuries, including burns (heat rashes, sunburns and thermal burns), hives/allergic reactions, eczema, insect bites, lacerations, bruises, and splinters.    

Be sure to include: 

  • Broad-spectrum sunscreen (SPF 30 or higher)
  • Second skin moist burn pads
  • Medications for severe allergies (e.g., Epi-pen, Benadryl)
  • Hydrocortisone ointment 
  • Alcohol swabs
  • Band-Aids, butterfly strips and gauze/tape 
  • Triple antibiotic ointment 
  • Tweezers, scissors 

Coaches and parents should call 911 and go to the closest emergency center for cheerleaders with severe allergies/anaphylaxis (facial swelling, lip/tongue swelling, inability to swallow, wheezing, difficulty breathing, nausea/vomiting, hives, lethargy/unresponsiveness). Those with deep or persistently bleeding cuts that need stitches can be seen at an urgent care clinic or emergency center.  

Just remember:

“C.H.E.E.R” Emergency Kits can be individualized to meet any cheerleader’s emergency needs! By anticipating and preparing for unexpected illnesses and injuries, coaches and parents can ensure timely medical care and treatment. Additional preventative measures, such as annual physical examinations, proper strength training and conditioning, avoiding stunts and tumbling on hard surfaces, and requiring coach training and certification, will, also, ensure a safe, cheerleading environment for all athletes.

Post by:

Katherine Jennifer Leaming-Van Zandt, MD

Dr. Katherine Leaming-Van Zandt is an Assistant Professor of Pediatrics at BCM and, an attending physician in the emergency centers of Texas Children's Hospital.  She also serves as the Medical Director of the TCH West Campus Emergency Center.  

Dr. Leaming-Van Zandt’s academic interests...

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