Jennifer King had a lifelong passion for dance. It wasn’t until she found herself waiting in a lengthy line outside an airport hotel that she discovered her cheerleading talent.

Having danced throughout her childhood and even minored in dance while studying at the Philadelphia College of Osteopathic Medicine (PCOM), she never anticipated that attending what was dubbed a hip-hop audition would lead her to become a cheerleader.

When she expressed her frustration about the lack of adult classes for hip hop and jazz to a fellow student, they responded, “The Eagles are holding auditions this weekend. It’s a free class.”

So there she was, in her second year of medical school, standing in a line that circled the building near Philadelphia International Airport, ready for a dance audition.

“I was in ballet attire, hair neatly in a bun, and absolutely no makeup,” she recalls. “Everyone else looked like they were prepared to cheer for the Eagles.”

“Somehow, I made the team.”

This newfound role introduced her to stunts and the intricacies of maintaining balance when being tossed in the air, while also providing insights into the physical demands of a sport that continually pushes athletes to their limits.

“We now expect 12-year-olds to perform at the same level as 17-year-olds did two decades ago,” King explained during an interview with YSL News Sports. “This raises the risk of injury as they try to execute skills for which they may not be physically ready, especially now that they can easily find tutorials on any skill on YouTube and try them out themselves.”

Today, King serves as the section chief of Pediatric Sports Medicine at Kapi’olani Medical Center for Women and Children in Honolulu and is a mother to two teenagers, Jude (15) and Eva (14). She has also co-authored the latest policy statement from the American Academy of Pediatrics on cheerleading safety: “Safety in Cheerleading: Epidemiology and Recommendations.”

The updated policy was released last month, coinciding with the participation of over 3.5 million youths, primarily girls aged 6 and older, in cheerleading. Estimates suggest that around 35,000 cheerleaders suffer injuries each year, mainly in the 12-18 age bracket.

Cheerleaders often grapple with body image issues and feel undervalued compared to athletes in other sports. YSL News Sports consulted King along with Brittany Poinson, a neurologist at Children’s Hospital New Orleans who specializes in concussion management for cheerleaders, to offer guidance on how to navigate these challenges.

The health and safety suggestions provided by the physicians can benefit all young athletes, helping them compete more confidently.

Cheerleaders are highly skilled athletes, yet often feel marginalized

King recalls a moment from her medical fellowship at Rutgers two decades ago when an athletic trainer remarked that cheerleaders didn’t see him for treatment.

“They don’t get injured,” he said.

To which she responded, “They do get injured, but they don’t come to see you because they don’t feel recognized as competitive like athletes in other sports.”

This stigma is still prevalent, affecting injury prevention and care.

“Many people don’t view cheerleading as a legitimate sport, resulting in cheerleaders not seeking medical attention in the same manner as football or soccer players,” King said. “Often, cheerleaders don’t pursue care because they feel inferior to their counterparts in more traditional sports.

“However, perceptions are shifting, especially as spectators witness the complexities of cheer competitions. … Some skills performed are even more demanding than what I observe among ballet dancers today.”

Cheer is more than a school activity; it’s also seen in clubs and recreational settings. At high schools, cheerleaders not only support teams during games but also participate in “competitive spirit” events that challenge schools against each other through jumps, tumbles, and intricate stunts.

This sport serves as a pathway for youths and their families to gain recognition, sometimes aiding in college admissions for both traditional and STUNT cheerleading.

As seen in other youth sports, both expectations and injury risks have begun to affect much younger participants.

“Some cheerleaders now cover Pee Wee football events,” King mentioned. “They start from a very young age.”

Concussions are a major concern in cheerleading; are you aware if you have one?

While cheering for the Eagles, King was invited to judge local cheer competitions. At her very first judging event, she witnessed a flyer who fell during a stunt and momentarily lost consciousness.

“I can’t even recall how many concussions she has had. Is it her sixth? Seventh?” King remembers the girl’s mother sharing.

“She’s only in ninth grade,” King replied.

“Well, she’s a cheerleader and she flies, so that’s somewhat expected,” the mother said. “She’ll recover.”

A concussion is now understood to be much more serious than merely “getting your bell rung.” The consequences for both mental and physical health can be severe and may last a long time.

A recent report from the High School Reporting Information Online (RIO) database indicates that concussions represented 31 percent of injuries among cheerleaders, as noted by King in the AAP policy statement.

“Cheerleaders often have very ambitious personalities, with many taking on honors or AP classes,” she explains. “This makes managing concussions particularly challenging, as these students are reluctant to take a break.”

It’s important to note that concussions don’t necessarily cause someone to lose consciousness. According to King, many seventh and eighth graders might not even realize they have one.

“They think, ‘I play football, so of course, I expect to get hit and have headaches or feel dizzy,’” she asserts.

King’s findings indicate that most concussions related to cheerleading result in one to three weeks away from the sport. However, concussions are the top cause of injuries that lead to more than three weeks of lost time.

Increased Risk During Practice: Tips for Safety

Practicing makes cheerleaders particularly susceptible to concussions, especially when they are attempting skills that are challenging for them.

Poinson, a neurologist from New Orleans, recommends a checklist to ensure safe practice.

Instruction and Technique: “Coaches should consistently teach athletes to perform skills safely, and only advance to more complex techniques once the fundamentals are secure,” Poinson advises.

Most high school athletic associations require coaches to undergo certification in spotting, safety, and injury management through USA Cheer’s safety and risk management programs. According to the latest participant survey by the National Federation of State High School Associations, 32 of these associations recognize competitive cheer as a legitimate sport.

“I wouldn’t advise any sport to perform advanced skills without a coach present,” she states. “Practicing routines and choreography is acceptable, but the risk increases with tumbling and stunting.”

‘You Don’t Have to Compare Yourself to Others’

King shares that growing up in dance class was tough due to the mirrors that reflected her alongside her peers.

Similarly, cheerleading has a historical focus on having a slender frame. King writes in her policy that cheerleaders often face challenges such as body image issues, inadequate nutrition, and bone injuries.

“It’s important to communicate that everyone’s body is unique, and you shouldn’t feel pressured to look like someone else,” she emphasizes.

Unlike dance, cheerleading requires strength. According to Poinson, cheer athletes should follow a conditioning program that targets neck and core muscles, as a strong core can enhance stability and help prevent injuries. In addition, cheerleaders need to be physically strong, especially when forming the base of a pyramid, which should not exceed the height of two and a half individuals, as advised by the NFHS.

Consult with your child’s doctor to discuss what a healthy weight looks like and to promote a balanced lifestyle. Athletes, according to King, should have a snack 30 to 60 minutes before practice and eat another meal (like dinner) within 45 minutes post-workout.

As you proceed through training, it’s crucial to be aware of bodily changes.

“Most kids experience an awkward phase during adolescence, where previously easy skills may become harder as their bodies develop into adult forms,” King explains. “As their hips and knees grow, they might notice decreased flexibility, leading to frustration.”

However, a supportive coach can reassure a young athlete, saying, “This is a normal part of growing up. We’ll find a way for you to successfully execute the skill, considering your body’s changes from last year.”

Importance of Sleep: How Much Do Athletes Need?

Numerous studies confirm that getting enough sleep significantly lowers the risk of injuries or accidents, in both children and adults.

Research indicates that adolescent athletes who achieve over eight hours of sleep on school nights can reduce their risk of injuries by up to 60 percent.

King advises that teens ideally need around eight hours of sleep per night. She poses a question: How can a child from Hawaii take a redeye flight to a cheer competition in Florida and expect to perform well the next day?

Lack of sleep can impair coordination and response times.

Sleep issues in teenagers can persist into adulthood. UCLA Health reports that drowsy driving incidents claim more than 1,550 lives every year, often involving young people under 25.

Engage with Your Athletes: Empower Them to Opt Out of Activities, But Maintain Balance with Fun

King cheered for the Eagles for two years and then spent another year cheering for the Philadelphia Soul, an Arena Football team partially supported by a rock legend.“`html

“To sum it up, turning Jon Bon Jovi down is quite a challenge,” she chuckles.

Now, she is a second-year medical resident.

“I started by saying, ‘I can only do this for one year because balancing everything is going to be hectic,’ ” she explains. “(It’s) a lot of fun too, as it feels different being in the arena.”

As a medical professional today, she provides her patients with “five pillars” for success: nutrition, hydration, sleep, exercise, and stress management.

She advises children to find a quick stress-relief technique that isn’t tied to their sport. Options could include a meditation app, listening to music, reading, or even watching Netflix.

It’s important to touch base with your kids periodically to ensure that they are thriving in their team environment. If your teenager seems uncommunicative, reach out to their coaches.

Instead of asking about playing time, focus on ensuring your child is in a situation where they can excel.

While we support our children in their athletic aspirations, we must also be ready to help them if they don’t achieve those goals.

“Typically, burnout happens during the later years of high school, leading to feelings of guilt for the parents’ investment in their activities,” King states. “Sometimes, they’ll push through even if they’ve lost their passion for it.”