Cheerleading Injury Prevention Interview

Dr. Vangsness with injured cheerleader
Dr. Vangsness treats an USC cheerleader on the sidelines.

Injuries from cheerleading are on the rise. LoveToKnow Cheerleading was fortunate enough to snag Dr. Vangsness to share his expertise on cheerleading injuries and how to prevent them. Thomas Vangsness Jr., M.D., has been in the University of Southern California's (USC) Department of Orthopaedic Surgery for around ten years. He is the physician for USC's Department of Athletics and serves as co-director for athletic medicine. He also serves the school as an associate professor of orthopaedic surgery. He works directly with USC athletes, including the USC cheerleaders. Dr. Vangsness has lectured all over the world, won many awards including Teacher of the Year, and is doing amazing research on stem cells and regenerative medicine.

About Dr. Vangsness

LoveToKnow (LTK): Dr. Vangsness, thank you for taking the time out of your very busy schedule to share your knowledge with LoveToKnow. You specialize in orthopaedics and sports-related injuries. When did you first become interested in this field of study?

Dr. Vangsness (Dr. V): I was an athlete in college, so working with athletes seemed natural. When I got into medicine, I never thought I'd be a professor too. When I came to the university, USC had a lot of sports and I started working with various athletes and looking at really exciting research into tissue engineering.

LTK: Let's talk about Dr. Vangsness a little. Do you have any cheerleaders in your own family?

Dr. V: I have a bunch of jocks in my family. I have two sons and two daughters. One of my girls has spine injuries from a skiing incident in Aspen. One daughter is playing Division One soccer. My youngest boy is into snowboarding.

LTK: Are you a sports fan? What is your favorite sport?

Dr. V: I work with a lot of different athletes and different types of sports, so I like them all, but college basketball and football are my favorites.

LTK: You've won several awards, including Teacher of the Year and a Neer award. Will you share a little more about these?

Dr. V: I'm blessed to be an upbeat guy. Teaching is like sales. If you are a salesman, you have to be upbeat and enthusiastic. I bring that kind of attitude to my classroom and clinics. I demand a lot from young doctors, but we have fun too. What we do is a serious business. If you create a fun environment, then everyone wins.

Working with Cheerleaders

LTK: You work with a lot of cDr. Vangsnessheerleaders in your practice. What are some of the most common injuries you see among cheerleaders?

Dr. V: If we look at the reality of the incidence of injury of cheerleaders, they are as injury prone as other athletes. The exception is football, which can be a little different. If you look at just the hours of competition and training most cheerleaders put in, you can see the possibility for injury. Most injuries are from the unsupervised practices.

Cheer can be difficult for the young athlete. They're doing repetitive tumbles, throws, and jumps. They are often training year round and getting injured. Then, they might put music on and dance. These are busy young athletes. You see stress and sprains in ankles, fingers, knees, and backs.

LTK: How common are serious injuries; ones that is hard to recover from?

Dr. V: Most injuries I deal with are ligament tears and strains. Catastrophic injuries are usually seen in flyers. When you start doing competitive formations, pyramids, and flips, the risk of injury is increased. Once you start throwing people in the air, and doing difficult stunts, you get the potential for falls, concussions, neck injuries, and even brain injuries.

Cheer Standards

LTK: If you watch national competitions, it seems like each year the cheer stunts are bigger and bolder. Has this changed how you work with cheerleaders in your practice?

Dr. V: Competition gets fiercer every year, and cheerleaders are pushing envelope more and more. There are taller pyramids, more flips, and more twists. Those are the individual incidents that will cause more difficulties for more athletes. Fierce competition can cause things to get too wild and could give you the opportunity for the bigger injuries or head trauma.

Girls are training for Nationals more. Often, athletes are so focused on competitiveness that you see overuse injuries. A really good database could reduce incidents and the whole sport could benefit.

LTK: How would a national database work?

Dr. V: Right now there are no standards across cheerleading squads. For example, in football, you can't clip (hitting below the knees) or hold (grabbing face mask). Maybe they should do the same in cheer that the coaches and national people could have some safety standards. Limiting formations would be a good place to start.

There could also be training for coaches in injury prevention. Coaches should understand some of the training issues that cause the most injuries. If a standardized body, like the NCAA, got involved and created a database of dangerous stunts and associated injuries, then the coaches could look at this information to get the big picture.

LTK: Many coaches are a parent or teacher just trying to help a squad of girls. They sometimes don't have training in the proper way to do stunts or even tumbling. What advice would you give these men and women to help their cheerleaders stay safe while cheering?

Dr. V: Younger athletes often have mom and pop coaches. The best thing to do is try to get parents involved. Tell them what their son or daughter is doing at practice. Explain stretches and why it is important the child does those basic things to protect his body.

More Ways to Prevent Injury

Dr. Vangsness with patient

LTK: What can a cheerleader do to prevent injury and protect her back?

Dr. V: It's hard, because an athlete with a lot of drive will push through the pain. Even if she has stress fractures in her back, she may ignore them. Common strains in cheerleading are not catastrophic. The athlete will recover if he or she simply focuses on different muscles and rests. The catastrophic injuries are usually created when cheerleaders fall from pyramids or from heights during a stunt. The higher the cheerleader is thrown in the air, the faster she accelerates coming down. This force is what causes serious injuries.

Conditioning is very important. Stretching is very important. These are all things you can do prior to the competition. Parents should be in close contact with your child and the coach. If the coach is abusive, parents can step in. Parents should watch and make sure there is not abuse of the athlete in any form. It's hard because coaches want to tone and get their athletes to do the best they can. Communication is key.

Mix up sports a little, so you are training your body, but not always doing the same repetitive motions. Parents should monitor athletes in the family and discourage them from focusing on a single sport. Keep the body moving in all different directions and it will probably decrease the risk of injury.

Dr. Vangsness' Future Plans

Dr. Vangsness is on the cutting edge of research. One of the studies with which he is involved, includes methods to repair anterior cruciate ligament tears by reconstructing the ligament with grafting from either the patient or a cadaver. He is also studying stem cells to find solutions for menisectomy patients.

LTK Cheerleading thanks Dr. Vangsness for sharing his knowledge about injury prevention in the sport of cheerleading. If you'd like to know more about the work he is doing, you can visit It will be interesting to see if his advice about a database can come to fruition in the coming years.

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Cheerleading Injury Prevention Interview