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Cheering for her Life


Posted on August 23, 2007

BruceBrown.com

When Jessica Smith fell 15 feet onto her head at cheerleading practice last year, she was lucky she only broke her neck. Now that cheerleading has evolved into a competitive sport involving airborne acrobatics, the question must be asked: How safe is it?

Her parents, says Jessica Smith, were always afraid to watch.

Whenever the tiny, 4-foot-11 cheerleading flier was flung into the air to perform a stunt, they would grip the seats with their hands, saying to themselves, ‘I hope they catch her. I hope they catch her.'

This past October, Mack and Christine Smith's worst nightmare came true. During a practice session with the squad at Sacramento City College, their daughter was asked to try a new trick (Jessica's Stunt) requiring her to perform an airborne handstand, be caught belly down and then thrown again before landing in the arms of her teammates. But things went awry when the cheerleader whose head she was being hurled over lost his balance, leaving Smith wide open to sail down from a height of some 15 feet.

I came straight down on my head, says Smith, who was new to the role of flier and says she resisted doing the stunt but caved under pressure. When I hit the ground, I heard a crack.

The accident left Smith with two fractured neck vertebrae, an injury whose arduous rehabilitation included two painful months in a 10-pound steel halo, an immobilizing device bolted to her skull and attached to a hard plastic vest.

She was confined to a hospital bed in her family's West Sacramento home, her movements so restricted that she couldn't bathe or wash her hair without assistance. Smith describes the experience as like being in jail, behind bars. She dropped out of school and her weight zoomed from 105 to 150 pounds. Though she finally returned to school (American River College) this summer, she still takes pain medication for the residual sharp jabs that shoot through her neck and relies on sleeping pills to escape from the nightmares that continue to haunt her&emdash;a problem so severe she's been diagnosed with post-traumatic stress disorder.

Still, Smith says, it could have been worse.

Doctors tell me it's a miracle I wasn't paralyzed, says the 19-year-old, who once dreamed of being a Kings dancer or Oakland Raiderette and now feels just lucky to be alive. Her orthopedic surgeon, Roy Rubin, M.D., of Sutter Medical Center, confirms that Smith's injury, classified as a high cervical fracture, could have resulted in paralysis or death had her spinal cord been severed. (As a nurse friend put it, Think Christopher Reeve.)

Although fatalities are rare, more female athletes suffer catastrophic injuries from cheerleading than from any other sport, according to a report from the Journal of the American Academy of Orthopaedic Surgeons. Among these, head and spinal fractures are common: In 2004, a San Jose State University cheerleader was paralyzed from the waist down after taking a fall during practice; that same year, a cheerleader from Prairie View A&M in Texas had a paralyzing fall whose complications led to her recent death. Cheerleading injuries at the high school and college levels were second only to football between 1982 and 2005, according to the National Center for Catastrophic Sports Injury Research.

From Rah-Rah to Rigorous: Cheerleading's Evolution

Traditionally the domain of the prettiest girls with the buffest bods, cheerleading today is more than just eye candy for football jocks and fans. Dating back to the 1980s&emdash;and even earlier, according to one expert&emdash;it has evolved into an increasingly competitive athletic endeavor, requiring real muscle and, for the fliers who perform flips and twists from 20 feet in the air, real guts. We have a video that shows that the high-flying acrobatic style started as early as 1975, when cheerleaders were using a trampoline to make themselves go even higher, says Bobby Biggs of the Universal Cheerleaders Association, who coaches two cheerleading squads at Sacramento State, where he once was a cheerleader himself.

Cheerleading's transformation into a more aggressively acrobatic activity is linked to the widespread demise of high school gymnastics programs in the 1980s, when many female gymnasts found themselves switching from the high beam to the cheerleading team. As routines grew riskier, new safety rules were enacted by the American Association of Cheerleading Coaches and Administrators, which recently has ramped up those efforts with new restrictions and a college-level initiative. As a result, cheerleading is actually safer today than it was 20 years ago, claims Biggs, who believes most media reports about cheerleading injuries are sensationalized and that injury statistics are often unfavorably skewed.

But just try telling that to Christine Smith, who is still mad as hell at what happened to her daughter&emdash;especially under the school's seemingly safe auspices.

As a parent, I trusted that coach&emdash;that instructor&emdash;to take care of my child, says Smith, her voice rising with emotion. I was let down big-time.

According to Christine Smith, the instructor/coach was not watching when Jessica's accident occurred and no one immediately called for an ambulance. Instead, the school contacted her. They wanted me to come and pick her up, says Smith. I told them, ‘No, call 911. Get her over to the hospital.' If I had picked her up myself, she could have died. How dare they. Smith says she got to the hospital before her daughter arrived there via ambulance.

The Smiths tried to sue Sacramento City College for negligence. But because their daughter had signed a medical waiver&emdash;a standard document required of all cheerleaders&emdash;they didn't have a case. We consulted two lawyers and both told us they can't get past the waiver, says Christine Smith. So I'm pretty much giving up on it.

Jessica Smith recalls being on the way to class one day when she hurriedly signed the waiver but I didn't understand what it meant. I didn't know it was a death waiver. If you died, they didn't care.

Amanda Hamilton, a spokeswoman for Sacramento City College, says the college regrets what happened to Jessica Smith. We're very sorry for the accident and for the suffering it caused, says Hamilton. The college stands by the team's coach, who still is employed by Sacramento City College and was unavailable for comment. The coach's qualifications include a safety certificate from the AACCA, says Hamilton.

Cheerleader Safety: What's Being Done?

Despite its ascent into a rigorous athletic activity with all of the attendant risks&emdash;strains, sprains and, in cases such as Jessica Smith's, far graver injuries&emdash;most states, including California, don't classify cheerleading as a sport, which is why it does not fall under the governance of the California Interscholastic Federation, the state's athletic association. Indeed, there is no single governing body for cheerleading in California, and rules are all over the place: Only NCAA-level college coaches are currently required to be safety-certified by the AACCA, for example; coaches at lower levels (including community colleges) are not.

The problem with cheerleading is that it's evolved from just ‘cheering' to more of a highly competitive sport and yet it hasn't had the governance that other sports have in terms of established safety guidelines and adherence to those guidelines, says Meredith Bean, M.D., a sports medicine specialist for Kaiser Permanente in South Sacramento who often treats cheerleaders for routine injuries. It goes back to not having any standardization for rules.

Jim Lord, executive director of the AACCA, sees it differently, pointing out that the organization has in fact developed standardized rules for schools that want to use them. But in the absence of any kind of state mandate, not all of the schools do, opting instead to create their own guidelines.
 

That's the case at Placerville's El Dorado High School, home to one of the area's most competitive cheerleading programs. But that's not to suggest they don't take safety seriously.

Cheer is the one sport that scares me to death, says Joe Volek, El Dorado High's athletic director. If you see how high we throw these girls and the stunts we're asking them to perform . . . his voice trails off. Football players have helmets, but there is no protective gear for a cheerleader. To better address the safety issue, the school's new cheer coach has developed a rubric requiring students to master each step in a progression before moving to the next level, says Volek. Teaching progression is synonymous with safety, and it's critical for our kids to stay safe.

Progressive, step-by-step training is the key to cheerleader safety, concurs Biggs, who says the number of local participants in his AACCA safety certification classes has probably tripled in the past five years. Mostly I've been certifying high school coaches, but athletic directors, principals and heads of programs come for training, too, he says. In the past two years alone, Biggs estimates he has certified at least four schools in every school district in the Greater Sacramento area.

In the private sector, all-star teams (competitive cheerleading clubs) generally follow U.S. All-Star Federation safety guidelines, which are more specifically suited to their needs than AACCA rules, according to Melanie Swift, owner of Club Spirit All-Stars in Rancho Cordova. I can't say all the local clubs are following these guidelines, because new all-star programs are starting all the time, says Swift. But it's better for all the kids to be trained the same way. Swift admits there was a time when things got pretty crazy in all-star competition and that stricter safety guidelines were brought into place to bring everybody back to reality. I'm very cautious because I don't ever want to have a child injured. And I've never heard a parent complain about that.

After the Accident: Moving On

At least one local parent, Christine Smith, has yet to be convinced that things are hunky-dory in the world of local cheerleading. Instructors need to be more diligent about safety and practice equipment should be standardized, she says. (Smith charges that the wrestling mat used at her daughter's former school was not appropriate for cheerleading.) Gender stereotyping also persists, she says, even in today's era of co-ed cheerleading. People think, ‘Oh, she's a girl, she'll get over it, she's just crying,' says Smith. They don't realize that it's a serious sport and that someone can be seriously injured. 

Even she didn't realize how dangerous cheerleading can be, admits Smith. I knew Jessica could maybe break a leg or an arm, she says. But it never entered my mind that she could die.

It never entered Jessica Smith's mind, either.

If someone had said ‘cheerleading and death' together, I would have said, ‘What do you mean?' says Smith, a cheerleader since she was 8. I know if a lot of girls knew that [the medical waiver] they signed was a death waiver, they would look at it a second time.

Still, she says, she's not blaming anyone for what happened.

It was just an accident, she says philosophically. It could have happened to anybody. With dreams of becoming a professional cheerleader behind her, Smith is focused on finishing college, with hopes of becoming a fashion buyer someday.

The accident has changed her perspective on life, she says.

The average 19-year-old doesn't think about the fact that any day could be your last, she says. But I do.

A Guide to Cheerleader Safety

Most of the cheerleading injuries that trickle into her office are comparable to the kinds gymnasts get, says Meredith Bean, M.D., a local sports medicine physician for Kaiser Permanente. But while gymnastics is governed by the California Interscholastic Federation, cheerleading lacks state regulation, making it even more critical for parents&emdash;and cheerleaders themselves&emdash;to keep a close watch on safety. Here are a few tips from the pros:

1.
Make sure the coach is qualified. Safety rules aren't nearly as important as having a qualified coach in place, says Jim Lord, executive director of the American Association of Cheerleading Coaches and Administrators. In California, only NCAA-level college coaches currently are required to be safety-certified by the AACCA. Find out if your child's coach is safety-trained and if not, ask the school or club to make it a requirement.

2.
Inquire about safety rules. Is the school/club using AACCA, U.S. All-Star Federation or other standardized rules?

3. Look for skills progression training. Skills progression&emdash;teaching skills in the proper sequence and requiring mastery of each before moving on to the next&emdash;greatly reduces risk of injury, says Bobby Biggs, a Sacramento State cheerleading coach who conducts safety certification classes for the Universal Cheerleaders Association. Properly trained cheerleaders tend to stay safe,
he says.

4. Prevent injury with proper conditioning. It's really important to think about prevention, says Kaiser's Bean, who often treats cheerleaders for overuse injuries. Warm-ups and muscle-strengthening exercises go a long way toward injury prevention, she maintains. And athletes shouldn't try something beyond their ability; they should work up to it gradually.

5. Location, location, location. Parents may want to check out where their children are practicing, suggests Bean. Are they practicing in a hallway with a low ceiling and people walking around? she asks. All cheerleading practice should be done under the supervision of a coach, on an appropriate mat and away from excessive noise and distractions.

6.
Emergency preparedness. The great majority of cheerleading injuries are not life-threatening. But emergency room visits from cheerleaders more than doubled nationwide between 1990 and 2002, according to a study by the Columbus Children's Research Institute in Ohio&emdash;and Jessica Smith's story brings it home. Having a comprehensive emergency plan in place is a vital part of any safe cheerleading program.
&emdash;Cathy Cassinos-Carr
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