Date of Award


Degree Type

Honors College Thesis

Academic Program

Athletic Training BS


Human Performance and Recreation

First Advisor

Melissa Kay, Ph.D.

Advisor Department

Human Performance and Recreation


Context: Cheerleading and gymnastics are sports containing dangerous skills that place athletes at risk of severe injuries, such as axial skeleton fractures. In addition, cheerleaders and gymnasts frequently have less access to on-site healthcare, such as athletic training services, which requires increased utilization of emergency departments. Objective: To compare national estimates of axial skeleton fractures in cheerleading and gymnastics by injury characteristics over a 10-year period. Design: Descriptive Epidemiological. Setting: United States Emergency Department via the National Electronic Injury Surveillance System Database. Participants: Cheerleaders and gymnasts presenting to a sample of US hospitals. Interventions: Independent variables included body region fractured. Main Outcomes: The primary outcomes of this study included frequencies and distributions as well as Injury Proportion Ratios (IPR) comparing the prevalence of axial skeleton fracture characteristics in each sport. Results: An estimated total of 8,360 axial skeleton fractures occurred to cheerleaders and gymnasts nationally in a 10-year period (84.9% female; mean age=17.3±8.5). The most prevalent axial skeleton fractures in cheerleaders and gymnasts occurred to the face (n=4,183; 74.6%; n=1,492; 54.2%) and spine (n=1,334; 23.8%; n=1,212; 44.0%). Fractures to the upper trunk (IPR=0.43; 95%CI=0.33-0.53) and neck (IPR=0.33; 95%CI=0.25-0.41) were more prevalent in gymnasts whereas facial fractures were more prevalent in cheerleaders (IPR=1.38; 95%CI=1.05-1.70). Conclusions: Heightened awareness of injury types sustained by these athletes highlights the need for appropriate on-site healthcare providers, such as athletic trainers, who can work to optimize the physical, emotional, and financial burden by referring patients through the proper channels and only when medically necessary.