Extreme cheerleading: how schools grapple with the new risks

But even schools with coaches and safety certifications say injuries are simply a part of athletics. "Accidents come with the sport," says Alice Rogers, squad coach at Texas Southern University in Houston.

The fact is, the activity has changed dramatically in the 22 years Ms. Rogers has coached.

When the National Cheerleaders Association was founded in 1948, for instance, cheerleading was "really a sideline attraction to keep the crowed engaged and entertained when the team wasn't doing that well," says spokeswoman Martha Selman.

That shifted during the 1980s, when a lot of high schools got rid of gymnastic programs and equipment. Many gymnasts simply moved to cheerleading, pushing the activity to a new level. Now, because of increased competition, says Ms. Selman, "teams are pushing the envelope and going to extremes. And the more eye-catching the moves that are created, the more risk is involved."

Quantifying that risk, however, is controversial. Yes, cheerleading injuries doubled between 1991 and 2001, according to the US Consumer Product Safety Commission. But some say those numbers don't tell the whole story. For instance, 100,000 female basketball players visited emergency rooms last year, compared to 25,000 female cheerleaders, points out Jim Lord, executive director of the American Association of Cheerleading Coaches and Advisors in Memphis, Tenn.

"We are by no means minimizing the injuries; we are simply putting them into perspective," says Mr. Lord, whose organization sets safety standards and certifies coaches. "When compared to other sports, cheerleading is a low-risk activity."

Pete and Robin Buczek take issue with the notion of "low-risk" cheerleading. Their daughter, Ashlee, suffered a skull fracture in November when she fell from a basket toss at an Indianapolis high school football game.

Mr. Buczek says cheerleading injuries are not being reported accurately - and so the numbers look lower on paper than they actually are. Ashlee's accident, for instance, was classified as an extracurricular activity injury instead of a cheerleading injury.

"They are covering up the truth," says Mr. Buczek, who is suing the school and is attempting to get legislation passed in Indiana that would recognize cheerleading as a sport in order to regulate it. About a dozen states have done so already.

Those regulations - and the overall crackdown - come with a cost. Duke cheerleading coach Teresa Jones Ward says she loses a lot of strong talent because of the ban on stunting and a lack of scholarships. But in her mind, the benefits outweigh the disadvantages. The cheerleaders learn more about real school spirit, she says, have more time for academics, and are more active in their communities.

What's more, stunt-free squads put the focus back on the game.

"A lot of times you go to a game and you can hardly concentrate on it," says Ms. Ward. "Cheerleaders are being thrown in the air, dance teams are circling the court, and gymnasts are doing flips. They're almost like circuses, and that's a byproduct of stunting."

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