Aug. 15, 2008 -- The sport of cheerleading -- with its daredevil flips and pyramids -- accounts for 65.1% of catastrophic injuries among high school girl athletes in the last quarter century, according to a new study.

Cheerleading also is responsible for 66.7% of catastrophic injuries among female college athletes during the past 25 years, according to a report prepared by the University of North Carolina at Chapel Hill's National Center for Catastrophic Sports Injury Research.

Catastrophic injuries fall into three categories: fatal injuries; injuries that cause a severe permanent functional disability; and serious injuries such as a fractured cervical vertebra (broken neck) that do not cause a permanent disability.

The annual study looks at catastrophic injuries for both men's and women's sports. The goal of the center, originally founded to look at football injuries, is to prevent catastrophic injuries by analyzing data and coming up with ways to reduce serious dangers in high school and college sports.

Catastrophic injuries to female athletes have increased over the years, in large part because of cheerleading, according to Frederick O. Mueller, the director of the research center and author of its annual study.

From 1982 to 2007, there were 103 direct injuries to high school women in the study; 67 were due to cheerleading. No other sport even came close, with gymnastics totaling nine and track numbering seven. For college women, there were 39: 26 due to cheerleading, three due to field hockey, two due to gymnastics, and two due to lacrosse.

Falls from pyramids were a common cause of the injuries, leading to concussions, skull fractures, paralysis, and death. Other injuries happened during back flips and when cheerleaders were tossed into the air and dropped.

"If these cheerleading activities are not taught by a competent coach and keep increasing in difficulty, catastrophic injuries will continue to be a part of cheerleading," Mueller, a professor of exercise and sports at the University of North Carolina, says in a news release.

The report made 11 safety recommendations, including:

• Not allowing pyramids over two levels
  
  
• Banning mini-trampolines and flips and falls off pyramids
  
  
• Having a coach trained in gymnastics and partner stunting