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Cheerleading can be dramatic and dangerous.

The daredevil activity of cheerleading – entrenched in tradition as a team-spirit booster on university campuses – is taking a physical toll on young participants, according to North American experts.

A study in the journal Pediatrics found that for every 1,000 kids involved in cheerleading each year, eight will require hospital treatment for injuries.

Cheerleaders, mostly girls between ages 12 and 17, have been paralyzed and suffered broken bones and concussions. A 14-year-old female cheerleader in Massachusetts even died after a fall last year.

The American Center for Catastrophic Sport Injury Research calls cheerleading the most dangerous women's sport. The U.S. Consumer Product Safety Commission puts the number of annual cheerleading injuries requiring emergency-room care at 2,800.

The U.S. study, published in January, mirrors the situation in Canada.

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Kristen Reichbach suffered a twisted ankle.

In fact, the study may underrepresent the number of children being hurt, said Dr. Louis Francescutti, an emergency medicine specialist and director of the Alberta Centre for Injury Control & Research in Edmonton.

"I'm sure a lot of them are getting injured and being attended to by a trainer, or the school nurse or by their family doctors," said Francescutti.

Those injuries wouldn't be included in the database used by the U.S. study's authors.

Canadian standards

In Canada, 14 hospitals track cheerleading injuries. Over 10 years, they reported nearly 600 admissions to emergency, with the typical patient between ages 12 and 18.

Injuries may be on the rise because cheerleading has become more athletic and competitive, said Dianne Greenough, who coaches the cheer team at the Victoria School of Performing Arts in Edmonton.

"It's a sport in its own," said Greenough, who also coaches and choreographs routines for the Edmonton Eskimos football team. "These athletes practise three to four times a week, and they run their miles and they do their weight training, the same way any other sport does."

In Ontario and Alberta, where the sport is popular, the most dangerous stunts have been banned. The most common injuries in Canada are a rolled ankle from jumping or a sore wrist from stunts, rather than the more serious injuries seen in the United States, Greenough said.

Cheerleader and coach Dave Liska of the CFL's Eskimos throws other team members several metres into the air and then catches them. He says technique and practice are key to making cheerleading appear exciting and scary while keeping it safe.

"You want to catch her high and slow her down and squeeze her into your body," said Liska.

Liska's cheer team member, Kristen Reichbach, suffered a twisted ankle about six years ago.

"I just wanted to be back there so bad that I didn't let it heal fully," said Reichbach. "It's giving me problems now, but it was worth it."

In Canada, national standards for high-risk moves are in the works, along with coaching certification. The study's authors recommend the same changes to reduce injuries in young people.