What does #likeagirl mean?

Last week I saw this Always ad defining #likeagirl. It went pretty viral among my facebook and twitter circles. If you didn’t get a chance to see it, see the link below. If you did, it’s worth another watch.

Upon watching this, I found myself wanting to cry, scream, smile, laugh, and fist pump. My personal and professional worlds were colliding. I love kids. I love psychological development (it was my major). I have studied peer relationships of children and teens. I love young athletes (it’s the title of this blog). I love a good youtube video and I love social media. I love advocacy for women’s health issues across the lifespan.

Like in the video, I wondered who is defining #likeagirl and why it is viewed by so many as an insult, especially when it comes to young athletes. Where did all of this come from–is this a thought women have of other women? Or a thought men have of women? How did girls’ own views of the phrase #likeagirl spin 180 degrees from positive to negative in a just few years across the young female lifespan?

Like any deep thinking blogger, I of course thought “this would make a great blog post.” I began to reflect on some striking #likeagirl challenges in my own upbringing as a female and how it affects my thoughts and views on this idea.

#Likeagirl defined during the “growing up” years

In 4th grade, I was one of only 3-4 girls in my class. I was teased, bullied, and outcasted for being the only member of the class in the gifted program. Anything anyone could try and take from me, they would. Lunch, pencils, erasers, paper, sanity, innocence…you name it. We tried to get the teacher and school to intervene but nothing really changed. So, fight #likeagirl I (well, my parents and I) did, and I moved on to a different school.

In 7th grade, the most “popular” girls sat next to me in science class. I specifically remember my “friend” asking me if she could cheat off of me during tests. I said no. There went that friendship. Apparently the way to popularity and being accepted #likeagirl was compromising morals.

As we walked down the staircase toward our 9th grade geometry class, my friend said “You know if you keep it up at this rate, none of the boys are going to like you.”  It was me making straight A’s, swimming 5 hours a day, and setting nearly every school swimming record.

My friend then followed with “they’ll think you’re intimidating. Boys don’t like intimidating girls.”

At the time I remember thinking “wow, that sucks, boys won’t like me” for about 2.5 seconds. Then I was mad at her for thinking that saying that to me was going to change who I was and make me “give in” to the female norm (whatever that was) just so that boys would like me.

As if my friend were a fortune teller, I didn’t have a boyfriend for 3 years after that. That’s eons as far as high school goes. I had my moments of insecurity about it, but had plenty of other things going for me to distract me. I wasn’t worried about finding Mr. Right at 14, 15, 16, or 17. Ironically, I found him at 18. Mr. Right will tell you that he wasn’t intimidated by me, but looked up to and was inspired my successes. We started dating a month before high school ended. We’ve been together since then and now we’re married.

Daniel & I at our wedding in 2009

Daniel & I at our wedding in 2009. Duluth High School Class of 2002 representing!

Take that, Mean Girls.

Growing up, I was too busy swimming to get bogged down in the details and drama of teenage life. Being surrounded by a team that fostered friendship, acceptance, self discipline, self-confidence and the ability to rise from failure is an immeasurable benefit of youth sports teams. Unlike “throw #likeagirl” and “run #likeagirl,” there was no concept of “swim #likeagirl.” We trained in the same lanes as the boys, often pushing each other during practice to help each other improve.

That’s not to say I wasn’t an emotional, annoying teenager (sorry Mom and Dad) and that I didn’t have my moments of being challenged by the #likeagirl norm. I’m also not saying that every girl has to be a competitive athlete to have these values instilled in them. In fact, I believe just the opposite. There are countless other non-athletic outlets and avenues for girls to be successful and gain self confidence and self respect. We, as a society, need to embrace and encourage that.

Defining #likeagirl in the most educated circles

Along with sports, not every female needs academic success to define her, either. You may be surprised to know that even in the most educated circles of women, there are still struggles to define what #likeagirl means.

In college I was surrounded by new ways of defining female success. I’m not sure that I could have picked a better place to foster the  #likeagirl mentality. But even Duke harbored its own challenges for women.

I remember walking around East Campus my freshman year thinking “why do these girls all carry purses with a big F or C’s on them? Who is Lilly Pulitzer? And who actually gets dressed in all of that stuff for an 8 AM Chem Lab when you have to wear a lab coat and goggles anyway?” I was completely flabbergasted with the materialistic side of all of the women around me. I had never been around so much privilege and entitlement. Feeling the “sink or swim” pressure, I accepted that I didn’t have to be just like them, even though I did gain an appreciation for things like Tory Burch shoes.

tory burch shoes

Let’s be honest, materialism is everywhere, not just at Duke. What I found more overwhelming than that was the fact that every female sitting in class with me was somehow like me. Everyone graduated in the top 1% of their class, made ridiculous SAT scores, was an incredible athlete, was devoted to community service and had already published books about it, was going to be the next Maya Angelou or rocket scientist…you get my drift. It was intimidating, impressive, and inspiring.

Here I was, surrounded by successful, accomplished women. I’d yearned for that given I’d run into problems with the definition of #likeagirl success in elementary, middle, and high school. I’m thinking “yes! finally people who are like me who will accept me!.” But something was still missing. I was a nerdy female athlete who liked to wear dresses and pearls one day, do crossword puzzles and hike the next day. This challenge to fitting in to the #likeagirl norm became abundantly obvious to me during sorority recruitment. Like in middle school, these women went to great lengths to be accepted into the most “popular” groups. Sometimes at the sacrifice of their own strengths and morals. That just wasn’t who I was. Also like in middle school, I did not sacrifice my standards to be popular. This was a blessing in disguise. I ended up being president of the sorority I joined, which was a phenomenal leadership and networking opportunity. In my group, women went on to become accomplished and successful lawyers, physicians, published authors, Teach for America leaders, CEOs, Miss America pageant contestants, Peace Corps and military officers, and stay-at-home moms. In our group, #Likeagirl took on many definitions of “awesome”, and that was ok.

The leaders of Duke sororities got together to support Duke Women's Basketball. Our shirts said "Duke Women's basketball: the greatest thing since sliced bread." We even got a notable men's basketball player to join in our efforts.

In a men’s basketball-dominated school, the leaders of Duke Panhellenic sororities got together to support Duke Women’s Basketball. Our shirts said “Duke Women’s Basketball: the greatest thing since sliced bread.” We even got a notable men’s basketball player to join in our efforts.

#likeagirl challenged by Duke Women’s Initiative

While I was at Duke, these #likeagirl challenges played out before me on a daily basis like a great soap opera drama. It wasn’t just obvious to sorority women. Some smart Duke researchers caught wind of this, too.

The Duke Women’s Initiative was rolled out by woman President Nannerl Keohane in 2002-2003. It was a research initiative raising awareness to issues faced by women at Duke-women you’d think would have no problem defining or championing their successes. It highlighted the juxtaposition that the same women who were some of the most talented in the world in their fields would also find themselves downplaying their success by submitting to disillusioned social norms. They often gave into social pressures to build and mend their developing and broken female egos, respectively. In a sense, there was a real problem among Duke women to define what #likeagirl meant. Being around during this initiative is exactly why I chose to major in developmental psychology with a special focus on development of peer relations, particularly passive aggressiveness among females. I was so curious to know why we as girls act the funny ways we do.

Here is the 43-page initiative in case you’re interested: WomensInitiativeReport(1)

The initiative coined the phrase “effortless perfection.” This describes the amount of effort many of these talented women put in to appear as if they’d put no effort into being successful. Why were they ashamed of people knowing they worked hard or were total nerds? Women confided that they didn’t want to make it look like they’d worked hard to achieve their successes, because hard work and determination connote “male”-like qualities they thought would be intimidating. And really–what it came down to–they wanted to appear this way because they were worried about acceptance and relationships with males and females on campus.

Whoa whoa whoa. That’s kind of like when my 9th grade friend told me boys wouldn’t like me for being successful, because that was intimidating. Or my 7th grade “friends” not liking me because I would not let them cheat. Or being bullied in 4th grade for being the smart girl.

#Likeagirl challenges extended to body image and social success too. Duke women would go to great efforts to mask eating and psychological disorders behind guises of normal-appearing, almost reckless or “laid back” behavior. You’d have the summa cum laude chemistry major who partied every night with her friends, but never studied with her friends because she didn’t want people to know she spent 10 hours/day in the library to get a 4.0. She only wanted them to see that she was a “cool party girl.” She probably didn’t like to talk about her grades or successes.

Like her, many women didn’t want men or other women to be intimidated by their efforts at appearing perfect, so they often hid those efforts or behaved in polar opposite, sometimes reckless ways. They didn’t eat or exercise with others for fear people would see how hard they worked to remain thin. They didn’t want to appear aggressive and dominating or weak and vulnerable for fear that they would not find friendship or intimacy because of those things. So we didn’t want to appear aggressive or intimidating, but we didn’t want to appear vulnerable either. Whew. Make up your mind, ladies!

On the swim team, there was no hiding how hard we worked or how much we ate. We all trained together, ate together, and often studied together, supporting each other through all of our efforts to be successful.

On the swim team, there was no hiding how hard we worked or how much we ate. We all trained together, ate together, and often studied together, supporting each other through all of our efforts to be successful. This is my friend Julia. Julia was a Rhodes scholar finalist who went on to Harvard law school. Now she’s a rock star lawyer in Chicago.

As much as we did not or do not want to admit it, all Duke women likely had a piece of this mentality in us. After all, I’ll bet several of those women were 9th graders who were told it was not “cool” to be smart or successful. Why else would we, as a cohort, mask our successes in “effortless perfection” to try and fit in?

It wasn’t as bad as it sounds, though. There were great things about being around so many smart, successful women. I was fortunate to live with a different woman each year. Each woman had her own unique background and definition of #likeagirl. One was a varsity athlete, another was a biomedical engineer. One was a former pageant contestant, Duke cheerleader, brilliant double major, international public servant and future rock star pediatric NICU specialist. One was a champion of all things liberal arts, challenging abstract and socially responsible thinking on a daily basis.

Duke psychology majors. The blonde at the far right of the photo is my freshman roommate, Katie.

Duke psychology majors. The blonde at the far right of the photo is my freshman roommate, Katie. Katie is now a lawyer. The girl on the left side of the picture is my sorority sister, Claire. Claire did Teach for America and now works as a science teacher.

These girls all had one thing in common: like me, they all had their struggles with defining what #likeagirl means. But they also didn’t let their athletic, nerdy, or “intimidating” pursuits get in the way of their relationships with significant others or friends. They didn’t compromise their personal standards so that “boys or friends would like them.” And they didn’t hide their efforts in being successful. We didn’t compete, but challenged each other. We were ALL far from perfect and accepted each others’ effortful imperfections. We were proud of being successful women without feeling shame for it. Maybe that’s what #likeagirl meant to us and should mean to everyone else.

The girl in the boot is my junior roommate, Kaitlyn. My sorority sister and good friend Becca is at right. Dr. Kaitlyn just completed pediatric residency. Dr. Becca now has a PhD in child clinical psychology.

The girl in the boot is my junior roommate, Kaitlyn. My sorority sister and good friend Becca is at right. Dr. Kaitlyn just completed pediatric residency. Dr. Becca now has a PhD in clinical psychology.

Defining #likeagirl in the professional world

In physical therapy school, I continued to raise the bar for myself. I didn’t make straight A’s and get uber-involved because I cared about the 4.0 or what involvement would look like on my resume. I did these things because, after all, this is the profession I chose to do and was paying a lot of money for. People were going to be trusting me with their injuries and their lives…and paying money for that!  I wanted to soak it all in, then continually grow and learn more.

That’s pretty much what I’ve done–and I’ve done so following in the footsteps of some other PTs who totally rock it #likeagirl. Read this keynote address for incoming PT students last year given by one of my PT mentors who also happens to have founded the practice where I currently work. She has a great message of fighting #likeagirl to overcome adversity, embrace change, challenge the “norms” and become successful. She mentions the idea of surrounding yourself with people who are better than you are, surrounding yourself with people who challenge you, and taking in as many professional development opportunities as you can. Never does she mention compromising your values because “it’s not cool to be successful.”

I love what I do and I love learning more. I keep finding new things to learn about and courses to take. And now-I love teaching about it too. I have the privilege to teach students in the clinic and teach in the same PT program from which I graduated. I’m surrounded by fascinating female (and yes, some awesome male!) colleagues to keep me driven.

Nerdy PTs have fun together. Here is part of the #pelvicmafia, a grassroots group of PTs advocating for awareness of women's health needs all over the globe.

Nerdy PTs, mentors, and mentees have fun together. Here is part of the #pelvicmafia, a grassroots group of rock star women PT leaders advocating for awareness of women’s health needs all over the globe.

Recently, along with some awesome PTs, I was invited to share my nerddom with other PTs by teaching at next year’s national convention. It’s completely intimidating, but in an inspiring way. But, to be honest, I don’t need a convention to share my excitement for what I do. In my own life, I’m retweeting, sharing, pinning, instagramming or posting every article or inspirational item I can find. To all of you who follow me—sorry I’m not sorry for bombing your newsfeeds and timelines with this stuff.

Nerdy PT posts dominate twitter feed, often accompanied with #nerdclub

Nerdy PT posts dominate my twitter and facebook feeds often accompanied with #nerdclub

#Likeagirl, I’ve turned from the girl being bullied or shamed for being nerdy and successful to someone who is proud to own it. It helps that I have a few supporters who are proud to “own it” with me.

Nerds can be princesses or Wonder Women, too. Here I am with the #nerdclub president.

Nerds can be princesses or Wonder Women, too. Here I am with the #nerdclub president.

#likeagirl, Dr. Julie style

And now I find myself colliding all of my passions, specializing in and working with young athletes. Working with young girls from age 6 and up, I have the joy of seeing girls go from “cute” and running #likeagirl in elementary school turkey trots, “sassy” and competing #likeagirl to make the middle school cheerleading squad, to “sophisticated” and swimming #likeagirl in high school to set records. I’m just happy to help them explore and stay strong in their passions and dreams. Unfortunately, along the way I’ve seen my fair share of girls who have fallen prey to peer pressure and given up on the dreams they’d once devised for themselves at that cute, turkey-trotting age.

My favorite 6 year old cheerleader

My favorite 6 year old: being a rock star cheerleader

The most common age for sports dropout is 13. It’s that “magic window” age when girls are in that 7th-8th grade world of “to give in or not to give in.” Unfortunately in our world, there aren’t other great activities that are always “acceptable” for girls to put their hearts and minds into. Though I imagine there are exceptions to this, girls who hang out with the geeky boys, are in engineering club, beta club, national honor society, robotics club, and the 4H club—but don’t play sports or do “girly” things– likely won’t get elected to be prom queen.

And that makes me sad. I’m not saying the traditional “girly” or “sporty” things are bad. Be a pageant queen! Be a princess! Be a star athlete! Go you! I’m also not saying that the 4H club president needs to be famous. But girls need credit and encouragement for more than the traditional #likeagirl roles they have been given. They shouldn’t have to become “effortlessly perfect” for fear that someone will think they’re intimidating, nerdy, or not feminine for being successful.

My favorite 6 year old is the president of the junior #nerdclub

She may not know it yet, but my favorite 6 year old is also the president of the junior #nerdclub

See this fabulous video from GoldieBlox, a company and campaign devised to inspire girls AND our culture to balance, nuture, applaud, and respect girls’ interests, regardless of what they may be. When I saw that video, it took me back to more of my college observations about defining women’s success by more than just a gender role.

In my experience as a youth sports PT, I find in that “magic window” age of 10-14, too many girls show up on my caseload riddled with pressures placed on them for being too athletic or not athletic enough, too nerdy or not nerdy enough. Some have injuries that just won’t go away without a medical explanation for them. It’s no secret to many of the professionals with whom I work that the girls are often subconsciously using their injuries as an “out” from the pressure of sports. As long as they are injured, they don’t have to compete. Plus they get a lot of love and attention by way of parents, friends, and healthcare professionals worrying after them and making them feel special. It becomes an endless, often sad, cycle, that can end in being socially outcasted, or in medical complications including anxiety, depression, and general decreased conditioning because they are no longer exercising. I think we can all agree that overall these situations probably aren’t the most productive or positive ways to make the girl feel special and valued.

It’s my wish in working with young female athletes or non-athletes, that they never feel pressured to stay involved in a sport or activity that doesn’t make them happy. Likewise, she should be accepted for doing the things that do make her happy. If a girl does or doesn’t love an activity, she should live in a world where she feels ok saying so. She shouldn’t be shamed for being successful because “that’s intimidating.” That can backfire, too. She’ll give up on her dreams and eventually get herself into trouble in some way. Even the young athlete who loves her sport should be encouraged to find balance in her interests, to find success in more than just her sport, academics or her appearance.

It’s important we as a society (and medical profession) encourage success and self confidence in any interest a girl has. We need to encourage that #likeagirl means something awesome, not awful. Maybe that 8 year old princess-loving girl will become a beauty model or Hollywood actress. Awesome! Good for her! Or maybe she will be the CEO of a Fortune 500 company. Or perhaps she will design the next vehicle that takes humans into space. See this GoldieBlox video about women becoming engineers.

GoldieBlox: This is your brain on “princess.” This is your brain on “engineering.”

Developing girls are vulnerable. What we as adults say to them makes a lasting effect. What their peers say to them makes a lasting effect. Just notice how vividly I remember 16 years later when my friend (who is still a good friend) said to me how unpopular or undesirable I was going to be for being a successful female.

So please—no matter what inspires her—help your daughter, sister, niece, friend’s daughter, friend, student or patient have the confidence to be proud to be #likeagirl, no matter what she does to succeed. Help her be proud to humbly share with others how much effort she put into doing so.

  • Model positive behaviors. Service, encouragement of other women, making friends with boys without making them boyfriends.
  • Encourage healthy competition on things that should be competitive (which is almost nothing we do). Encourage teamwork, compassion and support on everything else (which is almost everything we do).
  • Help her learn the difference between “humility” and “weakness”.
  • Help her learn the difference between “aggressive/intimidating” and “assertive and motivated”
  • Define success and confidence in something other than trophies, first places, makeup, number of boyfriends or girlfriends, or the size of her bra or her pants.
  • Help her learn that she does not have to strive for perfection in anyone’s eyes, not even her own. Flaws and differences are good, too. If she is that successful girl (which she will be if you follow all this blogworthy advice), let her know it’s ok to show and be proud of how much effort she put in to that success.
  • It’s ok to be different. Help her embrace the things that inspire her and make her unique, even if you don’t necessarily find yourself inspired by those things.
  • Encourage her to fight #likeagirl in whatever area inspires her and not let her gender define her in any way.

Step it up ladies! You don’t have to be a muscle bound, Rosie the Riveter type to be #likeagirl. It’s ok to be a pageant superstar, a cheerleader, or a princess. But it’s also ok to be an aerospace engineer, high powered CEO, blacksmith, NFL football coach, farmer, or construction worker. Be proud of who you are and model a positive female outlook for all those girls who are looking up to you. If you think someone looks “weak” just say so. If they look strong or successful, just say so. It doesn’t have to be tied to gender roles. Let’s make #likeagirl mean #likeawesome and not #likeawful.

We_Can_Do_It!

National Cheerleading Safety Month: Why it Matters (Part 2)

Now that we’ve established cheerleading as a sport, why does it matter to sports medicine?

My point in painting this picture in Part 1 of cheerleading-as-a-sport is not because I want to see cheerleading in the Olympics. It has nothing to do with my former 6th grade dreams to become a cheerleader. There is the bigger issue. At the end of the day, as with all other sports, cheerleaders get injured. The more participants and complex skills that are required for participation, the more kids will get hurt.

Just as with any other athlete, we are all faced with having to understand cheerleading so that we can rehabilitate them back to their sport. Or better yet—prevent the injuries in the first place. Part of understanding a sport you’ve never done is taking the time to learn about it. So I’ve been to cheer practice, a competition, got the team t-shirt, and have been doing some bedtime reading. I’ve been completely out-tumbled by a 6 year old, too.

According to Shields & Smith (2009 and 2010), some of the most common injuries in cheerleaders (of any variety) are ankle injuries, knee injuries, and low back injuries. When humans have to lift other humans overhead, there is going to be a risk of falling. Either the lifter (known as the “base”) or liftee (known as the “flyer”) could be injured as a result of a flying human failure (that’s a technical term, by the way). Shields & Smith showed that up to 52% of all injuries in competitive cheerleading happen during stunts, up to 24% occur specifically to the base/spotter, 15% from tumbling and 14% from traumatic falls of the flyer. That’s a lot of flying human failure.

In addition to stunting and tumbling skills, the surface on which these athletes cheer may vary from grass to spring floor, resilite (foam) to hardwood floor. The same 2009 study mentioned above showed that 34% of competitive cheerleading injuries occurred on foam floor and 30% on spring floor. The diversity in competition/performance surface literally impacts an athlete’s ability to perform certain skills and has the potential to place undue strain on certain areas—putting them at greater risk for injury. A different study by the same researchers showed marked differences in risk for head injury in cheerleading stunts performed on various surfaces, with higher height of stunt and lower impact-absorbing surfaces leading to greater risk for injury.

Patients of mine have ranged from the competitive cheerleader with a traumatic ACL tear or ankle sprain, to the sideline cheerleader with a stress fracture in the back from improper base and tumbling mechanics. I’ve seen flyers who have fallen from a stunt with severe concussions. I wrote about concussion in cheerleading last month, and the CDC has some great educational information and athlete stories out to spread the word, too.

Last month I began working with a 15 year old high school cheerleader/tumbler who very eloquently told me the reason for her injury was “because I don’t tumble or base with the right form.” Not only was I impressed that a 15 year old identified the root of her problem, but she identified a risk factor that Shields & Smith (2009 and 2010) have shown to be the biggest predictor for injuries in bases. Remember how I mentioned in Part 1 how impressed I was with the University of Kentucky base body mechanics? I take notes for my patients. This is part of what we make sure our bases can do before they can return to cheerleading after injuries. Check out this photo of great base mechanics being taught in 4-6 year olds. Great coaching from an early age instills great injury prevention for the future.

Great body mechanics, coaching & spotting at Stingray All Stars (4-6 year olds) in Marietta, GA

Great body mechanics, coaching & spotting at Stingray All Stars (4-6 year olds) in Marietta, GA

So what do we do in PT? I find that generally for all cheerleaders, no matter what their position or role, the treatment plan mirrors the same plans that I use for gymnasts, divers, or even pole vaulters with similar injuries. The only difference is that for several sideline and all star cheerleaders, we also have to train the skill of avoiding flying human failures.

It is unfortunate to be injured, but fortunate when a young cheerleader ends up in physical therapy. I see it as a great educational, rehabilitative and prevention opportunity to keep a young athlete active and engaged in the sport he or she loves so that he or she can move into a healthy and active adulthood. I love a good challenge and love being creative with my PT skills to develop cheerleading-specific programs to help these young athletes get back to their sports.

I use some cool tools like Pilates apparatus and Redcord Neurac to design kid-friendly and cheer-specific exercises while educating on alignment, spinal mechanics, central stability, breathing mechanics, and all other “typical” concepts I teach to other tumbling and flying patients. If you want to read more about other “core” ideas I incorporate into my young tumbling and stunting athletes, visit this blog or check out this video from my PT colleague Julie Wiebe in Los Angeles.

Unfortunately, many young and even collegiate level cheerleaders do not often make it to a medical provider. In fact, the same 15 year old I mentioned above was injured then immobilized for 6 weeks. That’s a long time to not move a body part, folks. Had her mother not brought it up in conversation with me one day, she would have returned to cheerleading without correcting the imbalances and poor mechanics that likely led to the injury in the first place. As I mentioned, even she knew her mechanics were an issue. They had to ask to be referred to physical therapy. It shouldn’t happen that way.

The disconnect in sports medicine: why cheerleaders don’t get the right care

Why is it that cheerleaders do not regularly receive medical attention? Due to the fact that several sport governing bodies like the NCAA, AAU and sports medicine governing bodies like the ACSM and NATA do not always recognize cheerleading as a sport, cheerleading does not receive money nor sanctions to create a standard set of rules and standards of medical care. It is not heavily researched, though several small groups of researchers have begun to explore this concept. The American Academy of Pediatrics released a position statement on cheerleading. The STOP Sports Injuries campaign also has begun with cheerleading advocacy & safety campaigns.

Most cheerleading competitions are not held in traditional athletic venues; rather they may be held in large convention centers which may not be designed to support emergency medical needs. It is rare to hear of athletic trainers covering cheerleading events and competitions, or for a cheerleading squad to have their own team physician. Without recognition by national and/or international sports and sports medicine governing bodies, there is no requirement for standardization of safety and care.

Enter several of the national cheerleading safety organizations which have formed over the years. Some have been formed by parents who see the need for awareness and advocacy for their young athletes.  It’s not perfect, but it’s definitely a start. See links to some major cheerleading safety organizations below:

American Association of Cheerleading Coaches and Administrators (AACCA)

National Cheer Safety Foundation (NCSF)

United States All Star Federation (USASF)

These organizations are not necessarily unified. Each has different rules and standards for competition and performance and they have different governing “roles” for each type of cheerleading. The spread of leadership and rules contributes to confusion of “who’s in charge” and requires a very diverse skill set in coaches and in athletes.

As we move along the chain from national organizations into the various forms of more “local” cheerleading, including high school, middle school and recreational leagues-there is even less organization. Some school systems include cheerleading as a varsity sport, while others call it a “club.” In college, some schools offer varsity scholarships for competitive cheerleading, while at others it is not recognized as a varsity sport. The NCAA Injury Surveillance survey, an ongoing project chronicling incidence and risk factors for injuries in 16 collegiate sports does not include cheerleading in its study of collegiate sports. This means that these athletes may not be covered nor managed by the school’s athletic training and medical team. They may not be required to undergo preseason physicals or baseline concussion testing, two key injury prevention checkreins. At the end of the day—there is no standardization of rules and care. This leads to an overall problem of funding for research, prevention programs, and management.

In summary, without all of this information, people just don’t know the right way to handle cheerleaders. It’s a safety issue.

What do we do about this?

So what do we do about this? We have to change our language and understanding. There is no use in denying it as a sport. What does one gain from doing this? Does it make one feel like more of an athlete to say that someone else isn’t an athlete? A 2004 study showed that the Vo2 max, body composition, strength & endurance of collegiate cheerleaders rivals that of other collegiate athletes. They’re in shape, they are performing feats that require a high level of athletic skill, and they deserve the same wellness and prevention attention of other athletes. With the number of cheer-related concussions and injuries on the rise, it’s just not worth the risk of ignoring it at this point.

anna-watson-11

To be fair, the cheerleader on the right is a competitive body builder. Impressive! http://nationalconfidential.com/2014/02/anna-watson-photos/

The AACCA is one of several organizations offering a credentialing process for cheerleading coaches. While there are likely many non-credentialed skilled and talented coaches out there, it is generally accepted credentialing protects the consumer—in this case the athlete and family. It improves safety awareness, injury prevention/management, and standardization of coaching and level progression protocols. While there has been conflicting evidence to show the relationship between coaching credential and injuries, a 2004 study in North Carolina high school competitive cheerleaders showed a 40% decrease in cheerleading injuries when credentialed coaches were present. I am a firm believer that a credential does not guarantee skill. However, it does show a commitment to the betterment of a profession and a sport. Find a credentialed coach near you.

In the case of the young cheerleader, this is something that runs rampant on my caseload—and I blogged earlier this year about how am seeing injuries and early specialization in sports from increasingly younger ages. Some of that is parent-driven, as described in this post, but some of it is culture-driven. Early specialization leads to injuries. It’s a problem. But on the flip side-there has to be a balance. Our kids need to stay healthy and active, and sometimes early participation and specialization in a sport is a way to do that.

Ride the cheerleading safety and prevention wave with me! You just might get to wear a cool shirt like the one below and support one of the fastest-growing athletic activities for young athletes.

Disclaimer:

Out of respect for all sports, the comparisons made in this post were not meant to downplay or discount the hard work or dedication of athletes in any other sport or activity. In addition, this was not meant to be an exhaustive post about all factors which contribute to sports injuries in cheerleaders. Be on the lookout for future posts that highlight additional issues in these and other athletes. I welcome your feedback and thoughts for future ideas.

 

Rah! Rah! It’s National Cheerleading Safety Month! (Part 1)

Welcome to National Cheerleading Safety Month!

Wave your pom poms, do a few jumps and leaps, and get excited for this marvelous awareness campaign!

duke cheerleader

Photo credit: goduke.com

For anyone who knows me, you may wonder why in the world I’ve decided to blog about cheerleading safety. I’ve never been a cheerleader. In 6th grade when every single one of my female friends was signing up for recreational cheerleading—the penultimate way to become popular and gain friends in middle school—I was qualifying for travel swim meets to California and Orlando. I went to Disney on both coasts in one summer. Let me tell you, I really suffered at making friends. Regardless of that, I still felt a little left out at the time from this seeming rite-of-passage activity for many young ‘tweens. Nowadays we call this a #firstworldproblem.

So why do I care? Perhaps it’s because a friend of mine has a high-flying-tumbling-and-stunting fanatic 6 year old who can pull off some pretty fancy skills. Or maybe it’s the plethora of cheerleaders I have treated over the past few years for a plethora of injuries and problems. While I’ve learned there are many types of cheerleading, there always seems to be a common denominator among their injuries: no one definition for the sport, leading to no unified standards for safety, and subsequently increased risks for injury.

So let’s just start with one fact: Cheerleading is a Sport.

There. I said it. Did you agree with me? Roll your eyes or shudder at the thought of considering it a sport? Vehemently disagree? Still on the fence? If you answered yes to any of those, then please humor me and proceed.

By calling cheerleading a sport, it would imply that I’m lumping all types of cheerleading into the same category. Yes, I do realize there are differences. Keep reading.

The cheerleading “purists” out there might argue that sideline cheerleading is not the same as all star or competitive cheerleading. You may be thinking “well MY KID does the athletic type of cheerleading. Those other kids who stand on the sideline: that’s not a sport.” Some types of cheerleading require higher levels of athletic skill and teamwork than others. But for the sake of argument and keeping me from writing 4 separate blog posts, let’s just put them all together.

On the contrary, some cheer “haters” would throw out every excuse and argument in the book to support the “cheerleading is NOT a sport” campaign. Some have even blogged about it, asking “how dare cheerleaders compare themselves to LeBron James?” I’m not sure anyone is actually comparing cheerleading to LeBron, except perhaps the author of that post. That’s like apples and oranges. Both are fruit, yes, but there really is no comparison. Both cheerleaders and basketball players are athletes, yes, but comparing is futile. If I could figure out the reason anyone would spend his or her time arguing against cheerleading as a sport, I think it would solve the meaning to life. Did cheerleading wrong you in some way? Did it trip you in middle school or steal your lunch?

I’ve heard that girls (and guys!) who jump and clap for another sport are not, in fact, participating in their own sport. Who cares if the sport is in support of another sport? Take cheerleaders who cheer on football players, for example. They jump for 2-3 hours, dance, lift each other up overhead, tumble, and perhaps perform a well-choreographed routine for several minutes at halftime. A casual observation would see that some cheerleaders—even the sideline ones—do more on their feet than the 4th string benchwarmer. I’m not knocking the freshman who is anxiously waiting for play time, but I’m just sayin’…the cheerleader is burning more calories than you dude.

Let’s look at it another way. How great it is that two sports are put together for an overall end result of everyone-gets-a-workout and everyone-works-as-a-team? What a marvelous concept! You go to a football game and also get to watch cheerleading. That’s two-for-the-price-of-one, folks. And who doesn’t like a good BOGO deal? Perhaps we should rephrase and say you’re watching cheerleading and as an added bonus, there are guys in funny padded costumes knocking each other over in the background. Depending on how your favorite football team’s season is going (or not going), you may prefer to spend your season ticket money watching those tumblers and stunters.

Then there’s the “costume” argument. I’m going to just call it like it is. If you’re going to argue anything about the appearance of a cheerleader having anything to do with it being a sport or not, I’d urge you to reconsider. I’ve heard the phrase “Girls who wear barely any clothes, wear makeup and glitter are not athletes.” So how do you explain gymnastics? Have you SEEN the hair spray, makeup, glitter, and lack of clothing in gymnastics? If you haven’t, take a look at the photos below.

Have you been to a swim meet lately? We all used to joke about girls who curled their hair and put on make up just to dive in the pool and mess it all up. Then they’d go re-do their makeup in between events. And last time I checked—swimmers don’t wear ANY clothing. Don’t even get me started on the “acceptable” amount of swimsuit wedgie. Let’s just say that we all knew who THAT girl was who crossed the line (literally) in her Arena suit. She always swore that’s how they’re worn in Europe. And we won’t even discuss guys in racing Speedos.

Skilled runners all over the world wear spandex shorts that barely cover their bums and sometimes up top they wear only a sports bra. Last time I watched the Olympics even the male runners had on jewelry and the female runners had beautiful hairstyles and wore makeup. Don’t believe me? Check out this blog on “What Professional Runners and Prom Queens Have in Common”.

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Shout out to Duke ’06 runner & 2008, 2012 Olympian Shannon Rowbury! Photo credit: http://www.donidexter.com/blog/2012/07/02/womens-1500-meter-semi-finals-olympic-trials/

Makeup, glitter, and barely any clothes are just part of the pedagogy in most of these activities. It’s what helps them function in their roles. Visualize an Olympic sprinter in full football gear, or a gymnast in a helmet or elbow pads. Gotten a good mental image down? Just wouldn’t have the same effect, now would it?

Next argument. If an activity has organized practice, requires conditioning, stretching, strengthening, coaching, hydration in between exercises, stresses someone’s cardiovascular reserve—is that not an athletic activity by any other name? Then you add the judging and scoring associated with all star cheerleading—and now you have an athletic competition.

There are the artistic and skill components of choreography and tumbling in cheerleading. Wait! Gymnastics has choreography and tumbling in the floor routine! Interesting! Some may argue that a “subjective” activity like gymnastics or diving with a scoring system is not really a sport or game. I’d like to see you practice gymnastics for 20+ hours per week and tell me you’re not doing a sport. Tell Gabby Douglas she’s not an athlete. Let me know how that goes for you.

In addition, there’s synchronized swimming and one of my favorites- the new Olympic sport of synchronized diving (shout out to Duke Women’s Diving Olympic Silver Medalist Abby Johnston, by the way!). Both have choreographed tumbling-esque components. Oh, and check out the makeup and costumes in synchronized swimmers. Minus the whole don’t-drown-while-dancing-upside-down-underwater part, how is synchronized tumbling in cheerleading any different?

Let’s layer on teamwork. The amount of teamwork required for cheerleading stunts is impressive if you have ever seen a competitive cheerleading routine. This level of teamwork and coordination is present in other activities we call “sports” including rowing, soccer, basketball, and football. And no, if you think I’m being the pot calling the kettle black– I’m not comparing University of Kentucky Cheerleading to the Miami Heat. I’m just making a point on teamwork. So, if sports require teamwork, then I would presume that cheerleading should fall into the sports category, correct?

But wait! Some of those sports I mentioned are games. Cheerleading is NOT a game, right? So what is a game? According to the University of Google, a game is a “form of play or sport, esp. a competitive one played according to rules and decided by skill, strength, or luck.” By that definition, I think we can call cheerleading a sport, athletic activity, and I would go so far as to call it a (gasp!) game.

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Stingray All Stars Grape Rays. Photo credit: https://twitter.com/Grape_Rays/status/348063948752449537/photo/1

Unlike the similar activities of gymnastics and diving that I already mentioned, there is one element of cheerleading that makes it unique. Weight lifting. Let me clarify. This is not CrossFit Cheerleading. By “weights” I mean humans. Now that’s some high-risk weight lifting. While I completely respect (and love!) diving and gymnastics, neither of those sports requires humans to lift other humans in a completely well-timed choreographed routine. Then there is the comparison we could draw with weight lifting and throwing. Do you see Olympic weight lifters dead lifting another weight lifter? No. Do you see the javelin thrower launching another human into the air? No. Come to think of it, the entertainment behind both of those ideas might actually get me to watch them on TV.

So in summary—if cheerleading is not an athletic pursuit, sport, game, or whatever term you’d like to use, then I feel I’ve been misinformed for 30 years about what IS a sport.

Still not convinced? Check out this video. These collegiate cheerleaders (arguably the best in the nation) have earned the title of “sport” in my book. I might also add that I’m ridiculously impressed with the body mechanics of the bases. They make it look easy. Read on to Part 2 to find out why basing body mechanics are important and why cheerleaders, like all athletes, need good safety awareness, sports medicine care, and research.