It is more competitive than ever before, and a new study suggests more and more cheerleaders are getting hurt participating in the sport they love.
Today's cheerleader has to be part dancer, part gymnast and part high-flying acrobat.
Mandy Jenkins, an athletic trainer at Robert E. Lee says she the demanding sports puts cheerleaders in her office all the time.
"A lot of the injuries that we see are mainly over-use injuries; wrist sprains, ankle sprains, that type of thing," says Jenkins.
She and her crew can deal with many of the injuries, but sometimes it's more serious.
According to a study by the National Center for Catastrophic Sports Injury Research there were 104 reports of head and spinal injuries among female high school and college athletes from 1984-2005. About half of those were cheerleading related, which surpasses all other sports combined.
Dr. Kim Foreman with Azalea Orthopedics in Tyler sees some of the more serious injuries. He remembers one accident that caused a spinal fracture.
"She was doing what is called a basket toss, where several people throw her up in the air and are supposed to catch her, but she didn't get caught," says Foreman.
Leaders in cheerleading organizations say when you consider the millions who participate, cheerleading is not dangerous to the overwhelming majority. However, efforts to make it safer often fail, because there are so many different cheerleading groups. Each one has its own set of safety regulations.