Patty Phommanyvong, a cheerleader for Marshall High School in Los Angeles, was thrust into the air while performing a stunt at a football game two years ago. The next thing anyone knew, she was limp. Her heart had stopped beating.
Paramedics were called, but by the time they got her heart restarted, her brain had been deprived of oxygen for too long and she was in a coma. Experts say she may have been inadvertently struck in the chest on her descent from the stunt.
Confined to a nursing home, Phommanyvong, now 19, can't eat or speak. She communicates by blinking her eyes.
Her father, Say, a Laotian immigrant, said: "I didn't know that they were throwing her up in the air. That's for professionals. Why would the school allow that?"
Variations of Patty's story are all too familiar among cheerleaders. While her tragic circumstance wasn't because of anyone's mistake, there are many examples of even more experienced cheerleaders being seriously hurt in spectacular spills.
Jessica Smith of Sacramento City College broke her neck when she fell headfirst about 15 feet in 2006; Rechelle Sneath, a cheerleader for San Jose State, fell while practicing in 2004 and is paralyzed from the waist down. Yet daredevil stunts are routinely performed at youth, high school and college sporting events across the country.
And, according to experts and reporting by The Times, these stunts are often done without proper safety precautions or supervision.
"Right now, cheerleading is out of control," said Dr. Frederick Mueller, director of the National Center for Catastrophic Sports Injury Research at the University of North Carolina. "Kids are practicing all over the place without mats. They practice when they want to, do what they want to, and some coaches aren't certified and don't know what they're doing."
Statistics confirm the danger. Cheerleading injuries resulting in emergency room visits have increased almost sixfold since 1980, to nearly 30,000 in 2008, the U.S. Consumer Product Safety Commission reported.
The exact number of serious injuries isn't known because there is no formal reporting system, but annual statistics tracked by Mueller's organization offer a snapshot of the situation.
Over 26 years, disabilities or deaths caused by head or spine trauma are almost double for female high school cheerleaders than for female players of all sports combined: 73 "catastrophic injuries" -- including two deaths -- from fall 1982 to spring 2008. Gymnasts were second, with nine injuries.
Cheerleading advocates say the percentage of debilitating injuries is low considering the participation numbers, which, by some estimates, is at least 3 million nationwide -- more than 400,000 at the high school level. But several reports say cheerleading accounts for a disproportionate percentage of major injuries when compared with other activities.
In college, the NCAA insurance program reported that as recently as 2005, about 25% of what it spent on student-athlete injuries was related to cheerleading. Football, with nearly 10 times as many participants, accounted for 57% of the money spent.
After several highly publicized injuries in cheerleading, the NCAA mandated more safety measures. However, there is little consistency in rules and protocol among dozens of cheerleading organizations nationwide.
For example, in California, as in most states, high school cheerleading is not recognized as a sport. As a result, regulation is left to individual school districts.
Experts attribute cheerleading's danger to three things: inadequate safety measures, improper training and the competitiveness of the activity. One television experiment showed that the sideline action might be more perilous than a powerful football tackle.
The Fox Sports show "Sport Science" examined a popular move called a basket toss, in which a "flyer" is launched into the air by her teammates. The UC Irvine cheer squad performed the move as scientists measured the speed and height reached by the woman. A crash dummy was then used to determine the effect of a fall. The impact was measured at 2,000 pounds, which was compared with the force of a hit by an NFL linebacker at 1,800 pounds.
Though many athletes throw a ball around, cheerleaders throw each other around. Even at youth levels -- there are teams for girls as young as 5 -- participants try to make their routines more spectacular than the next by adding spins, flips and twists regardless of the danger.
"Parents should attend practices and competitions," said Kristen Dostalik, cheer coach at Santiago High School in Corona. "They think they're signing their kids up for the cheerleading [that existed] when they were in high school, but it's changed."
As in the past, the activity still includes plenty of pompoms, megaphones and glitter. But today, routines also feature dynamic gymnastics and tumbling elements -- things that look easy on a video but are difficult for neophytes.