NEW YORK (Reuters Health) – Cheerleading is behind a greater share of severe injuries in student-athletes than previously thought, according to a new report.

In fact, researchers found, over the past 25 years, the sport has accounted for two-thirds of catastrophic injuries among female high school and college athletes. Catastrophic injuries include fatalities, permanently disabling injuries and traumas that are serious but not permanent — such as a non-paralyzing spine fracture.

Injuries like these are not common in high school and college sports.

In 2007, for example, two U.S. high school cheerleaders sustained a catastrophic injury, according to the report, from researchers at the University of North Carolina at Chapel Hill.

However, the rate of such injuries among female student-athletes has been increasing over the years, lead researcher Dr. Frederick O. Mueller said in a statement released by the university.

For the past 25 years, Mueller and colleagues at the UNC-based National Center for Catastrophic Sports Injury Research have been issuing an annual report on rates of such injuries at the high school and college levels.

Past estimates have had cheerleading accounting for 59 percent of all sports-related catastrophic injuries to female student-athletes. For this year’s report, however, Mueller’s team had additional injury data from a California non-profit called the National Cheer Safety Foundation.

They now estimate that between 1982 and 2007, there were 103 fatal or severe injuries among female high school athletes, with cheerleading accounting for 67. By comparison, the next two most risky sports were gymnastics and track sports, which accounted for nine and seven injuries, respectively.

At the college level, there were 39 catastrophic injuries among female athletes over the 25-year period; 26 were related to cheerleading.

“A major factor in this increase has been the change in cheerleading activity, which now involves gymnastic-type stunts,” Mueller said.

“If these cheerleading activities are not taught by a competent coach and keep increasing in difficulty,” he added, “catastrophic injuries will continue to be a part of cheerleading.”

It may never be possible to eliminate such injuries from school sports, Mueller noted, but rates can be reduced.

He and his colleagues recommend that besides ensuring that all coaches have the ability to teach the fundamental skills of their sport, schools should also have a certified athletic trainer on their faculty, and have emergency plans in place in the event of a serious injury to one of their students.