CINCINNATI, OH (FOX19) - There are no helmets and no shoulder pads. Cheerleaders have to rely on themselves and each other in what researchers say is the most dangerous sport for female athletes.
"I was doing competitive cheerleading and I got kicked in the face, and I got stitches," said Ashley Albin, a Fairfield High School cheerleader.
"Landed on my foot sideways and broke my bone in my foot," added her teammate, Katie Overbee.
Lauren Goldfuss, a 12 year old from Boone County, has also experienced the dangers of cheering.
"I'm the flyer, so I like getting thrown up in the air," she said. "I fell and the they weren't able to catch me, because I fell like too far away. I was just in a tremendous amount of pain.
She fractured her humerus, the bone in her upper arm, after falling and landing on her shoulder at cheer practice. Goldfuss has to wear a sling for a month and a half and can't cheer for three months. She'll also have to go through physical therapy.
"I'm a nurse so I was definitely worried about whether she would have to have surgery, whether it would effect her growth plate," said Mary Shok, Lauren's mom.
Doctors say Lauren is one of the lucky ones. Hundreds of YouTube videos show cheerleading stunts and tumbles taking a turn for the worst, from being dropped on the gym floor, elbowed in competition and flipped in the wrong direction.
"A lot of the catastrophic injuries that happen in sports, such as neck injuries and head injuries, almost half of those happen in cheerleaders," said Dr. Nicholas Edwards with Cincinnati Children's Sport Medicine.
High school cheerleading accounts for 65 percent catastrophic injuries among female athletes to be exact, which can cause brain damage, paralysis or even death.
Dr. Edwards says the other half of cheerleading injuries they see are sprained and strained ankles or even concussions.
"Concussions are really common in cheerleaders," said Dr. Edwards.
Edwards' staff treats dozens of high school athletes each week. He says he often worries more about the girls doing the flips than the guys with the football.
"The cheerleaders are operating on a hard surface and they don't have helmets," said Edwards.
Research shows cheerleading tops the list for injuries, ahead of soccer, basketball and even football for high school athletes.
"Football players wear helmets and they're on grass," said Edwards.
Fairfield High School coach Kari Hansee says warming up and stretching is part of the routine to prep her girls for game day.
"We do a head to toe stretch before games, practices, even pep rallies, anything performance that we're going to do, to make sure that the girls are ready to go, ready to jump, ready to kick ready to tumble," said Hansee.
And many on the squad view the injuries as a right of passage that all comes with the cheer and tumbling territory.
"It just makes me work harder, one person doesn't carry a team, it's the whole team , so you have to fight for your team," said Albin.
"Even if it was a worse injury, I probably would have kept cheering," said Overbee.
As Goldfuss waits for her shoulder to slowly heal, she's not putting away her pom poms.
"It's a lot of fun," she said. "I don't think I would want to give that up just because I got hurt once."