The Effects of Cheerleading Surfaces on Landing Characteristics During Vertical and Flip Landings

Lateral ankle sprains are common injuries in cheerleading and typically occurring during tumbling. The landing surface can impact injury risk by modulating loading parameters and risky joint positions. Most surface-landing studies have used vertical landing tasks to study acrobatic populations, and few studies have compared vertical and flipping tasks. Therefore, the purpose of this study was to compare the effects of two cheerleading surfaces between vertical drop landing and flip landing tasks. Doing so explained surface characteristic influences on landing and the validity of using vertical landing tasks to represent acrobatic sports. Twelve collegiate cheerleaders (7 females, 5 males; age: 21.0 ± 2.5 years; mass: 64.5 ± 14.5 kg; height: 1.7 ± 0.1 m) performed flip (FLIP) and vertical (VERT) landing tasks over a harder (HARD) and matted (MAT) surface. Three-dimensional kinematics and kinetics were collected, and sagittal and frontal plane kinematic and kinetic variables were extracted during landing. Repeated measures ANOVAs (task x surface) were conducted to determine task and surface effects (p < .05). The FLIP task caused significantly greater impact peaks and loading rates, greater knee flexion at IC, peak knee extension and abduction moments, greater ankle plantar flexion and eversion moments, and less ankle plantar flexion at IC. There was greater vertical foot velocity at IC during FLIP tasks which was primarily due to angular velocity, and it likely explains the greater loading characteristics during FLIP tasks. The HARD surface landing caused significantly greater loading rates, greater knee flexion and ankle inversion at IC. Sagittal ankle moments had a significant task and surface interaction (p = .006), but no joint moment surface effects were observed. These indicated that FLIP and VERT tasks are significantly different due to angular components. The larger forces and joint stress observed in flipping places individuals at greater risk for ankle injuries. Flipping on a harder surface also introduced higher risks. The theory that landing on harder surfaces increases injury risk is supported. These results also caution individuals when generalizing vertical landings to acrobatic populations.

Year	Entry
1985	Tropp H, Askling C, Gillquist J. Prevention of ankle sprains. Am J Sports Med. July 1985;13(4):259-262.
1994	Surve I, Schwellnus MP, Noakes T, Lombard C. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the sport-stirrup orthosis. Am J Sports Med. September–October 1994;22(5):601-606.
2007	Fong DT-P, Hong Y, Chan L-K, Yung PS-H, Chan K-M. A systematic review on ankle injury and ankle sprain in sports. Sports Med. 2007;37(1):73-94.
1983	Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.
2014	Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. January 2014;44(1):123-140.
1993	Barrett JR, Tanji JL, Drake C, Fuller D, Kawasaki RI, Fenton RM. High- versus low-top shoes for the prevention of ankle sprains in basketball players: a prospective randomized study. Am J Sports Med. July–August 1993;21(4):582-585.
1991	Milgrom C, Shlamkovitch N, Finestone A, Eldad A, Laor A, Danon YL, Lavie O, Wosk J, Simkin A. Risk factors for lateral ankle sprain: a prospective study among military recruits. Foot Ankle. August 1991;12(1):26-30.
1995	Baumhauer JF, Alosa DM, Renström PAFH, Trevino S, Beynnon B. A prospective study of ankle injury risk factors. Am J Sports Med. September–October 1995;23(5):564-570.
1999	Hewett TE, Lindenfeld TN, Riccobene JV, Noyes FR. The effect of neuromuscular training on the incidence of knee injury in female athletes: a prospective study. Am J Sports Med. November–December 1999;27(6):699-706.
2007	Marshall SW, Covassin T, Dick R, Nassar LG, Agel J. Descriptive epidemiology of collegiate women's gymnastics injuries: National Collegiate Athletic Association injury surveillance system, 1988-1989 through 2003-2004. J Athl Train. April–June 2007;42(2):234-240.
2011	Mok K-M, Fong DT-P, Krosshaug T, Engebretsen L, Hung AS-L, Yung PS-H, Chan K-M. Kinematics analysis of ankle inversion ligamentous sprain injuries in sports: 2 cases during the 2008 Beijing Olympics. Am J Sports Med. 2011;39(7):1548-1552.
2017	Mauntel TC, Wikstrom EA, Roos KG, Djoko A, Dompier TP, Kerr ZY. The epidemiology of high ankle sprains in National Collegiate Athletic Association sports. Am J Sports Med. July 2017;45(9):2156-2163.
2009	Villwock MR, Meyer EG, Powell JW, Fousty AJ, Haut RC. Football playing surface and shoe design affect rotational traction. Am J Sports Med. 2009;37(3):518-525.
1987	Nigg BM, Bahlsen HA, Luethi SM, Stokes S. The influence of running velocity and midsole hardness on external impact forces in heel-toe running. J Biomech. 1987;20(10):951-959.
2009	Winter DA. Biomechanics and Motor Control of Human Movement. 4th ed. Hoboken, NJ: Inc, John Wiley & Sons; 2009.
1988	Siegler S, Chen J, Schneck CD. The three-dimensional kinematics and flexibility characteristics of the human ankle and subtalar joints, I: kinematics. J Biomech Eng. November 1988;110(4):364-373.
2002	Beynnon BD, Murphy DF, Alosa DM. Predictive factors for lateral ankle sprains: a literature review. J Athl Train. October–December 2002;37(4):376-380.
2005	Beynnon BD, Vacek PM, Murphy D, Alosa D, Paller D. First-time inversion ankle ligament trauma: the effects of sex, level of competition, and sport on the incidence of injury. Am J Sports Med. October 2005;33(10):1485-1491.
2011	Waterman BR, Philip J. Belmont J, Cameron KL, Svoboda SJ, Alitz CJ, Owens BD. Risk factors for syndesmotic and medial ankle sprain: role of sex, sport, and level of competition. Am J Sports Med. 2011;39(5):992-998.
2010	Wannop JW, Worobets JT, Stefanyshyn DJ. Footwear traction and lower extremity joint loading. Am J Sports Med. 2010;38(6):1221-1228.
1971	Radin EL, Paul IL. Response of joints to impact loading, I: in vitro wear. Arthritis Rheum. May–June 1971;14(3):356-362.
2001	McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. Br J Sports Med. April 2001;35(2):103-108.
2012	Fong DT-P, Ha SC-W, Mok K-M, Chan CW-L, Chan K-M. Kinematics analysis of ankle inversion ligamentous sprain injuries in sports: five cases from televised tennis competitions. Am J Sports Med. November 2012;40(11):2627-2632.

Year

Entry

1985

Tropp H, Askling C, Gillquist J. Prevention of ankle sprains. Am J Sports Med. July 1985;13(4):259-262.

1994

Surve I, Schwellnus MP, Noakes T, Lombard C. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the sport-stirrup orthosis. Am J Sports Med. September–October 1994;22(5):601-606.

2007

Fong DT-P, Hong Y, Chan L-K, Yung PS-H, Chan K-M. A systematic review on ankle injury and ankle sprain in sports. Sports Med. 2007;37(1):73-94.

1983

Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.

2014

Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. January 2014;44(1):123-140.