A new report from the journal Pediatrics looked at concussion rates in high school sports and found cheerleading came in second only to football on the list of most concussions sustained during practice, beating out contact sports like lacrosse and hockey.

Dennis A. Cardone, DO, co-director of NYU Langone’s Concussion Center and Center for Young Athletes, says part of the problem may be a disparity in concern about head injuries between contact sports and cheerleading programs.

“We have seen some evidence that female athletes may take longer to recover from head injuries than male athletes,” says Dr. Cardone, who is also an associate professor in the Departments of Orthopedic Surgery and Pediatrics. Additionally, some school districts may not recognize cheerleading as a sport, meaning there “may not be proper trainers on hand during practices,” he says.

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