WINSTON-SALEM, N.C. — From pom-poms to powerful stunts, cheerleading simply isn't what it used to be.
"People think we show, we smile and we say go Deacs and it's so, so much more than that," Lexi Bosetti, Wake Forest cheerleader, said.
"I don't think even student-athletes understand what goes into our practices and how much effort, time and blood and sweat and tears goes into cheer," Emily Potts, Wake Forest cheerleader, said.
With high flying skills comes high-risk injuries.
WFMY's Stacey Spivey interviewed four cheerleaders and their coach. When she asked them to raise their hand if they've ever been injured in cheerleading, all five raised a hand.
Dr. Chris Miles works in sports medicine at Wake Forest School of Medicine. He said concussions are the second most common injury in cheerleading.
"It has gone up more so than other sports like football and hockey," Dr. Miles said.
That's why coaches are practicing new safety measures. At Wake Forest, their cheerleaders wear foam helmets any time they try something new like a stunt.
"We started doing those and I feel like we have very minimal concussions this year based on what I've worked with in the past by adding helmets into our safety protocols," said Christy Creson, Director of Spirit Programs for Wake Forest.
Creson said while work is being done at the collegiate level, she thinks more needs to be done to improve safety at the lower level like with middle and high school cheerleading programs.
"I don't think they understand how dangerous cheerleading can be if it's not taken seriously and it's not done in the right way," said Creson.
Dr. Miles and his team are studying concussions and their effects long-term for young athletes including in sports like cheerleading.
"It's a safe sport overall when done appropriately, but when injuries occur they can be very catastrophic, dangerous and even life-threatening," Dr. Miles said.
If your athlete experiences any symptoms like headaches, dizziness, trouble with bright lights and loud sounds, inability to perform daily activities, mood changes or sleep disturbances, they need to be evaluated.