Cheerleading has evolved from sideline cheers into evolved and elaborate pyramids, dangerous routines, and gymnastic stunts.

A new study finds that now, cheerleaders are getting injured more frequently and more severely than ever before. More than half of all cheerleading injuries are sprains and strains, and doctors say these injuries are on the rise.

“They’re increasing in number and so we kind of had to sit back and ask ourselves why these are happening,” said Jeff Mjannes, doctor of sports medicine.

The study was conducted by the American Academy of Pediatrics. Using data from the U.S. Consumer Product Safety Commission found that hospital visits between 1980 and 2007 rose 400-percent to 26,786 cheerleading-related injuries.

Doctors say the increase in hospitalizations is related to cheerleading’s more gymnastics-type routines.

Mjannes said, “The more complex stunt, the more gymnastic fast paced routine, the higher the injury.”

According to Aaron Curl, High School Athletic Director and former cheerleading coach says mats and other safety measures are used at the high school level.

“We follow FHSA guidelines. We have our coaches, they’ve been trained properly,” said Curl.

The American Academy of Pediatrics recommends that coaches have more training, and that cheerleading be considered a sport. Dr. Mjannes noted that when sports are a sanctioned school sport, the athletes have access to trainers or team physicians at the practice facilities.

But while Athletic Director Curl sees the good intentions of the Academy’s recommendations, he sees challenges in moving them forward. Curl says, "It's a good idea, but it's gonna be very hard I think to find coaches to meet those requirements at the high school level, at least at all high schools."