Out of America: Cheerleading has become a matter of life and death

his is March madness season in the US. No, I am not referring to the timing of the invasion of Iraq, or even the St Patrick's Day frenzy among people who have never sipped a Guinness in their lives. March madness is something even more deeply embedded in the collective American psyche - the national college basketball championship, a landmark of the country's sporting calendar as beloved as the World Series or the Super Bowl. But this year something will be missing.

Think basketball or American football, and you think cheerleading. For most of us, that means bevies of jaunty young ladies prancing around in skimpy costumes with pompoms on their derrières, twirling batons to the strains of John Philip Sousa. It's shallow, regimented, sexy and narcissistic - a metaphor, perhaps, for American popular culture.

It's not only basketball and American football games that need their cheerleaders to while away the time-outs and intermissions. In January last year I proudly attended George Bush's second inauguration parade, watching my son in the colour guard that led his high school band past the presidential viewing stand. That frigid afternoon wouldn't have been the same without a contingent of skimpily clad Texas cheerleaders, high-stepping past with broad come-hither smiles frozen on their faces.

But forget the clichés. Cheerleading these days is a sport in its own right. I was reminded of that earlier this month when I saw the TV pictures of a girl on a stretcher, her head in a medical brace, waving her arms to the music as she was carried from a Midwestern basketball court.

The girl was Kristi Yamaoka, a member of the cheerleading squad at Southern Illinois University. She had just fractured a vertebra in her neck and bruised a lung after falling 15ft to the ground from the top of a four-storey human pyramid during an intermission routine. Yet when the band struck up the team's anthem, "Go, Southern, Go", she still found the strength to do her thing.

That moment a national heroine was born. "My concern was to show I was OK," she told the network breakfast shows. "I just knew that it would be a little easier for my team and squad to concentrate if they weren't worrying about me." Kristi's devotion to the common good is obviously admirable. But the episode also speaks volumes about what cheerleading is really about these days.

Even when it was frivolous fun, it was serious - and, in one instance, literally a matter of life and death. Not that long ago, a Houston woman was sent to prison for 10 years for hiring a hitman to kill the mother of her daughter's rival for a spot on the school cheerleading squad.

That, of course, was Texas, which is to cheerleading what Lord's is to cricket. But even there, things seemed to be getting so out of hand that the state's House of Representatives passed a law outlawing "sexually suggestive" routines by cheerleading squads. According to Al Edwards, the measure's sponsor, such displays "contributed to a social atmosphere that encourages teen pregnancy, poor school performance, criminality and the spread of sexually transmitted diseases". In fact, cheerleading is moving on, though a pert face and a jaunty stride still help. But fitness and agility are now what count. A cutting-edge cheerleader these days is less sex symbol than a cross between circus tumbler and Olympic gymnast.

For the ambitious there are now summer cheerleading camps. Colleges are recognising "competitive cheer", with its physically demanding, elaborately choreographed numbers, as a full-scale sport. Cheerleaders train and perform five days a week, six months a year. There are scholarships. The very best can turn professional.

But as their skills and repertoire have grown, so have the risks. A recent study found that cheerleading injuries more than doubled between 1990 and 2002. Over that period, 200,000 youthful cheerleaders had to be treated in hospital. Most were minor cases, but more than 50 involved "catastrophic injury". Last year a 14-year-old girl was killed after being thrown in a practice routine. Yamaoka - who is expected to make a full recovery - was lucky.

Now some of the most daring stunts have been banned, March madness or not. For instance, the human pyramids that led to Yamaoka's injury will henceforth be limited to two storeys. But the risks are surely here to stay. Indeed, they may only serve to make cheerleading more than ever a symbol of American womanhood: still the wholesome girl next door, but a girl who is also athletic, disciplined and brave. In short, someone like Kristi Yamaoka. "Life is full of risks, you can die at any moment," she says. Oh yes, and her team won its game, thus qualifying for the contest's final stages.