Modern cheerleading, featuring towering human pyramids, is physically demanding and potentially dangerous, which is why the American Medical Association (AMA) says it should be classified as a sport.

The AMA announced this week that it has changed its official policy to reflect that cheerleading should be classified as an athletic event, just as football and baseball are.

The decision could affect the decision-making of other organizations, leading to more safety measures for cheerleaders and better-trained coaches.

“These girls are flipping 10, 20 feet in the air,” pediatrician Samantha Rosman told the AMA at its annual meeting, according to the Associated Press. “We need to stand up for what is right for our patients and demand they get the same protection as their football colleagues.”

What started out as sideline entertainment has evolved into a competitive and physically punishing sport that now causes more catastrophic injuries in young women than any other sport in high school or college. And unlike sports such as football, many of those injuries are coming in practice. That cheerleading is not classified as a sport by many schools might account for that.

“When we delve into the data more closely, we can actually find out where practice-related concussions are occurring,” Dawn Comstock, a professor at the Colorado School of Public Health in Denver who runs High School RIO, a national database that monitors high school sports injuries, told fivethirtyeight.com. “With cheerleading, they’re occurring all over the place. They’re occurring on asphalt, on grass, on tile. And if you think about it, if cheerleading isn’t considered a sport, [it] may not be afforded the same resources—even for practice—as other sports.”

The AMA is not the first medical organization to reclassify cheerleading. In 2012, the American Academy of Pediatrics took a similar position. State governments also have been taking a different view of cheerleading: 35 states and the District of Columbia now consider it a sport.

-Noel Brinkerhoff, Steve Straehley

To Learn More:

AMA Officially Designates Cheerleading a Sport (by Lindsey Tanner, Associated Press)

Where Cheerleading Ranks in Safety Among High School Sports (by Walt Hickey, FiveThirtyEight)

Connecticut College Not Allowed to Replace Women’s Volleyball with Cheerleading (by David Wallechinsky and Noel Brinkerhoff, AllGov)