Poms-poms and cheering on the sidelines now play just a small part in the world of cheerleading. It's evolved to become one of the most competitive sports in the country and also one of the most dangerous.
A lot of media attention has been given to football players lately and how dangerous it can get on the field. They're susceptible to a range of injuries, one of the most common being concussions.
But what about cheerleaders?
At Garner Magnet High School, the cheerleading team spends hours training and preparing for pep rallies, football games, and cheerleading competitions.
Spend just a few minutes with these girls during practice and their athletic abilities are undeniable.
Lacey Castora is the co-captain of Garner's cheerleading team. She said, "It's a lot harder than you think. I've seen people fall and get hurt tumbling."
A quick search on YouTube and you'll see just how dangerous competitive cheerleading can be.
The sport comes only second to football in catastrophic injuries. This makes cheerleading the most dangerous female sport in the country.
During practice at Garner High, one of the girls fell during one of the stunts.
Former cheerleader Whitney Rigsbee said it's just part of the sport. "In high school one time, I dropped and dislocated my elbow. So, I was out about six weeks to two months for that."
Just as the sport has evolved, the rules to protect cheerleaders have also evolved over the years.
Helen Cole is Garner's cheerleading coach. Cole said, "A couple years ago they took out a 7-20, which is a spin down and you twist around twice. Well, there were apparently a lot of head injuries and concussions from that particular move. We cannot spin twice. We can only spin once."
The number of cheerleaders hurt each year has climbed drastically in the last 20 years. A national group of cheerleading coaches is campaigning to make cheerleading an official sport, so it can get the right staffing and resources other sports do, to protect their athletes.