The voice on the phone sounded calm to Tina Kropelin. It said her daughter had just taken a spill at cheerleading practice, and she should come get her.
As Kropelin headed to Holmen High School in western Wisconsin, she worried it might be a broken wrist or a sprained ankle. Her daughter, Brittany Noffke, was a freshman and already a varsity cheerleader, a "flyer" who hit the dramatic height of stunts with a smile on her face. Crutches would make her crazy, Kropelin thought.
Conscious but confused, Brittany said she and two other cheerleaders had attempted a stunt their coach suggested, one they'd never tried together. The last thing Brittany remembered was making it to the top and telling herself to stay still.
Her teammates had to fill in the rest: While Brittany teetered some 5 feet above ground, the spotter went the wrong direction. She fell backward with nobody to catch her. Even the cheerleader holding her didn't realize what was happening until Brittany's head hit the ground.
Brittany had seen the blood coming from her head. The 14-year-old told her mom that her ears felt plugged and there was a crackling sensation in her skull.
Until that moment in December 2004, "I never much thought of cheerleaders as athletes," Kropelin said. "I didn't realize the risk that these athletes face."
Kropelin also didn't realize how Brittany's injuries -- a fractured skull, concussion and bruising on the brain --would rock her family emotionally and financially. Brittany's physical symptoms mostly subsided after a few months, but the injury rippled through their household for years.
It led to long-lasting anxiety and depression, a lost job, a move to another town and mountains of medical bills that contributed to bankruptcy.
"It affected so many facets (of our lives)," Kropelin said. "It just kept going."
The severity and frequency of injuries across youth sports has drawn major headlines and deeper research during the past few years, and the onslaught of new information could revolutionize prevention and treatment for youth sports injuries.
In the years since Brittany's injury, doctors and researchers say, medical information in schools has improved dramatically. But parents are sometimes the least informed about what injuries their kids might face, and many are unprepared to guide their recovery.
The next great challenge for doctors: Implementing consistent health messages in all sports programs and schools -- and homes, too.
"If you think about decades ago, it was a ding. 'You had your bell rung, get back in there, tough it out,' " said Julie Gilchrist, a pediatrician and epidemiologist with the Centers for Disease Control and Prevention's injury prevention division. "Kids need to be active, and they need to be having fun, but don't take injury prevention for granted. We need educated health consumers."
'Information, inspiration and hope'
In 2001, Eddie Canales watched his son Chris lay on a football field, immobilized with a spinal cord injury. The family was overwhelmed by Chris' physical recovery -- he now uses a wheelchair -- as well as his psychological recovery.
About a year later, the father and son witnessed a similarly catastrophic injury during a high school football game. They had a rare perspective on what the player's family would need in the coming months, whether it was money for household supplies or the comforting words of someone who had survived the ordeal. They reached out to the family and saw that if they could help one athlete, maybe they could help more.
Within months, Eddie Canales founded a nonprofit, Gridiron Heroes, which aids other Texas athletes who experienced spinal cord injuries while playing high school football.
"We try to provide information, inspiration and hope," Eddie Canales, one of the Top 10 CNN Heroes of 2011, said earlier this year. "We want to make sure they don't feel alone.