Nearly 30 million U.S. children and youth participate in organized sports, according to the U.S. Centers for Disease Control, which also reports that high school athletes account for an estimated 2 million injuries, 500,000 doctor visits, and 30,000 hospitalizations each year.
All contact sports—including basketball, baseball, hockey, volleyball, even cheerleading—can cause permanent catastrophic brain and spinal injuries, or lead to death. Overuse injuries—those caused by repeated micro-traumas to the tendons, bones, and joints—are more common and harder to detect and treat.
When it comes to safety, students should have the necessary resources to prevent and treat injuries. This includes access to an athletic trainer (AT) on and off the field.
Emergency Care and More
The work of an AT involves more than the name implies. They don’t provide training, and their duties go beyond bandaging sprained ankles. ATs are health care professionals who work under the direction of physicians as prescribed by state licensure statutes. More than 70 percent of ATs hold at least a master’s degree. Areas of study include injury and illness prevention, first aid and emergency care, human anatomy and physiology, therapeutic modalities, and nutrition services. Equipped with this knowledge, they supply student athletes with preventive services, emergency care, clinical diagnosis, therapeutic intervention, and rehabilitation of injuries and medical conditions.
“We provide quality health care to student athletes of every sport,” says Larry Cooper, head athletic trainer at Penn Trafford High School in Pennsylvania where he also teaches sports medicine and health, and physical education. Cooper has 31 years of AT experience, and is qualified to conduct immediate injury assessment and provide treatment.
Concussions are among the injuries that garner the most concern. Last year, several U.S. student athletes died as the result of severe head injuries that were left untreated. The issue has attracted White House attention, and last spring President Barack Obama convened a first-ever summit on the topic to discuss prevention, diagnosis, treatment, improved funding for research.
To keep his school’s athletes healthy, Cooper offers in-service training for teachers, and conducts parent information sessions at the beginning of the season. He also ensures athletes receive a baseline concussion test before the session begins. These tests—which measure learning and memory skills, ability to pay attention or concentrate, and how quickly the student thinks and solve problems—help Cooper assess an athlete’s balance and brain function on a normal day. Later, if a player appears to sustain a head injury, the tests are conducted again and compared with the previous results.
During summer practices, Cooper monitors heat and humidity, and determines sweat rates to identify athletes who may be susceptible to heat-related illnesses. He also helps wrestlers manage their weight, and creates weight-loss plans and conditioning programs for other student athletes—tasks that barely scratch the surface of his other responsibilities throughout the year.
Cooper says he’s prepared to deal with any injury, including cardiac condition, heat stroke, and head injuries—the leading causes of sports-related fatalities. “We have an emergency action plan,” he says. “If athletes exhibit heat illness we can immerse them in ice and minimize any issue.”
Fran Bellinger—a physical education/team sports educator in Hawaii, who also officiates volleyball and basketball games—says school athletic trainers are an invaluable asset.
“The need for an athletic trainer to be on site is extremely important,” says Bellinger, who has officiated for more than 20 years. “If a student athlete crashes, the athletic trainer is right there—on the spot—taking care of the kid.” Bellinger has seen ATs assess as they triage, apply first aid, and help off the field with proper stabilization.
Hawaii is the only state with an athletic trainer in every high school, and the money that is earmarked for the hiring of an AT cannot be used for any other purpose. In the District of Columbia, every high school has an AT. And states such as Arkansas, North Carolina, and Oklahoma, are considering legislation that would mandate funding for athletic trainers.
‘A Public Health Issue’
The National Athletic Trainers’ Association (NATA) advocates for an AT in every U.S. high school. The organization’s president, Jim Thornton, says roughly one out of three U.S. public high schools has no access to an athletic trainer.
“Would you ever drop off your child at a swimming pool without a lifeguard?” asks Thornton. “Yet, parents would drop off their child at a lacrosse practice without an athletic trainer—it doesn’t make any sense. This is a public health issue.”
With 39,000 members, NATA is a sports safety powerhouse, and this year, in the Journal of Athletic Training, the organization proposed new guidelines on pre-participation physician exams and disqualifying conditions. The recommendations are designed to help physicians, athletic trainers and other health care professionals recognize health concerns in student athletes, which may warrant further evaluation, intervention, or disqualification.
Thornton says schools need to provide more than just “crisis management” services in cases of severe injury, like broken necks or heat illnesses.
“Young athletes need appropriate medical health care” for all types of injuries, says Thornton, underscoring the role of overuse injuries, and emphasizing that if the person responsible for the well being of student athletes is “just the coach” or “just somebody,” then students participating in collision or contact sports are not receiving appropriate health care.
And in response to the claim that financing is a hurdle Thornton has a simple reply: “If we can find the money to buy new uniforms and improve facilities, we can afford to have an athletic trainer.”