This is the first of a three-part series of articles examining the important role of athletic trainers.
Athletic trainers save lives. Fortunately, it’s not every day that they are called upon to handle life-threatening injuries, and of the many injuries they do treat, most are minor. However, when a major injury occurs, they are often first on the scene, and it is their training and their decisions that can prevent permanent damage.
The Massachusetts Department of Public Health states that “to be licensed, athletic trainers must have graduated from a college or university program accredited by the Committee on Accreditation for Allied Health Education Programs,” and “they must have passed a national exam and have been licensed by the Board of Registration of Allied Health Professions.”
There are more than 30,000 nationally certified/state licensed athletic trainers in the United States. More than 70 percent hold master’s degrees in related disciplines.
“We are not personal trainers, we are college educated and specifically trained health care providers, recognized by the American Medical Association,” Massachusetts Maritime Academy head athletic trainer Greg Folino said. “Athletic trainers work in many settings, from the professional level to the colleges and universities, clinical and Industrial settings to the high schools. As a college athletic trainer, when we pre-screen athletes coming into our setting we discover prior injuries sustained in high school that were never reported, or properly assessed with rehabilitation programs developed enabling the athlete to heal and completely recover. Therefore, it is the position of the National Athletic Trainers Association that Athletic Trainers are needed the most in the high school setting.”
Athletic trainers, whether at the high school or college level, can evaluate and treat injuries when they occur and follow up with the athletes under their supervision.
On the Upper Cape, Bourne, Mashpee, and Falmouth high schools all have trainers on staff. Sandwich school officials are working to fill the trainer’s post, which has been vacant for the past year.
According to the Massachusetts Interscholastic Athletic Association handbook, “Each member school should employ a licensed certified athletic trainer. Physicians, trainers, and coaches should receive sport medicine training, (and they) must have medical coverage at all football and varsity boys’ and girls’ ice hockey games per sport rules.”
However, the MIAA does not address the fact that the same injuries can happen in practice, and certainly no one would deny the importance of a trainer for a baseball player hit in the head, a soccer player who breaks a leg, or a lacrosse player who tears an ACL. Coaches simply don’t have the medical training; it is not their job. However, some schools, those without athletic trainers, put their coaches in the position of identifying and treating injuries.
“We leave it up to the schools during the regular season as to how they want to cover their medical requirements,” Paul Wietzel of the MIAA said. “Everybody involved with the teams has had the training to recognize concussions: all medical personnel, coaches, including assistant coaches, parents and players. Not every school can afford to have a trainer on duty all the time. We feel they should, but we require it for only football and hockey games.”
Brian FitzGerald, an athletic trainer and nurse, has worked in the field at Marquette University, UMass Boston, with the Boston Public School system and is currently with the Sports Medicine Department at Children’s Hospital.
“We’ve seen cardiac arrest in games in the Boston Public School system from athletes who show no sign of cardiac abnormality. It is something that doesn’t happen often, but we’re prepared to deal with it,” he said. “Athletic trainers are trained in a wide variety of areas. We understand and have in place emergency action plans. Many athletic trainers have degrees in a number of areas. We work under a physician and will consult and help players and parents once an injury occurs. We can help families cut costs associated with an injury, by working with the athlete.”
Bourne High School and Chatham Anglers trainer Dan O’Keefe recalled one worst-case scenario.
“A football player tackled the quarterback and in doing it got kicked in the head. He lost conscienceness. It looked like a possible neck injury. If we had not immobilized him, the damage could have been much worse. It’s a trainer’s worst nightmare. A broken bone you can see, but the head and the neck are unknown; you can’t see a bloody brain or a spinal cord injury. If something were to cut through the spinal cord, he might not walk for the rest of his life. Coaches don’t have that kind of knowledge or training. They don’t have the tools. Anybody can make an icebag or tape someone. The real reason we’re there is for when something serious happens. That’s what we’re trained to handle.”
Suffolk University athletic trainer Jeff Stone has been in the business for decades. He worked at Framingham State University and Natick High School prior to accepting his current position at Suffolk.
“I was at a junior varsity football game one night waiting for the varsity game to start. There was a boys’ soccer match on a nearby field. Two soccer players went up for a ball and hit heads. One of them was hit in the temple and had a grand mal seizure. I kept his airway open and called 911. Both the Natick Fire Department and a hospital ambulance were quick to get there. They called for a MedFlight. He turned out to be alright and when I spoke with him later he told me that if I had not been there at the school, he’d probably be dead,” he said. “I was in the right place at the right time. But many high schools will have events at the same time at different locations. If he was off at another field, he might not have made it.”
“You can’t be everywhere, and schools will hesitate to hire a per diem trainer. They think everything is covered and many times it is not. That’s the problem; school administrations just don’t understand what athletic trainers do. Many schools are open after the end of the school day. Teachers, the school nurse, they go home, but there are games, there is drama practice, there are things going on. Who is watching the kids after 2 PM?”
“The worst injury I had to deal with was a concussion with a possible spinal injury,” Mashpee High School athletic trainer Courtney Briggs said. “But in all honesty, it is not the injuries where I feel my work is most important. I feel it is the work related to educating the athletes about what their body is telling them and how they can learn what to do for it. I show student athletes how to strengthen specific muscles to support possible weak areas that need additional support. I try to be someone that they can trust and feel comfortable telling me their issues.
“I feel my presence is beneficial in preventing a more severe injury from occurring by trying to get the athlete to understand their bodies and when their body is telling them they need to rest to recover. I also try to be a calming influence during a stressful time during an athlete’s time of pain and during recovery. I try to be encouraging during times in the student athlete’s life, when frustration from an injury may be at its highest and hopes of a return to sport may be diminishing.”
Athletic trainers begin their education with a four-year bachelor of science program and most go on to advanced degrees. They are medical specialists who are called upon for everything from taping an ankle to emergency triage to injury follow-up and recovery. Trainers say that their role is often misunderstood and they seldom receive the recognition that is their due. Injuries happen in sports; sometimes they are life-threatening. They are the first to run onto the field, the first to administer medical care. It is their training and decision-making that often saves lives.