Athletic Trainers: Medical Professionals Making A Difference

By: Dan Crowley
Published: 10/28/11

 Part 3 in a three-part series on the importance of athletic trainers

Athletic trainers are educated and trained to treat almost any athletic injury, from minor sprains to much more serious trauma. Recognized by the American Medical Association as allied health professionals and certified at the national and state levels, they should not be confused with fitness trainers or personal trainers, who are not health care workers, but rather train people to become physically fit.

At any time during a game or practice, an injury may occur. That is the reason that athletic trainers are there.

“I have seen several ruptured spleens,” Bishop Stang High School athletic trainer Kathy Thornton said, “one in a baseball player, who you wouldn’t have expected to have one and another in a football player who walked into my training room complaining of some abdominal pain. I have certainly seen a lot worse, in terms of visually bad, but I think these could have gone really bad. If there had not been an athletic trainer there to recognize them, the athletes could have bled to death.

“For the baseball player, he had his spleen removed that night surgically and the football player tore his spleen and it splinted itself, so he was not in a great amount of pain. Had he gone back to football, it could have been catastrophic.”
“I had a hockey player suffer a fractured kidney and lacerated spleen during a game against Boston University,” Artie Poitras, head athletic trainer at the University of Massachusetts Lowell, said. “It is my opinion that if an athletic trainer wasn’t present, the athlete may not have been hospitalized in a timely manner and would have sustained long-term internal bleeding.”

“I’ve been fortunate in my career so far to have never been witness to a catastrophic incident, one where an athlete has died or come close,” Northeastern University athletic trainer Steve Clark said. “I have had friends who have. I’ve helped a hockey player cut by a skate near a major artery in his neck and had a hockey player almost puncture a lung falling on a skate. I’ve had to spine-board a couple of football players as a precaution for cervical spine injury. I’ve seen an open thumb fracture, a tibia/fibula fracture, and reduced a few shoulder dislocations, and referred probably a dozen ACL tears right after they happened.

“Many school districts choose to spot-cover athletic events with school nurses, and EMTs to save money while covering them from liability. These aren’t good choices because neither are appropriately trained to treat athletic injuries, the ones I refer to above that aren’t life-threatening but do require a very specific skillset.”

On the football field New Bedford High School athletic trainers Nate Walker and Rick Houston have had to deal with a variety of minor injuries as well as administer to players with broken femurs.

“Having a trainer at the scene is a definite plus,” they both agreed.

“I had a player in a football game hurt his ankle,” Sharon High School athletic trainer Alexandra DeMattia said. “He came out of the game. It turned out it was a muscle tear of the muscle that controls the foot. If there was not an athletic trainer there, they may have thought it was just an ankle sprain and sent him back into the game. It’s important to the athletes that a trainer be there.”

Nauset High School athletic trainer Michele Pavlu was present when one of the school’s cheerleaders fractured and dislocated an ankle.

“As an athletic trainer I was there to complete an initial evaluation, contact EMS and keep the athlete calm,” Pavlu explained. “I also contacted her parents, monitored vitals, and stabilized the injury. If an ATC were not present, the athlete may have gone into shock, or the injury could have worsened by damaging veins and/or nerves if anyone tried to move her prior to EMS arriving.”

While working with the Orleans Firebirds of the Cape Cod Baseball League, Pavlu assisted with the diagnosis of a severe blood clot.

“The athlete did not have symptoms until he threw a bullpen session here on the Cape,” Pavlu said. “The next day he had moderate to severe swelling in his shoulder and down his arm as well as numbness and tingling. If an ATC were not there for the initial evaluation or to make the appropriate referral to a physician, what took two days to be diagnosed and into surgery in Boston, may have taken longer. This would have caused more damage to the arteries and veins in his shoulder; he may never have thrown again. There was the potential for loss of function in his arm, or the blood clot could have traveled to his internal organs. The good news is he is back pitching now and doing well in the minors.”

“I encountered a shoulder dislocation in a high school football athlete,” Massachusetts Maritime Academy athletic trainer Chris Barry said. “Because he was suffering from reduced feeling in his hand and forearm, I was concerned about a potential nerve injury to the shoulder. I therefore did not reduce the dislocation; instead I stabilized the shoulder and had him transported to the ER. As it turned out, he did suffer nerve damage that would eventually heal. I was told if an untrained individual attempted to reduce the shoulder, a significant nerve injury could have occurred that would have had lasting effects.”

Stonehill College head football athletic trainer Gwen Chiaranda explained how even the weather can cause problems for athletes.

“A few years ago, during preseason football practice, one of our linemen reported feeling dizzy, freezing cold, nauseated and was experiencing a headache, all despite it being about 90 degrees outside at the time. I and my colleague activated our emergency response system. As we waited for the ambulance to arrive, the athlete became unconscious and exhibited a diminished pulse. We cut his pads off, covered him in ice and proceeded through all the emergency steps. The athlete was suffering from full-blown heat stroke. Had we not recognized the symptoms of such an emergency and called EMS [Emergency Medical Services] right away and gone through the steps to get his body temp down, the athlete might have died within minutes as he quickly progressed into shock.”

“I’ve pulled people out of races and had them transported to the hospital because of the heat,” Brian FitzGerald, an athletic trainer with the sports medicine department at Children’s Hospital in Boston, said. “Had I delayed, they could have fried inside and possibly lost an organ and faced organ transplant. As trainers we know the difference between a minor and major injury. We don’t send someone to the hospital with a sprain. We can save everyone money by treating an injury and sending someone to a doctor.”

“During a rugby game one of the players suffered a fractured orbit and zygomatic, essentially the eye socket and cheekbone, while being tackled,” Lesley University head athletic trainer Erin Cicone Brashear said. “The athlete was so injured that he was numb in the area as well as concussed and did not realize the severe deformity of his face. He came to the sidelines thinking he only had a bloody nose. The coach was not paying attention to the athlete as he was coaching the play on the field.

“By having an athletic trainer present whose job is to monitor the athletes’ status, I was able to assess and treat his injury. Without having an athletic trainer, a coach may miss the subtle or severe signs of an injury and allow the athlete to return to the field because they are concentrated on the game. In this case, the athlete was fortunate to have someone who was watching specifically for injuries and not the game. He was transported to the hospital, where he had emergency reconstructive surgery on his skull.”

“Last spring, during an early morning football practice, a player collided with another teammate and landed on his head while another player landed directly on top of him,” Stonehill’s Chiaranda said. “His neck was forced into flexion and he collapsed to the ground. When I got to him he was complaining of cervical neck pain and tingling and numbness down both his arms. I immediately immobilized his spine and activated the EMS system. We spine-boarded the athlete and he was taken to the hospital for x-rays and other diagnostic imaging to rule out possible cervical spine fracture. Had the athlete had a c-spine fracture and had he been allowed to get up off the turf, he could have suffered a catastrophic event rendering him paralyzed. Luckily, he simply suffered a cervical sprain and has since recovered.”

“We fear the cervical spinal cord injury,” Massachusetts Maritime Academy head athletic trainer Greg Folino said. “You just dread it happening. Most recently I had an athlete struck in the eye area by a lacrosse ball traveling at a high rate of speed during practice. I was concerned immediately because his vision was impaired. I transported him personally to the hospital, where it was confirmed he had multiple fractures in the vicinity of the eye and nose combined with hemorrhaging in the eye. He was transported to Massachusetts Eye & Ear in Boston, and it is believed that he will fully recover.

“As athletic trainers we are trained and prepared for almost any medical situation that we may be presented with. From the ankle sprain to the life-threatening emergency we have emergency action plans in place to best assist the athlete with initial care and referrals within the medical community.”

The role of athletic trainers is often misunderstood. However, their importance to an athletic program is paramount. They work with athletes to prevent, recognize, manage and rehabilitate injuries. As a part of a college or high school athletic program, they are the link between athletes, physicians, coaches and parents.

An athletic trainer is often the first medical professional at the scene of a sports-related injury. In a crisis, it is their training that can make a major difference in an athlete’s life.

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