Ensuring Youth Sports Safety on the High School Playing Field

For many years, professional and collegiate athletes have had the services of the athletic trainer (AT) on a daily basis. Yet only 37% of public secondary schools have a full-time athletic trainer. This often prompts the question "just who is taking care of your kids on the playing field and why don't all high school or middle school aged athletes have direct daily access to an AT?"

There has been a national spotlight on sports safety in the past few years and there is something that each and every one of us can do to ensure appropriate protocols and best practices are in place in the high school setting. As someone who is in the trenches on a daily basis, here are reasons why having an athletic trainer in the secondary school setting is critical and can help stave off injuries and save lives. We all share the same goal of keeping young athletes safe so they can excel on the playing field and enjoy the spirit of individual or group participation and the success that comes from hard work, determination and dedication.

Overall care: The AT is the health care professional that takes care of ALL student athletes during practices, games and once the staff, including the school nurse, has left at the end of the regular school day. Our daily routine includes injury rehabilitation, injury evaluations, protective taping, practice preparation, monitoring environmental conditions like heat and humidity, consulting with physicians, checking the status of weather conditions, concussion follow-up and return to play protocols among other responsibilities.

The end of the school day marks our "rush hour" - from the sound of the last bell to the first half hour of practice. All of these tasks involve student athlete safety. This also allows coaches to concentrate on coaching their sport, preparing an efficient practice or a successful game plan. Coaches should rely on ATs and the others that comprise the school's sports medicine team. This important separation of responsibilities is critical to ensure the coach, AT, athletic director and others work effectively and efficiently.

Injury prevention and treatment: ATs can help to prevent and treat a myriad of injuries that vary from sprains and strains to more severe, unusual injuries that require specialized training to recognize. One example is concussions. The athletic trainer works closely with administration, the school nurse and staff to help students prevent, manage and treat concussions. This can involve baseline testing, recommendations on "heads up" when tackling and the student reporting/sports medicine staff diagnosing signs or symptoms of concussion should it occur. The goal is always to return the student to school and once that is accomplished, get him or her to complete a multi-step return to play protocol. Other sports health conditions that the AT is skilled and educated to prevent, treat or manage include sudden cardiac arrest, heat illness, safe weight loss or gain and sickle cell trait among others.

If injuries are treated immediately and appropriately it improves the chance for a quicker recovery and fewer long-term chronic conditions. In addition, athletic trainers have to stay updated on current research, advancements in evaluation techniques and new developments in the management and care of athletic injuries.

Referrals and specialized care: Referral of injuries to the proper medical specialist is something that the athletic trainer is able to do on a daily basis. The AT often has made important connections with local physicians and specialists and has worked out agreements for their student athletes to be seen usually within 24 hours of when an injury occurs. Expediting the referral also allows for quicker treatment, rehabilitation and care, which in turn speeds up the recovery process. This also puts the coaches, parents and athletes at ease

Administration: ATs are adept at several administrative requirements and responsible to collect medical forms, complete injury reports, submit school insurance information, collect pre-participation physical exam paperwork, do baseline concussion testing, secure releases, ensure coaches are compliant with required documentation and monitor for HIPAA and FERPA compliance. The AT is also the person who works with the school nurse to ensure that academic or physical education accommodations are being followed correctly. This helps to speed up the recovery process.

Emergency Action Plans: It is highly recommended that all schools have an Emergency Action Plan (EAP) for every venue that their athletic teams use for practice and games. The AT is an invaluable resource for a school district and athletic director to help craft and coordinate this plan. This incorporates the AT's emergency response and planning expertise along with the connections they have made with the local EMTs to deliver an exemplary health care model in emergency situations. This EAP also helps in the event of an emergency to spectators, coaches and student athletes. It is critical to include weather emergencies such as thunder and lightning, tornados or another type of natural disaster.

Education: School districts are increasingly concerned about a plethora of student health issues. Athletic trainers can conduct and facilitate in-service programs for the teachers, support staff and administration. The opportunity to educate and help staff understand the importance of appropriate care has been extremely helpful in the recovery from all of these conditions. ATs can also facilitate appointments and referrals for staff members that have suffered injuries. This also helps reduce time loss or days missed due to injuries and illness.

As you can see, the AT can provide a very important position within an athletic department. This health care professional will work with physicians, school nurses, administration and coaches to reach the same collective goal: establishing a safe, successful program that will encourage students to enjoy, thrive and participate in sports - knowing they are in good hands and that there are appropriate sports safety protocols in place.

Larry Cooper, MS, LAT, ATC
Teacher/Athletic Trainer
Penn-Trafford High School
Chair-National Athletic Trainers Association (NATA)
Secondary School Athletic Trainers Committee (SSATC)