Athletic trainers The job is tough: Keep teens healthy and on the field

The Marietta Times
September 13, 2017

With more knowledge than ever before on the impact of concussions on athletes, having fully qualified athletic trainers consistently on the field is in growing demand.

“We don’t want coaches having to make medical decisions,” said Tom Bartsokas, a sports medicine doctor leading the charge through Memorial Health System.

Four schools currently utilize the athletic trainer program offered through the health system, with a single trainer dedicated full-time to their students.

At Marietta High School it’s Madonna Buegel; Warren, it’s Arielle Baker; Waterford, Joslynn Trail; and Fort Frye it’s Brooke Daniell; all four serve on Bartsokas’ sports medicine team.

“It was a slow start at first since this school never had an athletic trainer before,” explained Daniell, 23, who lives just across the street from Fort Frye. “But after that first injury when the teams saw that student back on the field in less time and able to play well again, the kids started coming in to see me.”

The placement of a trainer on the field and at practice also offers greater piece of mind to athletic directors and coaches.

“In this day and age with the increased knowledge we have on concussions it’s an important piece of athletics to have that access to medical knowledge immediately,” said Rick Guimond,

athletic director of the Marietta City Schools District. “It provides an additional level of education to our kids.”

Guimond said assigning the athletic trainer to games of high-impact action like football and soccer take first priority, then those sports’ practices.

“But these services are available to all students within the district we serve, even band has access to what we offer,” said Bartsokas.

The program per school system costs $20,000 to put on, though not all districts are paying the full price just yet.

Frank Antill, treasurer for the Marietta City School District, said currently the high school is paying the same $11,000 price tag that was previously going to Ohio University to utilize a master’s athletic training student on a two-year rotation. Up the Muskingum River at Waterford High School the Wolf Creek Local School Board signed off on a $15,000 contract this past spring to be paid in half by the high school’s athletic boosters and half by the school district. Similar costs are assumed by the budgets of Fort Frye and Warren high schools’ athletics and boosters budgets.

“Right now Memorial is absorbing the remaining cost,” said Bartsokas. “We didn’t want to hit these schools with the full $20,000 price that they couldn’t afford out of the gate and not be able to provide our services.”

But Bartsokas sees the program growing over the years to become integrated into services provided by schools like speech pathology and counseling.

“Then those additional treatments can be billed directly to the parents’ insurances and I can see this becoming self-sustaining after a few years and maybe we could get rid of pay-to-play eventually,” said the doctor. “For now when the trainers are there at the practices and the games and during school giving treatments they all have access to me as well if they want me to look at test results or consult even if it’s a quick text.”

Madonna Buegel, 23, of New Matamoras, said she sees her role as three parts: preventative care, treatment and hopefully mentoring.

“I do a lot of preventative stuff here at the school too but if people want to think of it as someone who’s just waiting around for them to get hurt, then isn’t it better to have someone on hand that can immediately address that?” she said. “But because it’s also at the younger level these kids see me at the same level as their coaches or teachers and I want them to trust me that I want to get them back to playing and healthy just like they want to play.”

For senior soccer player Dakota Lee, 17, of Marietta, having Buegel on hand has been a blessing.

“She does amazing things for us and always makes sure we’re healthy and 100 percent ready for a game,” he said. “This is the second year I’ve had a trainer at every game and she can do all the tests on us right on the field and get us back to playing quickly instead of having to wait to even get in to see a doctor … we know what’s going on there (at the field).”

Get to know your athletic trainer

≤ Fort Frye High School: Brooke Daniell.

≤ Marietta High School: Madonna Buegel.

≤ Warren Local High School: Arielle Baker.

≤ Waterford High School: Joslynn Trail.

Source: Memorial Health System.

More Teen Knowledge About Concussion May Not Increase Reporting

By Carolyn Crist

(Reuters Health) - High school athletes with access to a certified athletic trainer are more knowledgeable about concussions and their consequences, but that doesn’t make them more likely to report a concussion, a U.S. study finds.

“The underreporting of concussions is estimated to be high, and the No. 1 reason athletes do not report a concussion is because they do not want to lose playing time,” lead study author Jessica Wallace of Youngstown State University in Ohio said by email.

Although experts estimate that athletic trainers are present in 86 percent of U.S. high schools, only about 37 percent of high schools employ one full-time. In high schools with no athletic trainer, athletes are five times more likely to not report concussion symptoms because they didn’t know they had a concussion, Wallace told Reuters Health.

Sports-related concussions account for about 4 percent to 9 percent of high school injuries and have symptoms such as headaches, confusion, nausea, amnesia and trouble sleeping.

“This study sheds light on the multiple reasons why student-athletes may not report a concussion, including not thinking the injury was serious enough to require medical attention or not wanting to let the team down,” Wallace said.

She and her colleagues surveyed 715 student athletes ages 13 to 19, including 438 students who had access to an athletic trainer. Athletes answered 83 questions about their own concussion history, concussion knowledge, responses in specific scenarios, signs and symptoms of a concussion and reasons why an athlete would not report a concussion.

Overall, 55 percent of high school athletes underreported concussions. Eighty-seven percent of athletes from schools without athletic trainers understood the dangers of concussions, as compared to 94 percent from the schools with athletic trainers.

Similarly, 61 percent of athletes from schools without athletic trainers understood the signs and symptoms of a concussion, compared to 78 percent from the schools with athletic trainers.

Overall, in the schools without athletic trainers, 16 percent more athletes thought they could continue playing if they believed they had a concussion and 12 percent more athletes thought they could continue playing with concussion symptoms. This knowledge gap is prominent and should be addressed, the study authors write in a special concussion-themed issue of the Journal of Athletic Training.

“The athletic trainer serves a vital role in the health and safety of high-school athletes,” Wallace said. “One of the athletic trainer’s responsibilities is to help educate athletes, coaches and parents about concussions that appear to be happening within high schools.”

At the same time, access to an athletic trainer wasn’t linked to a higher proportion of concussions being reported, the study found.

In the survey, about 46 percent of the students said they had experienced a potential concussion during play and only 21 percent had reported it to an authority figure at the time. About 19 percent of these incidents were reported in schools without athletic trainers, compared to 25 percent in schools with athletic trainers, a difference too small to rule out the possibility it was due to chance.

“This multifaceted issue includes many reasons why students may choose not to disclose an injury, including knowledge, intention and attitude,” said Johna Register-Mihalik of the University of North Carolina at Chapel Hill, who developed the concussion survey used in the current study but was not part of the study team.

One limitation of the study is that the students came from 14 schools in two Michigan metro areas and participated in football, volleyball, basketball, wrestling, gymnastics, soccer or cheerleading, which may limit how broadly the results can be generalized, the authors note.

The Michigan students received state-mandated concussion education based on the Centers for Disease Control and Prevention HEADS UP program. Wallace and colleagues recommend that this or a similar education program be used to target schools without an athletic trainer in order to talk about the signs, symptoms and dangers of concussion.

“Improving concussion protocol will extend into other issues with student athletes, such as lack of mental health disclosure and allowing play when athletes are injured or sick,” Register-Mihalik said. “Involving parents, coaches and students can create a safe playing environment.”

SOURCE: Journal of Athletic Training, March 2017.