Half of California's School Sports Programs Have No Athletic Trainer!?!

Orthopedics This Week

Tracey Romero • Tue, November 19th, 2019


California, with more than 800,000 high school students playing in school sponsored sports, is the only state that does not regulate athletic trainers and a new study in the Journal of Athletic Training, the scientific publication of the National Athletic Training Association (NATA), warns that this is a health crisis because it puts student-athletes at greater risk of injury.

The study found that more than 47% of schools in California do not have an athletic trainer, and that in 7% of the schools who do have one, he or she does not have proper certification through Board of Certification, Inc. (BOC), which is the nonprofit credentialing organization responsible for the standards of practice and continuing education requirements for athletic trainers. The state of California does not currently require all athletic trainers to be certified by BOC.

“California has the second-largest number of participants in high school athletics in the nation, so it is especially troubling that over half of the schools do not employ an athletic trainer or choose to employ someone unqualified,” said Eric Post, Ph.D., ATC, lead author of the study and an assistant professor in the School of Exercise and Nutritional Sciences at San Diego State University.

NATA President Tory Lindley, MA, ATC added, “Currently in California, anyone, even if they have zero medical experience, can call themselves an athletic trainer. This should be a major concern to parents.”

“Imagine your son or daughter colliding head first with another player while playing basketball or lacrosse. The unexpected blow lands them flat on their back, unable to move. It could be spinal; it could be a concussion or just a hard hit that knocked the wind out of them. Now, imagine there is no qualified medical professional on-site. One wrong decision could leave your child paralyzed forever. That is how serious this is. There is no room in organized sports for this level of risk. Our athletes deserve better.”

Also, according to the study, only 13% of the schools employ a full-time, year-round athletic trainer. In addition, public schools (50.6%) were more likely to have an athletic trainer compared with charter schools (8.9%).

It has been well-documented that having access to an athletic trainer reduces the injury rate of student-athletes and improves the management of common acute musculoskeletal injuries such as sprains, strains and breaks as well as chronic injuries and concussions. Secondary schools with athletic trainers are also more likely to have emergency action plans in place as well automated external defibrillators on site.

Some progress has been made in the pursuit of better regulation in California. This past February, a bill, AB-1592, that makes it illegal for a person to practice as an athletic trainer without being licensed by the California Board of Athletic Training, was introduced by Assemblyman Rob Bonta (D-Alameda). In addition, the Assembly Bill 1: California Youth Football Act was recently passed. This new law requires that a licensed medical professional be present at every youth football. This means athletic trainers without proper licensure will not be able to treat athletes at the games.

The risks high school athletes face when there is a lack of athletic trainers


by Chris Renkel & Stephanie Kuzydym, WKRC

CINCINNATI (WKRC) – On Friday nights in the fall, in big cities and small towns, you find the heart and soul of a community on full display.

High school sports have become a staple of community pride and success and, this fall, a stage to highlight a growing issue in high school athletics. It involves a simple sticker and the letters “A” and “T."

As important as the results on the field is the safety of the athletes competing. That’s where an athletic trainer comes in said Greater Cincinnati Athletic Trainers Association president, Mike Gordon.

“Our whole goal is prevention,” Gordon said. “If we can prevent that injury from happening, if we can prevent that emergency from happening, then we’re doing our job well. Then hopefully we’re providing the best care possible. If we’re not doing those things, if we’re not looking forward or being those risk-management type mentality, then we could be putting our kids at risk.”

Only 37 percent of high schools in the United States have a full-time athletic trainer, according to the National Athletic Trainers Association (NATA).

At the University of Connecticut, there is an institute named after a former NFL player who died while playing professional football, former Minnesota Viking Korey Stringer. The Korey Stringer Institute (KSI)’s mission is to provide research, educate and advocate for athletes at all levels.

KSI created ATLAS, or Athletic Training Location and Services, and then mapped the status of athletic training at the more than 20,000 high schools across America.

According to ATLAS, of the 840 schools that make up the Ohio High School Athletic Association (OHSAA), only 390 schools have a full-time athletic trainer on staff and 290 schools have a part-time trainer. That leaves 160 schools in the state without any athletic training services at all.

In Kentucky, 100 of the 289 schools don’t have an athletic trainer, and in Indiana, 72 of the 438 don’t have one either, according to ATLAS’ data.

“If you have money to be able to have football and to have soccer and to have volleyball and all these sports, if you have money to be able to provide for all that, you need to be able to find money to be able to help have someone on site like an athletic trainer,” Gordon said, “to be able to prevent some of the injuries and to be able to be the risk managers for you.”

Schools with part-time trainers often only have a medical professional present at games, leaving athletes without a medical professional during regular practice hours.

“So when they are there only for game days and you just see them on the sideline with their fannypack on or their slingback on,” Gordon said, "and they are just handing out water bottles you think, ‘OK, they’re safe during that time.’ But the vast majority of the injuries happen during the week and prior to the game.”

Schools are not required by the OHSAA to have an athletic trainer. However, coaches are required to be trained in things like concussion safety and CPR.

Jerry Snodgrass, Commissioner of the OHSAA, said there are no requirements under OHSAA bylaws to have an athletic trainer present at regular-season events.

“We want our kids to be safe,” Snodgrass said. “We want everything to be safe, so most schools will make that conscious effort, but there can be no mandate that we have a trainer at a cost.”

The only time there is a requirement of an athletic trainer is at tournament contests, which are owned and run by the OHSAA. So the OHSAA pays for the athletic trainers to be in attendance.

So why aren’t there requirements during the rest of the year?

The OHSAA says it doesn’t have the ability to force schools to add something that would cost the schools money: an unfunded mandate. It would take a government entity like state legislators or the Ohio Department of Education. But it’s possible.

This is an Ohio law from 2004 regarding the placement of AEDs in high schools.

“I think it’s a standard of prevention. I think that’s necessary,” Snodgrass said of AEDs.

Gordon also thinks AEDs are a standard of prevention:

“AEDs are now a standard of care that if an athletic trainer or a medical site doesn’t have an AED, there’s a significant liability there.

“Shouldn’t athletic trainers be the standard of care? Shouldn’t athletic trainers, having one on site or on a campus or at a sporting event, shouldn’t that be a standard of care?

“I believe so,” he said.

Then wouldn’t the OHSAA say a standard of prevention would also be an athletic trainer?

“It would be hard to say anything different than that,” Snodgrass said. “I would agree.”

Local 12 Investigates’ reporting doesn’t stop here. We plan on taking a deeper dive into athletic trainers. We’re going to show you how programs work with athletic trainers and without and the challenges in both. We’ll be looking to talk to those people who can make those decisions why this is a priority.

Athletic Training services in the tri-state region vs. nation

Athletic Training Services by State 2018-2019