Athletic Trainers Loaned to High Schools

Wow.  That's very different from my experience with the athletic trainer at our high school.

Our guy was very professional.  He knew what he knew, and knew what he didn't know.  He never pretended to make diagnoses or predictions beyond his competence.  He made players follow the treatment plans given by their doctors.  Sometimes the players thought he was too cautious, but he made sure injured players didn't get back in unless the doctor, parents, coach, and player all agreed.  He gave his cell number to all parents and answered calls 24/7.  Very conscientious in administering the concussion program and sports physicals.  Educated the athletes and parents on supplements, hygiene, and other issues.  He was just an excellent partner in our athletes' health.  

Our high school had trained trainer/EMT's on site at the athletic complex for all practices and games. 

Another Wow here as well.  Our local HS (only one in the county) has an athletic trainer at every home game.  I know she was always at the football and basketball games.  Softball/baseball was tough since they usually had similar start times - can't be two places at once, but she was usually at one or the other.  She has always been very professional from what I could tell.

I'm sorry you've had a couple of bad experiences. Yes it's offensive to me for you to claim that I "shouldn't be making any type of diagnosis." Legally, I don't make any "diagnosis" but I evaluate injuries on a daily basis. Have I missed things before? Sure, but show me a healthcare provider who hasn't!

It also offends me when people say that they have a "trainer/EMT" at their school. Every high school should have a Certified Athletic Trainer at all practices and games. Most often an EMT onsite at a sporting event is likely violating his/her practice act which means he/she is breaking the law.

Athletic Trainers are nationally certified and in most states, licensed. We are healthcare providers recognized by the American Medical Association. We are on the front-lines of concussion recognition and management. Athletic Trainers are trained and educated in a variety of skills related to the prevention, acute assessment, emergency treatment, and rehabilitation of athletic injuries.

To become an athletic trainer, a minimum of a bachelors degree is required, however over 75% of all athletic trainers hold a masters degree or higher. Continuing education is required every year and actually athletic trainers require MORE CEUs than most other healthcare professionals. For example, in Illinois, an Athletic Trainer must get 40 CEUs in a 2-year period.

Every Athlete Deserves an Athletic Trainer

You know what the call the person who finishes last in medical school.........doctor.

Trainers are just like coaches, teachers, lawyers, doctors, carpenters etc.....some are great, most are average and some are terrible.  Kentucky does not require a trainer (at least when i was there) which lead to a lot of voo doo diagnosis by us coaches.  Looking back on it and some of the things I had to deal with when it came to injured players scares me.  I took the approach that I would error on the side of caution and let the doctor make those calls but some coaches didn't.  It is much better to have a bad trainer than to have nothing at all. 

In North Carolina it is law to have a trainer but it's almost impossible to get one.  In our county we have 8 high schools and we can't afford to pay a trainer just to be a trainer.  So we either have to reach out to the medical businesses and see if they would provide one.  We pay them a stipend each season to help them out but it's hard to get them to leave their professional job to come hang out at practice.  Or we find someone who is a licensed trainer that has a teaching license as well.  Then we can hire them as a teacher.  Needless to say these people are almost non-existant.  I don't blame these people for not wanting to do the job because of all the requirements the state puts on them for what is basically a volunteer position.

When I first moved to NC the trainer we had was horrible and I mean horrible.  But it was still a better thing than for me (or the other coaches) to try and figure out what was going on.  That trainer retired and we had to get a new one this past summer.  It was IMPOSSIBLE to find one.  We had several people call us interested and we reached out to several people but when we started talking pay and time involved every single one turned us down.  Luckily we had a RN on staff teaching some health science classes so we asked if she would take on that responsibility and she said yes.  Now we contacted the state to see if she would qualify for being our trainer - they said no because she didn't have some sort of something.  We were a week out of starting practice and if we didn't have some one in place by then we would not be allowed to start practice.  The state worked with us and allowed her to take a course online which got her cleared and we were able to start on time.  But it was a huge pain in the rear.

I firmly believe every school should have a trainer but sometimes in the name of safety / CYA it becomes impossible to get one.  Then when you get one (out of desperation) they turn out to be that one who's terrible.  So what do you do now?

Coach, state law in North Carolina requires either a Certified Athletic Trainer or a "trained first responder." These "trained first responders" are absolute jokes.

If your school cannot afford a Certified Athletic Trainer, your school cannot afford collision or contact sports.

We too have a Certified Athletic Trainer on site at all sporting events. She is very good and all the kids have faith in her ability.

To the OP, sorry for the bad experiences you've had. As a rule I've always relied on Orthos to make definitive diagnoses and followed their recommendations, regardless of the trainers opinion.

In my neck of the woods, there is always an ambulance on duty at football games; other than that it's just coaches.. no certified help.

 Here's an observation of mine that has helped me in dealing with injuries: Several years ago i am watching the HS basketball team play and one of the boys hurts his knee. After the game the head coach jiggles it around a little and then tells the boys' parents, "oh, it's nothing he is fine"... 2 days later the kid goes to the doctor and the doc ends up doing a total ACL/MCL and tells his parents, "well in my 15 years of putting knees back together, that's the worse one I've seen yet"...

I will overall agree with the first one but say there are some who are good but overall they are not good enough.

The second one I disagree with because you really don't have to have a trainer at every practice due to the fact that you may go years without an injury where a trainer is necessary.  But the thing is having a trainer is like having insurance - it's something I would rather have and never use than not have it and need it.  How many states do not require a trainer?

I'm not trying to discredit the need for a trainer but sometimes realistically a state (in this case NC) regulates themselves into a situation where it's becoming more and more difficult to follow the rules.  I don't know of a single school in NC that has a full time trainer who does not teach.  I'm sure there are some of the bigger / private (rich) schools who can do this but the vast majority of schools are like us - they struggle to find a real trainer. 

What is your situation - do you work for a high school as a trainer or do you work for a business that assigns you to a school?

We have had limited experience with his HS trainers so far, but they seem like a great group (there are 3 of them.)  In addition to being at each athletic event, they hold clinics every morning, work with the middle school coaches also and teach classes to student that are interested in pursuing that field.  Their credintials require them to be certified as both trainers and teachers!  I truly hope that we don't need them, but if we do I am comfortable with their ability to tell us what they know and what they don't know.

Could you please show me where I said anything negative about EMTs or a doctor? Because if you read it again, I didn't.

And if you believe that my job as an athletic trainer is to simply refer to a physician, then you're wrong. Now if I'm concerned about a fracture, then obviously I'm going to send them off to the doctor. But I do a lot more than "tape it, ice it, and wipe off blood."

I think this is an issue of a specific trainer/firm needing attention.  Trainers, in most cases, are more useful to a team than even an on-site doctor would be.  

The ACL example is interesting one because a trainer on site can oftentimes diagnose an ACL tear more accurately than an MRI just by trained hands.  This applies to the immediate aftermath, once the swelling has started it becomes more difficult to diagnose.  The most common misconception regarding sports medicine is the idea that MRI's tell all.  In many cases, the physical examination given by a PT is more accurate or more useful than the MRI.  You'll hear many cases where the on-site PT finds a torn ACL, the MRI reveals no harm, and the surgery indeed does reveal a tear.  There are obviously exceptions based on injury and the individual evaluating.

Likewise, most folks don't realize that doctors are not the most qualified people to talk about injury recovery.  Most don't receive much formal training in that area (nor do they in nutrition and other things we'd assume they must know about).  Have you ever dealt with your doctor after an injury and they were really vague about how your rehab would go?  That's because the PT they are sending you off to is the one that knows better.  Doctors are certainly the best at diagnosing, but the trainer is likely the most qualified individual in the discussion when it comes to whether the player is ready to come back or not.  This isn't to say doctors are inept or cannot give good advice in this area, but this is not a real area of expertise for most docs.  Obviously some, like Dr. Andrews and other noted orthopedists, take their highly useful knowledge and apply it to the field of rehabilitation and recovery...but that is a freely made choice by the doctor whereas whether they know how to diagnose an injury is a requirement.  

That said, it really sounds like the issue in the OP is a bad apple.  I've been around trainers of different skill levels and such, but haven't heard anything like described before.