Emerging Settings – The expansion of AT services

22 Apr

Training and Conditioning magazine published a feature article on three ATs working in emerging settings.  I have also been doing some research this week into the high schools and athletic training coverage provided within my home state of PA.  My experiences with the research and the article has me thinking that athletic training can experience exponential growth if we continue to look for the need for our services.  The middle schools, youth sports leagues, military, action sports and industrial settings are all good areas for ATs to expand our services and provide our unique services to the public.

Middle Schools

The PIAA membership statistics show that almost half of member schools are middle schools.  I do know that 91% of PA public high schools provide AT services for their athletes compared to 64% for private schools.  But there is no data for the middle schools.  With a job market as well covered as our public high schools are in PA, middle schools are the next logical choice.  But more importantly, injuries in the middle school can dramatically effect or even negate the ability to participate at the JV and Varsity levels in high school.  Providing access to an AT will not only help the athlete out in the short term, but well into high school and even into adulthood.

Recreational Leagues, Parks and Rec, Little League, Pop Warner, etc.

According to NFHS Participation statistics over 7 million high school athletes participate in organized athletic teams.  While I know of no source for participation numbers, I do know that many more millions of American children participate in youth sports programs starting as young as 4 or 5 years old.  Youth soccer, Little League baseball, Pop Warner football, basketball, gymnastics, etc. are well organized leagues often run and coached by parents.   A recent blog post opined the self-reported confidence level that parents have with their child’s injuries.  I also have known many, many high school athletes who had performance hindering problems from injuries suffered in the youth league levels.


Elizabeth Thometz, MSAT, ATC, CSCS is one of the three featured ATs in the Training & Conditioning article mentioned above.  She has this to say about her military AT position:

Because my position is contracted by the government, I don’t work weekends. But I do begin my weekday workday at 5 a.m.

For the first hour, I do general wound care and taping for the Soldiers before they start their training. This requires a significant number of arch support or plantar fascia, Achilles, and general ankle taping jobs. I also see a wide spectrum of blisters, many of which have evolved into crater-like wounds on Soldiers’ feet before they come see me.

For the next several hours while the Soldiers are in training, I run the musculoskeletal aspect of what the military refers to as sick call. All Soldiers who are sick or injured come see me or the medic in the facility. I perform anywhere from five to 12 evaluations per day, depending on what sort of training the Soldiers are participating in. Approximately 80 to 85 percent of the injuries are lower extremity chronic/overuse problems like patellar tendonitis, illiotibial band syndrome, and shin splints. I also see a lot of ankle sprains, large contusions, shoulder overuse issues, ligament sprains, and muscle strains.

If time allows after evaluations, I go out to the field training events to provide on-site coverage. Just like watching a game or practice, I’m there to make sure that if someone gets seriously hurt, the situation is handled correctly. During this time, the most common injuries I treat are acute ankle sprains, but I’ve also cared for a fair number of fractures.

Unfortunately, I don’t get to regularly practice all that I learned in school–this is especially true with regard to rehabilitation and acute care. For example, I don’t do as much rehabilitation work as athletic trainers who work with athletes. Because of the tight training schedule that the Soldiers must adhere to, it’s rare that they have time to visit me for follow-up rehab sessions. If a Soldier has an injury that he or she can safely self-manage, I usually give them stretches or exercises to do on their own.

I generally finish my day around 2 p.m. However, my schedule is flexible to accommodate off-hour training events, and it’s not unheard of for me to attend training events late at night.

Because of the nature of my government contract, its imperative that I keep up with all the paperwork that accompanies my daily duties within a 40-hour work week. This can make for a tight squeeze since paperwork includes everything from making sure that evaluation notes are entered into the computer before I leave for the day to filing numerous tracking sheets that give the Army command an understanding of what I do on a daily basis.

Though the hours are different, there are a lot of similarities between my setting and that of high school or college athletic trainers. For example, though I work with Soldiers anywhere between 18 and 40 years old, the majority of them are just out of high school or in their early 20s. You could also equate a high school athletic trainer telling a parent about their child’s injury to how I report a Soldier’s condition to his or her superior.

Being able to work a regular schedule, provide AT care for our nation’s military men and women, weekends off, etc. sounds like a good alternative for many ATs!

Action Sports (BMX, Skateboard, Motocross)

Eddie Casillas, ATC, CSCS is the 2nd AT featured in T&C’s article.  He is an action sport enthusiast and had an idea one day that has branched out.  He had this to say in the article:

“If you want to be the one running out on the field and in the trenches of sports medicine, then you need to be an athletic trainer,” she told me. That was all I needed to hear. I attended the University of Nevada-Las Vegas and the first time I walked into the athletic training room, knew that I was where I belonged. I had found my calling.

After graduation, I returned to the physical therapy clinic where I had worked prior to attending UNLV. The town I lived in had a large population of motocross and BMX athletes, and it wasn’t long before I started seeing them in the clinic. I had raced BMX professionally and am an avid skateboarder and snowboarder, so there was a lot of common ground between us. Working in the clinic allowed me a great opportunity to get to work with some of these athletes.

During this time, I met two motocross team managers and they invited me to work at a few races. They wanted to see how an athletic trainer might be able to help their teams. What started out as a few races turned into two full seasons.

During the second year, I met two physicians who were working together to develop a mobile medical unit that would offer services on the racing circuit. My dream of working in the action sports industry was within arm’s reach. Using information I found on the NATA Web site, I put together a proposal describing the importance of including an athletic trainer on the mobile medical unit staff.

I was immediately shot down and told they were looking to hire someone from a different area of healthcare. But I felt strongly that athletic training embodies sports medicine in a way no other healthcare profession can. So I made numerous phone calls and sent many e-mails expressing my frustration with their decision. A couple of months later, I received a call informing me that the job was mine.

I should note that this is a part-time gig for the medical workers on the team. For 30 weekends out of the year, we fly around the country to wherever that weekend’s race is being held on Friday evening, then fly home in time to work our respective nine-to-five jobs on Monday morning.

During the week, I am the owner and Clinical Director of iCHOR Sports Medicine–an athletic training facility that offers the same services to the public that athletes get when they visit their school’s athletic training room. On a daily basis, I do injury evaluation, rehabilitation, and prehab work. We also offer ImPACT testing, functional movement screening, and performance testing. My weekday job is a great one, but the weekends provide me with an opportunity to switch things up.

When I’m working on the AMMC, race day begins with a staff review of the previous week’s injuries, paying special attention to any concussion cases. We are very conscious of the long-term effects of concussions and place extra effort on educating riders about the dangers of competing with a head injury. We currently use the ImPACT testing system on a limited basis, but I hope to make it mandatory in the near future.

Bravo to the entrepreneurial spirit exhibited by Eddie.  If you find a job doing something you love to do, you never have to work a day in your life.

Industrial Setting

The 3rd AT featured in the T&C article was Traci Jo Hubbard.  She has worked for years in the industrial setting providing a variety of AT services to the workers.  She has this to say about this setting:

The main difference in industrial athletic training is the setting we work in and the people we work with. Our clients aren’t athletes per se, but their jobs are often physically demanding, and I’ve found this setting is a tremendous opportunity for athletic trainers to use our sports medicine knowledge. But we don’t necessarily work with injured workers all the time. My job also entails things like making work station setup suggestions for a safer and more ergonomically-friendly area for the worker.

In my role as Program Manager of the Injury Care Program at the Michigan Department of Corrections, I work closely with the officers and employees at the Jackson County facilities. Work-Fit provides both on- and off-site injury rehabilitation services, and my staff and I custom design fitness programs that include a combination of cardio, weight training, and functional conditioning so employees can stay healthy and in shape. Jackson County also allows retirees to utilize our fitness space and programs, so I work with a lot of different age groups.

We also triage all occupational injuries. A typical day may include providing first aid treatment for acute injuries as well as emergency care for more critical cases. We assist injured employees in figuring out their medical care options and act as a liaison for their care until their case is completed.

Though I work with an older population than a high school or college athletic trainer, the injuries I see and treatments I employ are often the same. Our on-site rehabilitation provides treatment for a plethora of conditions from typical strains and sprains to post-surgical care for knees, shoulders, elbows, and backs. Due to the nature of the job for many of the correctional facility employees, we suggest that an aggressive strengthening program follow any rehabilitation protocol.

I stay active in the world of high school sports as well. I’ve filled in as an official, coach, and athletic trainer when local high schools need help. It’s become a fun outlet for me and allows me to keep my emergency response skills up to snuff.

Standard hours and a regular schedule are two of the greatest draws for athletic trainers in the industrial setting. Burnout is a real concern in our profession, especially for those in the scholastic setting, but this environment allows me to continue contributing in my role as an athletic trainer while also affording me more time to enjoy my family.

I’ve found that the best part of working in the industrial environment is the opportunity to make an impact on someone’s life. Each and every day, I meet people who need my help to keep their job, lead a productive life, and earn a living. When a company employee gives me a hug with tears in their eyes and thanks me for helping them, I wouldn’t want to be anywhere else.

In today’s economic climate, Industry and Education are looking to cut costs and become more efficient.  They are looking to get more out of less.  This is a strength of the athletic training skill set.  Since we are a health care professional with training and expertise in a  wide array of skills from prevention to triage, from emergency management to rehabilitation, ATs are a valuable resource.   Not only do all athletes deserve ATs, all physically active people deserve access to an AT.

One Response to “Emerging Settings – The expansion of AT services”


  1. Emerging Settings – The expansion of AT services … | Sports Injury - April 22, 2011

    […] rehabilitation provides treatment for a plethora of conditions from … … Excerpt from: Emerging Settings – The expansion of AT services … ← TBPS-New Pick Inside! – Penny Stock […]

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