Why ATs Are Needed in High Schools

31 Aug

Nokesville, VA – The following story (linked below) maybe one of the saddest stories that I have read this year and it strengthens my resolve to be a better AT and hopefully prevent this from happening in my school.  As a parent of a daughter in high school, I can’t imagine the depth of pain these parents must feel in the seemingly preventable loss of their son.

Austin Trenum’s bed remains half-made, the way a typical teenager would leave it. On a shelf is his scarred black helmet, the one he was wearing when he tackled the quarterback near the sidelines during Brentsville High’s game against Handley some 11 months ago. Austin’s mouthpiece remains tucked neatly in the face mask, ready to be taken out for the next play.

For Austin, there was no next play.

Austin’s final play left him with a concussion. Two days later, with the rest of the family downstairs in the house, he went up to his room and hanged himself.

To the grieving parents, there is no doubt that one caused the other. Shortly after his death, Gil and Michelle Trenum made the difficult decision to donate Austin’s brain for research. Seated around their dining table, they told their son’s story, hoping his death can leave a legacy for others of lessons learned — thatconcussions still aren’t taken as seriously as they should be; that athletes, parents, coaches, trainers and even emergency room workers are often ill-informed as to how to treat them; that more of a culture change is needed in a sport in which blows to the head are considered badges of honor.

Concussion awareness in sports is on the rise. The NFL has done an about-face in recent seasons, instituting return-to-play rules and other strict guidelines after years of being accused of not taking the issue seriously. Hearings have been held on Capitol Hill. Only four months before Austin’s death, the football world was stunned by the suicide of University of Pennsylvania co-captain Owen Thomas, who was found to have a brain disease that could have been caused by repeated head blows to the head.

But the full trove of medical knowledge has yet to filter down to the high school level, and it wasn’t there on the night Austin was injured. His parents took their groggy son to the emergency room — Friday night is already one of the worst times to go to the hospital — and were told to watch for bleeding symptoms and to make sure their son had 24 hours of restful activity.

Restful activity?  What is that?  Other than being an oxymoron, what qualified medical professional with up-to-date knowledge on concussions gives those instructions?  The protocol from The Concussion Summit in Zurich should be standard now throughout our country as that information is from 2008!  3 years later and an ER still is giving bad advice.

So he watched game film the next day. He went fishing with a friend in the afternoon. He went to a concert with his girlfriend that evening. He texted. He played video games. On Sunday, he was doing homework. He planned to go to his girlfriend’s house later to watch the Redskins game. All of which seemed suitably restful.

If your home-bound instructions to the athlete AND parents (at the high school) or roommate (in college) doesn’t include cocoon therapy (complete rest, no electronics) then you are behind the times and need to update your concussion protocols.

The Trenums had their answer. Now they want to share it with others.

“It was scientific validation for what we knew,” Michelle Trenum said. “But it was an agonizing gift to be given that information because you realize there’s other parents out there that have unanswered questions and they’ve lost loved ones, too. It’s what you do with that. That’s why, with Austin, we would like his legacy to be that other people were helped, that other parents don’t have to go through this, that other teammates realize when a teammate has a traumatic brain injury, they realize it and bring it to the attention of the coach.”

The Trenums also learned how their son’s concussion should have been treated. Someone with symptoms as serious as Austin’s should have rest with virtually no brain stimulation at all. No watching game film. No fishing. No concerts. No video games. No texting. No television. It should be that way for as long as the symptoms last, even if it means days of inactivity.

“If it was my son again,” Gil Trenum said, “if he got another concussion, he would be just laying down on the couch.”

The focus of this blog isn’t concussion management.  Dustin Fink does such a great job with that over at The Concussion Blog, that another blog isn’t needed.  The focus of this blog is promoting the profession, improving the profession and motivating other ATs to do the same.  This story is fuel to that motivation fire.  This story should motivate you to want to be a better AT, to want to improve the quality of health care for high school athletes across the country.

The sad realization is this, that if a experienced athletic trainer was managing this football player’s concussion I firmly believe this young man would be alive today.  If the parents were instructed about cocoon therapy properly, then this young man may be a freshman in college today.  But, only 42% of this countries high schools provide an AT for their athletes!  We need to change this or there will be more sad stories, more grieving parents, more schools who will lose a bright student and a vibrant member of their community.

What can you do?  

Post this news article on your Facebook page, let other parents read it.

Send this blog entry to other athletic trainers for them to read.

Email a link to the story to all your coaches and reaffirm that concussions are literally a matter of life and death.

Tweet the story to your followers.

Link the story on your school’s athletic training website.

Use the story as an illustration during public presentations to parents and atheltes of why concussion recognition ANDproper management is so important.

Read more: http://aol.sportingnews.com/sport/story/2011-08-30/parents-seek-answers-for-sons-concussion-suicide?icid=maing-grid10%7Chtmlws-main-bb%7Cdl3%7Csec1_lnk1%7C91009#ixzz1WcQ12ucA

11 Responses to “Why ATs Are Needed in High Schools”

  1. Jessie Shanks September 3, 2011 at 1:11 pm #

    Paul, Can you tell me how much you know about the athletic trainer that was onsite the night of the injury? Or are you assuming from the article that there was not one present. I’m trying to figure out if everyone is getting the same impression from the article as I did.

    • Paul LaDuke, ATC September 3, 2011 at 1:55 pm #

      Crazy ATC, I am assuming that there wasn’t an AT at the game and I am going by the article. I am also assuming that there wasn’t an AT on site because of the Trenum’s subsequent actions after Austin tragic death. The Trenums have been very supportive of having an AT at high schools to manage concussions. I have read a few articles about this situation and none of them have mentioned an athletic trainer.

      Now, I have enough experience in my 16 years as an AT to know that an AT isn’t informed of all injuries. Parents will often run to the ER without the knowledge of the AT. If there was an AT at the school, my sincere apologies for “throwing them under the bus” in my original post for making it sound like they didn’t manage the injury correctly. That certainly was not my intention nor even a thought in my mind that there may have been an AT at the game. I certainly can empathize with having an athlete die as I have had 2 athletes die in car accidents as well as another situation I do not wish to post here. Deat is a devastating emotion and I wasn’t sensitive to the possibility that there was an AT on site.

      • Jessie Shanks September 3, 2011 at 2:41 pm #

        Paul thank you for your response. We’ve all unfortunately had our share of tragic situations. You were only responding to the information given in the article. You are correct that the Trenum’s have been very supportive of the athletic trainers and their role in concussion management. This is one reason an athletic trainer is listed as one of the health care professionals qualified to evaluate and return an athlete to play after sustaining a concussion. For their continued support, we are very grateful.

        Athletic trainers are employed full time in each of the 11 high schools in Prince William county. Fairfax, Stafford, Loudoun, Fauqier and Spotsylvania, which neighbor Prince William in VA, also employ an AT at the high school level. There is athletic training presence across the state through full time, part time and clinic outreach programs. In a perfect world an AT would be in each high school. As a state we are still working towards that goal.

  2. atc730 September 3, 2011 at 8:46 pm #

    don’t believe everything you read, dude. the author of this article has very little practical knowledge of tbi’s and he got most of the info related to this incident from people with no medical training and it suggests that athletic trainers in the prince william county don’t understand the severity of concussions or how to manage them. you should note that neither of the athletic trainers who were actually present at the football game were included in the composition of this article. also note that the “new” policies on how concussions are to be managed in the county are mostly composed of practices that were in place long before this incident occurred. the way that the article was written would have you believe that mr. trenum did all this leg work to build this program from scratch and that all the athletic trainers in the county were lost and clueless. it actually says that he was responsible for educating athletic trainers about concussions. i will not speak for anyone else, but i am an athletic trainer in prince william county, and i was state bluntly that mr. trenum never taught or arranged for me to be taught about head injuries. none of the information in the “new” policies is really new. almost all of it was stuff that athletic trainers had been attempting to have put into place for some time. unfortunately, it took a catastrophic event involving a young man who happened to be related to a person with some power to get them pushed along. this reply should not be mistaken for a stab at mr. trenum. it is merely a response to an article that uses incorrect and incomplete information to tell part of a story. it uses ugly colors to paint athletic trainers in a bad light. i believe that the author of this article was just trying to steal some thunder from another article about a more publicized incident that was released in a major news paper the day before this one was. there was not due time and care and research invested in the composition of this article, and as a result, some very good professionals were thrown under the bus.

  3. Sara September 3, 2011 at 9:19 pm #

    I agree with Jessie. I also think that as a fellow ATC, you would assume the other way and think there was an ATC present…. The article also states that the kid was referred to the ED… The ED said to rest 24hrs… the activities listed were not resting! ATCs are educated from day one of their education in college.. and on a continuous basis (how many lectures/sessions at inservices and meetings have we heard the latest and greatest on concussion research???). I have referred athletes many times to the ED and they are NOT diagnosed with a concussion because the CT scan is normal.. now, we all know that a CT scan is not the end all be all of used to diagnose a concussion… It is unfortunate that the kid took his own life. However, instead of “throwing people under the bus,” what can we do as professionals to promote the educaiton/qualifications we do have so that parents may feel more comfortable with us being there on the sidelines???

    Maybe a little more research on the resources that the school the article mentions and you (or anyone else for that matter) would know that the school does (and did at the time of the incident) have a LICENSED (by the Virginia Department of Health), Certified (by the Board of Certification) Athletic Trainer!!!!!!!!!!!!!!!!!!!!

    People these days are too quick to assume things… and I know you have heard the expression on what happens when you do so.

    Let’s support each other as professionals!!!!

    • Sara September 3, 2011 at 9:40 pm #

      I am NOT blaming anyone in any way for this incident… just trying to get people to take a different point of view!

  4. atc730 September 4, 2011 at 8:29 pm #

    the father of this young man is an administrator in the county school system. i don’t know if it’s the information the way he presented it to the reporter, or if the reporter took this and tried to dress it up and make it dramatic, but the right people aren’t getting credit for the work they did to put the current procedures in place, and we’ve been made to look like a group of idiots. all this talk about supporting the profession and improving our position as athletic trainers… it’s not going to happen in articles like this. if mr. trenum wants to support athletic training, he could take measures to ensure that atc’s get paid what their hours are worth. he could take measures to decrease the athlete-to-atc ratio. he could encourage or endorse a budget larger than $3000 a year for one athletic trainer to purchase goods and services for 30+ teams for an entire year. instead, this article gets dropped, and people are being made to thing that a single man put an entire issue on his shoulders and is setting out to change the world. i feel awful that a man lost his son. i sincerely do. but the sensation that he put all this stuff into place and came up with these guidelines and protocols with his own research and effort is absurd.

  5. Paul LaDuke, ATC September 5, 2011 at 2:29 pm #

    I will be writing another blog entry on this situation. This article is poorly written and leads the reader to believe that there was no athletic trainer present. Additionally, the athletic trainers VA are made to look ignorant in concussion management and the Trenum’s are responsible for educating athletic trainers in how to properly manage concussions.

    I am doing more investigating into this story and will post something when I feel satisfied that athletic training side of the story can be told.

    • Dustin Fink September 5, 2011 at 3:06 pm #

      Michelle and Gill have thanked and promoted AT’s in PWC. In fact Gill worked with AT’s including me to create the specific wording on the policy.

      The moral of the story is not to throw AT’s under the bus, rather point out that MD’s are the highest on the “food chain” of the medical team. Their words, whether correct or not, are usually adhered to over others. Is this right, NOT ALWAYS, especially with concussions, as we have learned.

      Information about concussions should be consistent across the injury and across the medical professionals. It is no “shot” at doctors to say a vast majority, especially in the ER, lag behind in the recognition and treatment of concussions, THIS IS THE PROBLEM!


  1. Promote the Profession x 2 « The Concussion Blog - August 31, 2011

    […] Paul’s most recent entry he uses the Austin Trenum story as fuel for having an athletic trainer at every high school, at the […]

  2. Follow Up – Why ATs are needed « promotetheprofession - September 20, 2011

    […] Sep On August 31, 2011, I wrote this blog entry highlighting an unfortunate situation in Nokesville, VA.  In the entry I wrote: The sad […]

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