Athletic trainers are ever-present medical professionals on the field and off

David Sikes | Corpus Christi

High school athletic trainers are the unsung guardians of their players.

We may see them tending to injured athletes, taping ankles, helping athletes stretch, passing out water and Gatorade, icing sore muscles, or bandaging scraped knees. But most casual observers fail to notice these professionally trained eyes are focused on seeing the sometimes subtle signs of injury in players.

Prevention is the primary job of athletic trainers. But that's an over-simplified description of their day-to-day duties. The profession's ancillary responsibilities are too extensive to list.

Athletic trainers: medical professionals High school athletic trainers are highly trained medical pros who work under the guidance of doctors and with coaches and students to prevent and treat injuries.

"We're medical professionals who work in the prevention, evaluating, rehabilitating, and treatment of athletic injuries under the direction of doctors," said Tamar Arnold, head athletic trainer at Orange Grove. "Working with athletes at the high school level, we're with these athletes all day every day. So, often we become the person they come to talk things through with, get advice from, discuss their futures with, and rant to."

On practice days, the trainers and their student aides, are often the first to arrive and the last to leave, Arnold said.

Moody's veteran athletic trainer, Robert Gonzalez, said the long hours that trainers and coaches endure have always been part of the profession. But the duties of today's trainers have expanded greatly since he began 29 years ago as Moody's lone trainer.

Many of the changes involve bureaucratic tedium and record keeping. But other obvious differences involve the health and safety of student athletes, and the highly regulated standards in medical treatments and safeguards against injury. Even something as basic as providing adequate water for the athletes has changed dramatically.

"When I played football in high school, our hydration system was a water hose held by the coach," Gonzalez said. "We all lined up to get our five gulps before the coach yelled 'next!'"

Today, chilled water is a constant at practices and during games. It's held and dispensed by several mobile vessels about the size of a washing machine. At any given time, the team has access to 200 gallons of water, Gonzalez said.

"When I played football in high school, our hydration system was a water hose held by the coach," Gonzalez said. "We all lined up to get our five gulps before the coach yelled 'next!'"

The district's hot weather policy dictates how often athletes must consume water based on the turf temperature on practice fields along with the length of practices in the heat. Athletic trainers carry a devise to measure the field's heat index, so they know when to hold practices and when to mandate water breaks.

"And we clear the field, no exceptions," Gonzalez said. "Everybody stops and drinks, whether they're thirsty or not. They've got to train their GI tracts to hold as much fluids as possible."

With increased media attention on concussions, mostly focused on the NFL, the public may get the impression this attention naturally trickled down to student athletics. But Gregory-Portland's head trainer, Robert Steele, said the intense focus and strict protocols surrounding concussions have always been part of high school athletics.

"Within the world of athletic training, despite what others may have said, head injuries have always been a priority, along with other major acute and chronic injuries," Steele said. "The problem with head injuries is there is not one definition that anyone can use; one set of signs or symptoms that point us in the right direction and one type of test or lab result that says this is a head injury."

Part of the athletic trainer's job is to educate student athletes about the symptoms and dangers of head injuries. Steele recalled a student several years ago who illustrated what trainers are up against.

"One year a freshman came up and said he had a concussion,” Steele said. "So I asked why he thought that, and he said it was because his head hurt. I asked him to take off his helmet and tell me how it felt. He said it felt fine. He puts back on the helmet, and his head hurts again. He thought the helmet was giving him a concussion, and that the concussion went away when he took it off."

Arnold echoed Steele's assertions about the complexities of head injuries, but added that her ongoing training on concussions has been influenced by recent research and treatment advances.

"Since the research for concussions has greatly increased over the last five years and is ever changing, it has been important to keep up with the current findings," she said, citing several training certifications she's received lately. "As athletic trainers in the state of Texas, we are required to have at least two hours of concussion training every two years. But with the continued new findings, it's beneficial for athletic trainers to keep their fingers on the pulse of the research year around."

Steele said the savvy trainer should be aware of the high-profile nature of sports-related concussions has spawned a number of unscrupulous or dubious marketers of devices and training courses that promise more than they can deliver. Trainers should be wary of these, he said.

"Many companies offer services that can certify a medical professional in the treatment and/or diagnosis of head injuries," Steele said. "Or they sell devices that can limit and/or prevent a head injury. While some of these companies may have good products, because of the fluidity of head injury causes, treatments, and outcomes, they are somewhat suspect, in my opinion."

Whatever the injury, Gonzalez said, prevention has always been the primary focus of athletic trainers. And often, injury avoidance is the result of basic observation, backed by training and experience.

Part of this prevention involves a team of student observers taught to recognize potential medical issues and immediately act upon these sometimes subtle signals of illness or injury.

At most high schools of a certain size, this responsibility is shared by student athletic trainers. The number of these valuable assets who serve as additional eyes and ears during practices and games vary from school to school. There could be eight to 10 at each school, said David Sanchez, who oversees all athletic trainers for Corpus Christi ISD, where each of the six high schools employ two professional athletic trainers.

The student trainers are essentially interns, willing to learn from the athletic trainers, while performing much of the labor associated with the job. Some aids gain valuable experience toward future medical careers. Senior student trainer Gabriella Lopez, who works with Gonzalez at Moody, plans on being a physical therapist after college.

"The experience has really opened my eyes to some of the processes for treatment of injuries and the symptoms to look for," said Lopez, adding that working with Gonzalez has solidified her resolve to become a physical therapist."

"I think I have what it takes," she said.

Before practices and games, the students set up equipment, fill water containers, make ice bags, apply tape to ankles and generally make sure players are properly protected against injury. But they also attend training classes to gain insight into medical and preventative treatments, said Arnold, who relies heavily on his student trainers.

"As the only athletic trainer here at Orange Grove, they are a great help to me," she said.

Infobox

REQUIREMENTS OF A LICENSED TEXAS ATHLETIC TRAINER

Bachelors or higher degree, to include at least 24 semester hours of academic credits from each of the following:

human anatomy

health, disease, nutrition, fitness, wellness, emergency care, first aid, or drug and alcohol education

kinesiology or biomechanics

athletic training, sports medicine, or care and prevention of injuries

advanced athletic training, advanced sports medicine, or assessment of injury

therapeutic exercise, therapeutic rehabilitation or therapeutic modalities.

EXTENSIVE APPRENTICESHIP

An apprenticeship in athletic training meeting the following requirements:

The program shall be under the direct supervision of and on the same campus as a Texas licensed athletic trainer, or if out-of-state, the college or university's certified or state licensed athletic trainer; must be a minimum of 1,800 hours, based on the academic calendar and must be completed during at least five fall and/or spring semesters.

Hours in the classroom do not count toward apprenticeship hours; the hours must be completed in college or university intercollegiate sports programs. A maximum of 600 hours of the 1,800 hours may be accepted from an affiliated setting which the college or university's athletic trainer has approved.

No more than 300 hours may be earned at one affiliated setting. These hours must be under the direct supervision of a licensed physician, licensed or certified athletic trainer, or licensed physical therapist; 1,500 hours of the apprenticeship shall be fulfilled while enrolled as a student at a college or university; and the apprenticeship must offer work experience in a variety of sports.

It shall include instruction by a certified or state-licensed athletic trainer in prevention of injuries, emergency care, rehabilitation, and modality usage.

DUTIES OF STUDENT ATHLETIC TRAINERS

Student athletic trainers work as an extension of the staff athletic trainers. Many of the responsibilities student trainers perform are cleaning and general athletic training activities. Many of the duties are not entertaining, but are essential to a working athletic training room.

Assisting the staff athletic trainers with treatment of

athletic injuries

rehabilitation of athletic injuries

taping athletes

administering first aid as directed

reporting all injuries and completing injury reports

learning by observing, listening, participating, and asking questions

assisting in record keeping, including the Daily Treatment Log, answering the phone and taking messages, filing

knowing the location and purpose of all equipment in the training room

assisting with stocking and inventory of equipment and supplies

preparing equipment and supplies for practices, games, meets and competitions

cleaning and storage of equipment and supplies

organizing and maintaining storage areas

keeping the training room clean and sanitary

treating the athletic training room is a medical facility

performing other duties as assigned by the athletic trainers.

Source: Texas Department of Licensing and Regulation & Robert Gonzalez, Moody athletic trainer.