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.