Advocates present the case for putting ATs in every school

Dr. Javier Cardenas was tired of the bickering.

As chair of Arizona’s Sports Medicine Advisory Committee, Cardenas was wedged in the middle of several institutions that all assumed it was someone else clogging the pipes of progress when it came to improving healthcare for high school athletes. A year ago, he had heard enough and decided the only solution was to get them all together.

“Rather than complain about these faceless and nameless institutions, let’s get these faces and names in the same room,” Cardenas said. “It turned out that we all had a common goal: To protect kids and have athletic trainers in every school.”

Arizona is one of many states across the U.S. searching for ways to increase the number of athletic trainers that work in its public high schools. The number of schools with some type of medical coverage for its sports teams has doubled in the last 20 years, according to a study released in March.

Experts in the field were pleasantly surprised with the increase but warn there is still a long way to go before the lack of athletic trainers in high school sports should be considered anything less than a public health issue. Nearly one of every three schools goes without trained medical professionals to take care of athletes.

Even in a room filled with smart minds and a common goal, folks like Cardenas are fighting a difficult battle. Money to pay for full-time athletic trainers — an average salary of roughly $40,000 to $50,000 annually — is hard to find for many school districts. A good pool of part-timers who can work at health clinics or other places during the day and cover after-school sports are also in low supply, especially in rural and less affluent areas.

The first step to finding a solution is raising awareness about the role athletic trainers play in keeping kids safe. Riana Pryor, who spent two years gathering the data for last month’s study for the Korey Stringer Institute, said there are many high school administrators across the nation that don’t know what athletic trainers do or why it is important for their school to have one.

“There were a good amount of phone calls that were frightening, to be honest,” Pryor said. “We asked some (athletic directors) why they didn’t have one, and they said they didn’t know. They had never considered they needed one. Not knowing that there is a specific medical professional who can help their athletes and possibly prevent deaths at their school is just mind-blowing to me.”

Many of those schools without any coverage rely on coaches to decide when injured players should leave or return to a game. Pryor said that presents a clear conflict of interest for the coach, not to mention an unfair task to add to the plate of someone who is already distracted and likely isn’t qualified to evaluate injuries.

Frequent headlines about concussions and, to a lesser extent, serious heat-related injuries during the last few years have helped the general public better understand the need for athletic trainers at sporting events. As the number of squeaky wheels increase, schools are growing more proactive about finding ways to add medical coverage. A handful of states have attempted to pass legislation that requires all schools to employ athletic trainers, but so far only Hawaii has an official law on the books.

Hawaii’s law, established in 1997, mandates that all public schools have a full-time athletic trainer. Roughly 90 percent of high schools in the state now have a least two athletic trainers on staff, according to Hawaii Athletic Trainer Association President Sam Lee.

Because of the relatively small number of schools on the islands, and the fact that Hawaiian schools are run by a statewide organization instead of broken into smaller districts like most places on the mainland, it’s difficult to pass similar laws in other states. There are still lessons that can be learned from the sustained success of Hawaii’s program.

Lee said it was a group of athletic directors, not the athletic trainers, who played an instrumental role in convincing the government to act.

“If athletic trainers went directly to the legislators it kind of seems a bit self-serving, ‘Hey you need more of us,’” Lee said. “But when the athletic directors help you in terms of talking about what kind of healthcare is out there for their kids and what are some of the challenges if a kid gets hurt and a big lawsuit comes, it makes a difference.”

Money remains the toughest obstacle for schools that want to improve their sports medicine coverage. Jim Thornton, president of the National Athletic Trainers’ Association, doesn’t buy that excuse though. He sees the problem as more of a lack of organized effort than a lack of funds.

“If someone came in and destroyed a high school’s football field in the offseason the boosters and the school would find the money to replace that field before the following season,” Thornton said. “If they wanted to find the funding they could be creative and find the funding.”

Thornton said the same logic applies to raising money for an athletic trainer. The NATA keeps a running list of ideas for new ways to squeeze more into school budgets, from hiring athletic trainers that double as security guards or health teachers to partnering with local hospitals.

Back in Arizona, Cardenas and company are trying to develop their own strategies. Last April, they set a goal to have an athletic trainer in every high school within 10 years. They started this year by providing one for all state tournament games, an effort funded by $200,000 worth of grants from the NFL and the Super Bowl hosting committee.

Eventually, Cardenas says he hopes that pool of money is large enough to sustain full-time salaries for as many athletic trainers as possible. His group is partnering with all of the state’s pro sports teams to find ways to raise money and public awareness of the issue and exploring other avenues that could lead to more solutions.

“I don’t want to come off as naïve,” Cardenas said. “I know it’s going to take a lot of work and a lot of collaboration, but I also recognize when enough people come together collectively they find ways to make it happen.”