People are often confused about how an athletic trainer fits into the sport ecosystem. What does an athletic trainer do for the team? And how can teams best take advantage of this resource? Often, athletic trainers are only mentioned in the context of an athlete who has been injured and needs a ‘return to play’ plan. But athletic trainers can provide much more value and should be integrated with the team when athletes are healthy, not just in crisis situations.
Here, TrueSport Expert Dennis Coonan, Program Manager of the Sports Medicine Center and an athletic trainer at the Children’s Hospital Colorado, explains what exactly an athletic trainer’s role should be, and how coaches can work with athletic trainers to build stronger teams.
What is an athletic trainer?
“An athletic trainer typically has a bachelor’s degree and a master’s degree related to exercise science,” says Coonan. “They’re nationally board-certified, and 49 out of 50 states require licensure as well.”
“Their role is the prevention, evaluation, diagnosis, treatment, and rehabilitation of emergent or emergency, acute, and chronic illnesses and medical conditions,” Coonan explains. Prevention is key here: The athletic trainer should be involved with the athletes before any health issues arise, since a key part of their job is to help prevent injury and illness. If an athlete does get hurt, an athletic trainer typically is the one who will do an initial evaluation, give a diagnosis, and work with the athlete on the rehabilitation plan and the return-to-play timeline.
They’re also able to handle catastrophic injury if it happens on the field. For example, an athletic trainer will know how to manage a cervical spine injury, heat stroke, and open fractures. They also end up being a sounding board for athletes, serving as a de facto mental performance coach. Athletic trainers aren’t licensed therapists or psychologists, but they are often the person an athlete will talk to first when they’re struggling emotionally or mentally.
“Short of prescribing medication and performing surgery, we’re often able to handle the entire continuum of care regarding injuries,” says Coonan.
An athletic trainer may also be the one responsible for cancelling games or practices due to unsafe conditions like heat, lightning, or cold.
While colleges employ the highest percentage of ATs (26%), a close second are secondary schools (24%). ATs are also very commonly found supporting physicians in their clinics, working with club sports, and contributing in other settings.
Who are athletic trainers working for?
It’s important for coaches and other stakeholders in the sports system to understand that athletic trainers have one “client,” and that is the athlete. The goal for an athletic trainer isn’t to win the most games in the season, it’s to keep the athletes as healthy as possible. In the simplest language, athletic trainers work for the athlete. Not for the coach, not for the school, and not for the team.
“Oftentimes, the athletic trainer is the most non-threatening member of the management team, because if an athlete is having a bad day, it’s not going to affect playing time for them if they talk to the athletic trainer,” says Coonan. “They can talk to us about things that they don’t feel comfortable talking to a coach about, because they don’t want to get judged or risk their playing time. They come to us to have these conversations in a protected environment.”
In a case where an athlete could play through a minor injury and an athletic trainer agrees, they would work to make the athlete as prepared for the competition as possible. “An athletic trainer also helps the athlete understand the risk they’re taking on by playing through injury,” Coonan explains.
Because the athletic trainer is someone knowledgeable but impartial—and not focused on the team’s outcome—they’re an integral part of the sport system for athletes.
How can coaches best work with an athletic trainer?
“Athletic trainers invariably get lumped into teams because we work with the whole team,” Coonan says. “Of course, we get emotionally tied to the wins and the losses, but an athletic trainer has to be able to take a step back, be an advocate for the kids, and not be a member of the coaching staff that’s just trying to win.’”
While an athletic trainer’s first duty is to the athlete, they are required to tell a coach about acute injuries or when something an athlete has told them could affect their performance. “I remind athletes that anything they tell me could affect their playing time because that’s part of the deal: A coach needs to know who they’re going to have available, and what the athlete’s ability is going to be on any given day,” says Coonan.
However, athletic trainers will keep information on a need-to-know basis. “For example, if a young woman is having a personal health issue, like with her menstrual cycle, I won’t tell the coach that personal information. Instead, I would say that the athlete is going to sit out a practice or take the day off for medical reasons. The details are private.”
Often, coaches and athletic trainers will engage in discussions around playing time and whether an athlete should be sidelined in order to recover from a minor injury or illness. “It’s important to have an athletic trainer in the room for these decisions because our number one priority is the health and safety of the kids,” says Coonan. “For coaches, there’s also pressure to focus on the team and the overall performance, because to some degree, their job is tied to wins and losses.”
When an athletic trainer and a coach are able to work in harmony, everyone benefits. “The best thing you can do is have an athletic trainer that wants to be around your team for a long time, because the longer they’re there, the better your team’s relationship will be,” says Coonan. “Athletic trainers build relationships with the parents, the kids, the coaches, and the organization, so you’ll see huge benefits if you embrace your athletic trainer and what their role and skill set is, versus seeing them as an adversary.”
What boundaries should athletic trainers maintain?
Because athletic trainers are the people that athletes can come to with any problem, it’s important for athletic trainers to set firm boundaries with the athletes, following SafeSport best practices.
“Athletic trainers tend to get to know athletes as people,” says Coonan. Because of this, it’s easy for lines to blur and boundaries to be crossed. Communication protocols should be clearly laid out at the beginning of the season so that athletes know how to contact the athletic trainer, and what modes of communication are not appropriate. For athletes who are minors, there are specific communication protocols and rules around not being alone with an athlete.
Athletic trainers are also often privy to sensitive information that does require reporting. For example, if an athlete is coming to the athletic trainer with an emotional issue, and it seems as though the athlete may be having some suicidal ideation, it’s the athletic trainer’s responsibility to report that and get the athlete the help they need. Athletic trainers also need to know when to urge an athlete to seek professional counseling rather than simply talking to the trainer about emotional issues or their mental health.
