Brad Swope, Tyler Summers and Mark Burns practice putting an injured player (Scotty Blackburn) on a board to be transported. Sumner County emergency personnel and athletic trainers recently underwent training exercises. / Larry McCormack / The Tennessean
By Nate Rau / The Tennessean
Fresh off a win in the state legislature with a new youth sports concussion law, the state athletic trainers association is embarking on a long-term effort to require all schools to have trainers.
The Tennessee Athletic Trainers Society is taking an incremental approach by pushing for high schools to have a trainer on hand at varsity football games beginning in 2014. The most recent survey by the organization found that 119 schools, about 32 percent of the membership in the Tennessee Secondary Schools Athletic Association, don't have athletic trainers.
With increasing awareness about the dangers of concussions, heat sickness and cardiovascular issues among young athletes, pediatricians and sports medicine experts say athletic trainers are important in reducing and properly treating injuries.
But cost and lack of access in rural areas make hiring athletic trainers difficult for some schools. Some rely on paramedics or other medical professionals at games instead.
The trainers association says that while other medical professionals are important, athletic trainers have specialty in athletic injuries. In addition to a four-year degree, trainers must pass a board test and perform dozens of clinical hours and job shadowing before becoming certified.
As an example, Johnnie Anderson, director of sports medicine for Sumner County Schools and the Middle Tennessee representative for the athletic trainers society, pointed to special training such as a recent session in his county.
At that session, athletic trainers practiced how to respond should a football player suffer a serious head or spinal injury.
The trainers were joined on the field by paramedics, who are frequently on hand at football games, but during a simulated session where a volunteer pretended to have such an injury, the paramedics didn't immediately know how to remove a player's face mask. That's where the athletic trainers' experience came in handy, as a special tool was wielded to pop the face mask off and give first responders access to assess the severity of the injury.
"It's that kind of experience and know-how that's invaluable," Anderson said. "An athletic trainer is specially trained to treat athletes from prevention through rehabilitation."
The Tennessee effort to put more athletic trainers at youth sports events is part of a larger trend. The National Athletic Trainers' Association plans to push for state laws requiring schools with collision sports to have them. A few states already have done this, said association president Jim Thornton.
TSSAA Vice President Mark Reeves, however, said his organization would be hesitant to include a financial requirement to hire a trainer when budget decisions are made at the district level.
Instead, Reeves said, he hoped the state trainers society could become a resource to schools by providing a list of athletic trainers that could be hired, at least for varsity football games.
An entry-level trainer's salary is between $28,000 and $35,000, according to the state trainer's association. Hiring one for a football game costs about $100, according to early estimates.
"In the same way there are resources for schools to hire game officials, we think the (Tennessee Athletic Trainers Society) could provide a list of a trainer who could be hired for the game," Reeves said.
Reeves said the TSSAA recognized the value of athletic trainers when it amended its concussion policy, which went into effect in 2010.
Initially the TSSAA concussion policy required an athlete showing concussion symptoms to be removed from the game and didn't allow them to return to play until a doctor had cleared them. The flaw, Reeves said, was that sometimes an athlete showed concussion symptoms when the real problem was mild dehydration, nerves before a big game or something else.
The policy was changed so an athletic trainer could make the initial diagnosis to identify whether a player had suffered a concussion.
"The fact that coaches who are fortunate enough to have those (athletic trainer) services at their disposal can't imagine it any other way tells you how critical they are," Reeves said. "Unfortunately, there are parts of our state where trainers are not readily available."
The issue of cost
Two problems preclude schools from hiring athletic trainers. The first is money. The other is availability in some parts of the state.
Cannon County went for years without athletic trainers at sporting events, according to Superintendent Barbara Parker.
"When we're cutting teachers and cutting other things in our budget, this has been something that was put back," Parker said.
This year, the school finally added an athletic trainer after working out an arrangement with a local medical provider that helped share the cost.
"I think there's a level of comfort that comes with having a trainer," she said.
In local school districts such as Davidson, Williamson and Rutherford counties, health care providers enter into agreements with school boards to provide athletic trainers at little or no cost to the district.
Still, a 2012 survey in Tennessee by the trainers society found that only 68 percent of schools had access to an athletic trainer. That echoes data being gathered by the National Athletic Trainers' Association, which is conducting a national survey on athletic trainer coverage.