As a young professional athletic trainer I am beginning to learn that our scope of practice is much larger than I had previously comprehended within my undergraduate education. Although our scope of practice is defined within the BOC’s 5 domains of athletic training (Injury/Illness Prevention and Wellness Protection, Clinical Evaluation and Diagnosis, Immediate and Emergency Care, Treatment and Rehabilitation, Organizational and Professional Health and Well‐being), I am finding that the many roles performed by an athletic trainer extend much further than I had previously anticipated. If you are an athletic trainer, I am fairly certain that as you read this you will be able to relate to how your role may extend further than what is written in your job description.

Even though I am enrolled in a post-professional AT program, I am beginning to explore my options of continuing education opportunities.  I am finding that there are a wide variety of programs to choose from and so many skills I want to gain. My undergraduate education provided me the skills and knowledge necessary to become a competent, entry-level athletic trainer. However, as I now seek to develop myself as a professional, I find myself asking; which direction should I go?

Personally, I find it difficult to maintain a high level of knowledge pertaining to all the domains of athletic training when I use them variedly.  Some skills (rehabilitation, organizational health and wellness) I use every day, while others, in my current setting, like emergent care, are used infrequently.   And although I understand my professional responsibility to remain current, I also want to highlight the skills I use most. Other healthcare professions such as physical therapy for example, have developed specialty certifications (such as Orthopaedic Specialist Certification (OCS), and Sports Specialist Certification (SCS)) so that health care professionals may continue to develop themselves professionally, and set themselves apart when seeking employment. I understand that organizations such as the National Academy of Sports Medicine (NASM) provide the opportunity for athletic trainers to gain post-professional certifications, however, our governing bodies (NATA/BOC) should be providing specializations like others do? It’s not that the conversations haven’t been occurring or that they don’t conceptually exist.  The NATA has provided a helpful definition,1 so that we can know about future possibilities, but it’s time for development, validation, and deployment of specialty certifications in Athletic Training.

1.       http://www.nata.org/education/educational-programs/athletic-training-specialty-board-certification

When an Athletic Trainer is attending to an injured athlete during an athletic competition, is it appropriate for a fan who happens to be a health care professional to come onto the field and try to take over?  Where do you draw the line?  It is not written into the Policy and Procedure Manual or the Emergency Action Plan, but often fans who are also health care providers insist on jumping in.  My professional opinion is that fans are there to observe the game and not to attend to injured athletes, particularly if there is a qualified health care provider working the event.  Fans and parents (regardless of if they are a health care provider or not) need to stay off the field and let the Athletic Trainer do his/her work, unless they are called upon or there is no other medical care available.  Athletic Trainers go through intensive education and training which is focused on the health care of the physically active.  Athletic Trainers are the experts on health care for the physically active.  When fans, parents, and officials who may or may not be health care providers try to step in, it causes confusion and often delays care to patient.

I understand that most health care providers have a caring spirit and want to use their skills to help an individual who they perceive as in need of care, however most are unaware of the type, level, and quality of care they are receiving from an Athletic Trainer.  Additionally, there is a professional boundary that should exist among health care providers to respect everyone’s skills.  If an Athletic Trainer walked into an emergency room with adequate staffing and said, “I’m an Athletic Trainer and here to help,” he/she would be quickly escorted away and probably told that this isn’t the place for them. Why doesn’t it work the other way around?  Too often there is unnecessary interference from fans that want to use their health care expertise to help, but are not part of the designated team and do not know the procedures for care on the sideline.  What’s worse, often times coaches, athletic directors, and other personnel allow these people on the field and sometimes trust the word of the other health care provider over the assessment of the Athletic Trainer!

It is the responsibility of the Athletic Trainer to attend to the injured athlete, determine the diagnosis, and treat appropriately. As Athletic Trainers, we have Emergency Action Plans in place if there is a need for emergency care. On the field, the Athletic Trainer is the leader of the health care team and if assistance is needed, he or she will communicate to other members of the team as needed.  We are not only qualified but also legally obligated to follow our protocols for care and any outside interference could result in legal against anyone providing care.  Let us do our job! 

We all have a role.  Let’s do what’s best for our patients and sport. We Prepare, You Perform.

Bobby Vallandingham LAT, ATC

I’ve tried to think of a great topic on my first year as an Athletic Trainer.  Some of my fellow bloggers have talked about the work-life balance, working with students and talking to physicians.  So I wanted to write about some enlightenment, but that isn’t me.  The thing that I have learned most in my first year is the importance of our colleagues.  We are rarely alone without a fellow Athletic Trainers to brainstorm and ask advice with. 

When I started at ISU working with the women’s volleyball team, I didn’t want to ask my fellow graduate assistants or supervisors for help on my injuries.  My perception was that asking for help was a weakness and I didn’t want to bother my fellow graduate assistants.  After all, they are just as busy as I am.  I was already asking a lot of questions to my collegues, supervisors and professors about the responsibilities of a single Athletic Trainer with a sport, and we were all busy learning the organizational structure which comes with any new job.  I felt like asking any more of my classmates was inappropriate. 

I couldn’t have been more wrong.  I’ve realized how important our fellow Athletic Trainers are, not just to share our knowledge with one another but also to keep each other sane and grounded in a profession where nothing is ever mundane.  Clinically, we confirm each others’ ideas, provide our own ideas, and help cover each other when things get busy.  Most days when we aren’t in class, having meetings, doing treatments or working with our teams, the graduate assistants are hanging around doing paperwork and joking around.  One of the best parts of coming to ISU and being a graduate assistant has been working with the other graduate assistants going through their early years of clinical work as well.  I know that having others in the same situation as myself has helped a grow as a professional.

Matthew Schafer, LAT, ATC

The mission of the National Athletic Trainers’ Association is to enhance the quality of health care provided by certified athletic trainers and to advance the athletic training profession.

To advance means to move forward in a purposeful way… in the last few weeks... the US has purposely advanced the LGBTQ community.

Between October 6-17th, eleven states (NC, ID, WV, OK, VA, CO, NV, AK, WI, IN, UT, AZ) experienced legislative progress for the LGBTQ community recognizing the legality of gay marriage.  

Furthermore, some of us celebrated National Coming Out Day on October 11th and Gay and Lesbian Alliance Against Defamation GLAAD Spirit Day on October 16th.

These actions and the words of my colleague, Ethan Roberts in his blog “Together We Must Do Better”, promote acceptance and eliminate prejudice within and outside Athletic Training.  Athletic Trainers are represented across the range of demographics: sex, age, education levels, religion, ethnicity, sexual orientation, race, marital status, political affiliation, etc. In the end we all have one thing in common and that is the only thing that matters: We are athletic trainers. #Iamanathletictrainer #TogetherWeMustDoBetter

If you would like to join with me in promoting acceptance and eliminating prejudice within the National Athletic Trainers’ Association, consider signing this petition. https://indstate.qualtrics.com/SE/?SID=SV_ezWW2OKD8KYOdpj

Ashley Crossway LAT, ATC

During my undergraduate education, I learned that Athletic Training encompassed the five domains we are all familiar with.  But one aspect wasn’t discussed often was the Athletic Trainer’s role as comforter, confidant, and in some situations the voice of reason. This year I have been blessed with the opportunity to be the Athletic Trainer for the boys and girls soccer teams at a local high school. The first half of the season everyone was relatively healthy and I was slowly gaining some trust with my athletes. The coaches eventually warmed up to the stranger that sat at the corner of the field just “watching” practice.

Then came the second half of season…injuries galore!! That’s when the coaches finally realized that I wasn’t just “watching” practice but I was instead there to get them back out on field healthy and ready to go. As treatments and rehabilitations progressed so did my relationships with the athletes. We began to get to know each other’s backgrounds, the different personalities, where I came from and why it is that I do what I do. Then somewhere along the way that initial barrier and “stranger” persona drifted away and they became MY athletes. I have to say, that is my favorite thing about this profession!

We’ve all heard that there is a psychological aspect to injuries and healing but I was never fully exposed to what that truly meant as an ATS. Because of this newly established level of trust and care that I have created with my athletes, I hear about their concerns, and their pains both on and off the field. Some people may feel the need to separate those conversations from clinical practice; however I am becoming a huge advocate for having the rapport building conversations. I have been able to better identify when my athletes are not emotionally or mentally prepared to return to play and when things outside of sport may be negatively affecting them.

Sometimes providing the best care for your patients means not focusing on the range of motion or sets and repetitions, but instead caring for the patient as a whole. We all have experienced the times of being swamped with treatments, getting athletes out to practice, and catching up on documentation that sometimes we miss that opportunity to really connect with our athletes and better understand what is going on with them beyond their injury in Sportsware. As I continue with my transition to professional practice, this is one aspect of the profession that I hope to grow in to provide better care for my patients as individuals, not just athletes.

Rachael Kirkpatrick, LAT, ATC

As a young professional entering my first major job experience as an Athletic Trainer, I have learned that life-work balance is imperative to success, and it must start early in the career. Often times we hear discussions on burnout, stress, and low retention rates in Athletic Training. In any demanding career, understanding the job requirements and expectations before we start is very important. And just as we reflect on the hard work associated with being an Athletic Trainer, we also have to reflect on what we can do to help ourselves.  Athletic Training is a service profession… we serve others, but how do we do that if we don’t serve ourselves. 

Accepting the following characteristics of the profession… is our own fault:

1.      Athletic Trainers cannot have a life outside the job

2.      Athletic Trainers cannot ever get sick.

3.      Athletic Training MUST be a 70-80 hour per week job.

4.      No one is here to help me, it’s just me.

It is not a “badge of honor” to work yourself to a point of exhaustion. The poor retention rate in Athletic Training is unacceptable, but we have to contribute to solutions.  This means we have to stay motivated and take care of ourselves as well as each other.  As professionals, we need to continue to promote the profession and explore other methods and outlets of stress relief.  This means talking to future Athletic Trainers about what “reality” looks like, but how to manage and cope with the nature of our work… not discouraging them from staying, but showing them that Athletic Training is manageable, has a ton of cool things to do, and is a fulfilling job!

In order to have life-work balance, one must have professional and personal goals. Developing relationships and advocating with co-workers, peers, and administration is helpful in achieving these goals. A supportive network of these individuals combined with a drive within yourself to succeed in your career is essential.

Athletic Training is without a doubt a demanding career, but this high demand comes with high reward. We must work to attain life-work balance through advocacy for ourselves, our peers and co-workers and make it known that our profession is worth it!

Emma Nye LAT, ATC

I have had many chances to advocate for the profession throughout my time pursing certification and after becoming licensed and certified.  In a recent instance, I was tutoring a student and eventually the conversation turned to the student pursuing a degree in Athletic Training and how the student wanted to be in a Professional Athletic Training Program.  Of course I was thrilled, so I asked the student about their goals for the future.  The student told me they wanted to be a Physical Therapist.  I wasn’t surprised.  A majority of the students who graduated with me from my undergraduate program are pursuing careers as PAs, PTs, OTs, and MDs.  However, this student continued to say that they had no intention of becoming dual credentialed; this student only wanted to work as a PT.  I didn’t understand why this student would go through the rigors of an Athletic Training program and not become an Athletic Trainer. 

The following portrays part of my continuing conversation with the student:

Student: “So are you in Grad School studying Athletic Training?”

Me: “Yes, I am.”

Student: “Oh, so what are you doing next?”

Me: “I am going to continue working as an Athletic Trainer.”

Student: “No, after that.  What is your REAL job going to be?”

I didn’t understand what she meant.  To me Athletic Training IS as real job.  However, it seemed to this student that Athletic Training is just a stepping stone, a means to a “better” profession.  Now don’t get me wrong.  I’m not trying to bash, PTs, PAs, OTs, or MDs.  I completely respect each profession and value their insight and experience.  However, when I am told that my profession isn’t real, I’m going to ask questions:  Where is this information coming from?  Are we educating our students that Athletic Training is a stepping stone?  Perhaps not directly, but it is happening all the same.

By allowing students who do not want to become Athletic Trainers into a Professional AT Program, universities are wasting valuable time, money, and resources in educating students who are not even investing in their education.  This allows students to think of Athletic Training as a means and not as a profession.

The Professional Education in Athletic Training: An Examination of the Professional Degree Level document, also infamously called the “White Paper” suggests that we may be able to address is issue with a Master’s level professional degree.  The Finding (#4: Professional education at the graduate level enhances retention of students who are committed to pursuit of an athletic training career. Graduate-level education attracts students who are better prepared to assimilate the increasingly complex concepts that are foundational for athletic training practice) is based on data that suggest 25% of students in Bachelor’s degree programs do not intend to practice as Athletic Trainers.  These students cite a lack of respect for the profession, the time commitment required of the job, and the use of Athletic Training as a conduit to other professions.     

I think it is reasonable to consider that all these perceptions can be changed… So, I will pose some things to consider:

-Should we restrict students who do not want to pursue a career in Athletic Training from being admitted into Athletic Training programs? 

-Shouldn’t respect for the profession come from within? And couldn’t we work to establish that by limiting this habit of stepping on Athletic Training to get somewhere else?

-Will transitioning professional education to the Master’s level solve this issue? 

I don’t know the answers, but I do know that I don’t want our profession considered a ladder to somewhere else...if anything, Athletic Training is a bridge.    

Nicolás Merritt, LAT, ATC

Athletic trainers use social media now more than ever before, and with that comes great responsibility. Social media allows us the opportunity to express our thoughts and opinions to other athletic trainers, and to the whole world. Oftentimes, individuals overlook that online communication is available for the world to see, even if that was not the intent. Once you have posted, you have made a permanent mark on the internet world.   

Recently, a comment was posted on a popular social media website. This comment received backlash from many athletic trainers. The anonymous writer stated, “It pisses me off when I see overweight/out of shape ATC’s out there. If our job is to keep athletes healthy, we need to keep ourselves healthy.”

I felt compelled to talk about this touchy subject in hopes that athletic trainers, will advocate rather than protest within the profession. I believe everyone is entitled to their own opinion, except when it demeans individuals within the field. Periodically, individuals express opinions that are meant to advocate for good within the profession, like becoming healthier, but rather, hurt the profession and people, because of a barrier in expression or communication.   

As NATA members, we are all required to uphold the NATA code of ethics. These principles are intended to establish and maintain the highest standards of professionalism for the field. Specifically, principle four states that, “Members shall not engage in conduct that could be construed as a conflict of interest or that reflects negatively on the profession.”  Comments on social media, that can be regarded as negative, biased, and disapproving violate the Code of Ethics.   An athletic trainer’s capabilities are not correlated to his/her physical fitness or health. A person should never be judged on how well he/she can perform based on their weight, or for any other physical characteristic. Expertise, knowledge, and experience frames a professional’s competence and qualifications. And although I can appreciate the promotion of health, for all people, I can neither condone nor empathize with judgment.

Many classmates of mine were discouraged by a blog post discussing this topic, for fear that it would discourage people from sharing their experiences on the internet. However, if nothing is said, then no progress can occur. So, to pull from an age old saying… think before you speak… and let’s all take care of each other.  #TogetherWeMustDoBetter

Ethan Roberts LAT, ATC

“Research is creating new knowledge”- Neil Armstrong

When I was an undergraduate athletic training student at Rowan University, our professors used to explain the importance of research to us. Even though I could see their passion for their research, I never felt that it was important to me for a few reasons. First, as a busy athletic training student, how was I going to find time to do research and stay motivated when I don’t find it interesting? Second, who am I to do research? After all I’m just an undergraduate student. And finally, how am I ever going to apply all this research and statistics into my clinical experiences?

These feelings all changed seemingly overnight. Late in my junior year, we had a lecture one night by our team physician. We knew it was going to be about the need for research in athletic training so my classmates and I weren’t overly excited to attend. However, by the end we left motivated. He broke down exactly how research could be interesting and why it is important to any medical profession. This is one of the busiest men I’ve ever met finding time for research in athletic training because he saw its importance. This opened my eyes and taught me that research could be interesting and there is always time, you just have to find it.

I continued to have those “light bulb” experiences throughout the end of my undergraduate education.  At an interprofessional in-service where athletic training students, osteopathic medical students, and physical therapy students shared knowledge, my classmates and I had an epiphany that no matter the academic level, everyone has more to learn, especially in the medical community. A medical student and also an alum from our athletic training program spoke to me about the importance of research and collaborating between professions. I think this is when it finally clicked that even as an undergraduate student we had a responsibility to contribute to research.

However, there was still that gap in my mind about how research applied to my clinical experiences? This gap was bridged my senior year when I had a preceptor that would use research in his clinical practice. Not only did he show me his graduate thesis, and have a library full of information that he was always referencing, but he always was learning something new. He subscribed to many journals and encouraged me to find an article that I could apply to my practice. Finally, I realized how research and journals could be useful on a day-to-day basis.

Unfortunately, by the time I realized all this, I was almost ready to graduate. However, I did have opportunities as I neared graduation to explore the value of research.  I conducted a literature review to determine if ultrasound or friction massage were effective for treating patellar tendinopathy.  The results helped me in treating a patient with this condition and I could see result in my patient that mimicked the evidence.  I also conducted a literature review of Achilles Tendon Ruptures, and this paper won me the NATA Foundation’s Deloss Brubaker, EDD, ATC Undergraduate Student Writing Contest in the literature review category. In my senior seminar class, we designed a research project and presented it to fellow students, faculty, and medical students. Although this wasn’t a particularly lengthy r weighty assigned, we were expected to present for an hour, which required us to find something we were passionate about.  I chose something that I am now developing for my master’s thesis, Physician’s Perceptions of Athletic Trainers.

So, I too had questions… does this stuff really matter?  And sometimes it took a little active participation on my part for that light bulb to go on, but research is important… even for undergraduate or professional students.  Research can help you to gain new knowledge and improve your clinical practice. Research can inspire your career path. Research can empower you to share what you know.

"Research is formalized curiosity.  It is poking and prying with a purpose." – Zora Neale Hurston

Joe Vogler LAT, ATC

Who should be making return to play decisions for athletes after injuries? As Athletic Trainers it is our job to ensure safe participation in sports. Although, Athletic Trainers are not found in every sport or high school (yet), it should be the job of a medical professional to make return to play decisions and guidelines.  Why are Athletic Trainers and medical professionals being omitted in surveys on news media such as the Today Show?

A current survey (posted 9/30/14) on the Today Show website asks the following question:

“Who should decide when an athlete is sidelined due to injury?”

The responses include:

“It’s the coach’s decision.”

Or

“The player should decide.”

Where is the Athletic Trainer in this survey? Or for that matter, any medical professional?

Following an injury, Athletic Trainers are THE health care professional responsible for the evaluation, assessment, treatment, and return to play of injuries occurring in the physically active. Neither the coach nor the player has medical training which allows them to evaluate an injury and make an informed decision on whether it is safe for an athlete to return to play.  First aid training and CPR training is NOT sufficient! Parents, coaches, and players deserve and should expect an Athletic Trainer at every event or practice to provide onsite medical care.  The analogy has been used a thousand times, but it holds true in this situation.  Would a parent drop their child off at a pool without a lifeguard and leave? If not, parents should not drop their child off at practice or a game without an Athletic Trainer! Athletic Trainers are specifically trained in injuries of the physically active.  Utilize them to ensure the health and safety for all participants.

Advocacy for the profession of Athletic Training can help to eliminate unsafe participation in athletics. Athletic Training is a field that athletes, parents, and even other health professionals are constantly learning more about. It is our job as Athletic Trainers to keep athletes of all ages safe, so why not show it in the media.  

This survey is a call to action for all Athletic Trainers to educate the people around them about safety in sports and of our profession.

In my opinion adding Athletic Trainers to the list of medical professionals on ESPN, FOX, and other news media, as experts on athletic injuries is the first step. On sports channels there are many medical professionals that are looked to as experts in sports injuries, why aren’t Athletic Trainers invited to share their knowledge and expertise? Why not add Athletic Trainers in the discussion of sports injuries in the media? Athletic Trainers’ expertise on injuries and their impact on return to participation in athletics would allow the media to better understand injuries, while positively promoting the profession.

Below is a link to the Today Show survey.  Take a look and let your comments be heard. If you choose to participate, we urge you to understand that your responses and comments demonstrate who you are as a professional and who WE are as a profession! This is an opportunity to educate a major media outlet and demonstrate our professional knowledge and professional behavior.

Today Show Survey

Jerrod Harrison LAT, ATC