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No ATs? Huge Problem: Shocking Number of Public High Schools Don’t Have Medical Providers to Protect Student Athletes

October 20, 2021


Highlighting the risks faced by high school athletes across the country, a 2020 Spotlight on America report by the Korey Stinger Institute, University of Connecticut, and the National Athletic Trainers’ Association (“NATA”)[1] recently found that 31% of public schools do not have any athletic trainer to render medical assistance to an injured student athlete even in the event of a medical emergency, including potential traumatic brain injuries.

Athletic trainers play a crucial role in athlete safety; they are critical members of any sports medicine team and are, in most cases, the “first responders” in preventing, identifying, managing, and treating injuries. Recognizing this, the study also focused on the benefits provided to student athletes in schools where athletic trainers are present. For example, athletic trainers observed at a Pennsylvania high school handled multiple injuries during a Friday night football game as well as other injuries such as taping up cheerleaders’ ankles and treating a soccer-induced open head wound.

There is significant geographic disparity among public high schools that have athletic trainers on staff and present at events and those that do not. According to the report, Delaware, Pennsylvania, and New Jersey are among the states that have prioritized staffing athletic trainers in their public schools, with 90% of public schools staffing an athletic trainer. Hawaii comes in on top due to its legal mandate for athletic trainers. Meanwhile, over 50% of public schools in Alaska, Idaho, Oklahoma and West Virginia do not have an athletic trainer on staff and present at events.

Beyond state-wide disparity, there is also less access to athletic trainers in rural and inner-city schools, where another recent NATA study found that student athletes were 50% more likely to have an unidentified or mismanaged sports-related concussion. [2]

The consequences to student athletes and institutions for not having an athletic trainer on staff is apparent in cases like Logan Wood, a South Carolina high school football player who suffered a traumatic and permanent brain injury during a game. His school did not have an athletic trainer present, and his family later successfully sued the school district for negligence based on its failure to have an athletic trainer on the sidelines while the school’s athletic trainer was out of town at a conference.[3]

While funding and awareness issues underly the lack of athletic trainers in most of America’s public high schools, NATA President Kathy Dieringer believes that every school should have at least one full-time athletic trainer on staff and present at sporting events in order to mitigate risk of injuries and be the first line of defense against any injuries.[4]

Schools must conduct their own cost-benefit analysis, but we contend that the benefits greatly outweigh the costs. While having a full-time athletic trainer is an additional, yearly staffing cost for the school, the benefits of having one on staff include preventing injuries, some catastrophic, to its students and ultimately mitigating any liability in lawsuits, which can rapidly cost more than an athletic trainers’ salary, including attorneys’ fees, costs, and settlement and verdict awards, which have been and continue to be astronomical.

A possible ad-hoc alternative is to hire athletic trainers as independent contractors to fill the gap and act as a medical provider for those events that pose risk to the student athletes. That said, studies have shown that participation in practice, not games, poses more risk for injury, including risk for potential concussions and other TBIs.

[1] Huggins, et al. ATLAS – Athletic Training Locations and Services Project, 3rd Annual Report 2019-2020 AY (https://ksi.uconn.edu/wp-content/uploads/sites/1222/2021/02/ATLAS-2020-Report_06.23.20_Final.pdf)

[2] McGuine et al. The Influence of Athletic Trainers on the Incidence and Management of Concussions in High School Athletes. Journal of Athletic Training. 2018:53(11):1017-24 (https://www.nata.org/nr11142018)

[3] Joce Sterman, Alex Brauer and Andrea Nejman, Students at risk: 31% of schools have no athletic trainer to handle concussions, injuries, Fox 17 WZTV Nashville, Oct. 7, 2021 (https://fox17.com/news/spotlight-on-america/students-at-risk-31-of-schools-have-no-athletic-trainer-to-handle-concussions-injuries)

[4] Ibid.