School sports season is almost upon us. With that comes the responsibility for attending Parent’s Night – the annual meet-and-greet between the athletic director, coaches, medical staff and parents.
It is critical that parent’s take an active role in the well-being of their student-athlete children. With that in mind, I’ve created the following must-ask questions that every parent should know about the medical care surrounding their children while playing school sports.
- Who is our athletic trainer? If we don’t have one, why not?
Athletic trainers are the lynchpin for medical care of student athletes. Yet, despite their critical job, their roles are often confused. First and foremost, let me say that athletic trainers are NOT personal trainers. Athletic training is an allied health profession that requires a 4-year college degree, as well a strict board certification. In fact, it is illegal for someone to call themselves an “athletic trainer” or “AT,” unless they have completed a 4-year collegiate athletic training program and obtained licensure from the National Athletic Trainers’ Association.
The primary role of the Athletic Trainer is to prevent injury and reduce further injury in athletes. To do this, Athletic Trainers, working in combination with the Team Physician and Athletic Director, develop injury prevention and management programs. Although the AT will “tape your ankle” as part of their injury prevention role, they can and do perform far more complex tasks.
Fundamentally, the AT is the first responder for athletic injuries. They are vital to your child’s well-being during athletic completion. They have the requisite skills to evaluate, triage and manage athletic injuries. They know when to send your child straight to the ER, when to send them to the Team Physician the next day or when to keep them in the training room for treatment. As such, it’s critical for you, as a parent, to know exactly who the AT is and how to get a hold of them.
The Athletic Training staff also serve a vital role in return to play. They see your child far more frequently than the physician who may have evaluated them and crafted a management plan. They know the strengths and weaknesses of your child and how they are able to cope with a rehabilitation plan.
If your school doesn’t have an Athletic Trainer, it’s important to ask why? Most athletic directors I speak to would love to have an AT, but the budgets are too tight to permit one. If that’s the case, I would urge each parent to discuss your concerns with the superintendent and school board members. Despite their skills, athletic training services can be obtained via several different mechanisms for a relatively low cost.
- Who is our team physician?
The team physician assumes the overall care of the student-athlete population. As a parent, you should know who the captain of the medical ship is. Frequently, this person will be the individual providing sideline medical coverage at football games and other high impact sports. Ideally, this person should also be the direct supervisor of the Athletic Trainer. The team physician will work closely with the entire medical team to ensure your child is appropriately treated and is safe and fit to return to play after an injury.
But, who is entitled to be the “team physician”? Unlike Athletic Trainers, there are no laws that directly state who may call themselves a team physician. However, there is the 2013 Team Physician Consensus Statement. This document was jointly authored and agreed upon by no less than 6 professional societies whose membership involves caring for athletes. This included the American College of Sports Medicine (ACSM), American Academy of Family Physicians (AAFP), American Academy of Orthopaedic Surgeons (AAOS), American Medical Society for Sports Medicine (AMSSM), American Orthopaedic Society for Sports Medicine (AOSSM), and the American Osteopathic Academy of Sports Medicine (AOASM). With full disclosure, I am a member both of AAOS and AOSSM.
This consensus statement precisely defines who may be a team physician: “The team physician must have an unrestricted medical license and be a medical doctor (M.D.) or doctor of osteopathy (D.O.).” In clear and unequivocal terms, these six societies have made it clear that a doctor of chiropractic (D.C.) or a doctor of physical therapy (D.P.T.) may NOT be a team physician.
- Is our school a “Safe Sports School” or trying to become one?
In my estimation, one of the best blueprints for how to create and maintain a comprehensive sports health program was put forward by the National Athletic Trainers’ Association. The Safe Sports School award program was started in 2013 to promote the importance of having a safe sporting environment in which our student-athletes participate. In just 3 years, 881 schools have met the strict requirements of being a Safe Sports School.
This program requires high schools to meet the following 10-point plan:
- Create a positive athletic health care administrative system
- Provide or coordinate pre-participation physical examinations
- Promote safe and appropriate practice and competition facilities
- Plan for selection, fit function and proper maintenance of athletic equipment
- Provide a permanent, appropriately equipped area to evaluate and treat injured athletes
- Develop injury and illness prevention strategies, including protocols for environmental conditions
- Provide or facilitate injury intervention
- Create and rehearse venue-specific Emergency Action Plan
- Provide or facilitate psychosocial consultation and nutritional counseling/education
- Be sure athletes and parents are educated of the potential benefits and risks in sports as well as their responsibilities
I’m disappointed that there are only 3 schools in Maine that have this distinction: MCI, Biddeford and South Portland. To me, this is unacceptable. Every school who has student-athletes should be able to meet these standards. They are vital to ensure their overall safety.
This year, I am pledging that all the schools I serve as the team physician for will work to meet the requirements and win the Safe Sports Schools award.
I would urge all parents to work with their schools to achieve this. For example, there are some schools in the Greater Bangor Region who do not have a permanent, appropriately equipped area to evaluate and treat injured athletes. While I understand that spaces are tight and budgets limited, space can be found in even the remotest parts of schools to allow for injury evaluation.
With all that nagging, it’s important not to lose sight of the big picture. We want our student-athletes to participate, have fun and learn good sportsmanship. But as Dr Robert Nirshel said “the goal of sport is to win, not good health”. Personally, I hope the purpose can be both.