Sport Club Athletic Trainers: Part I

July 18, 2011

We Can No Longer Afford Not to Afford Them!

Tom Roberts
Director Recreation and Wellness
University of Richmond

In the fall of 2007 a university rugby club member suffered a concussion during an away game. Ignoring the headaches, the rugby player continued to participate in club practices, only seeking medical attention once they became unbearable. The medical diagnoses was a fractured skull, a severe injury that could have lead to brain damage or death, had it not been treated. This university dodged a bullet, a near tragedy, and most likely very costly litigation that could have been avoided with the presence of an athletic trainer. This near fatal incident involving a rugby player was a wake-up call for the administration at Oberlin College, where the incident occurred. Several months after the incident, the Dean of Students at Oberlin College announced, “the protection of student athlete’s safety is a priority.” The university was taking important first steps to ensure the continued safety of its club sport athletes by hiring a sports medicine professional, an athletic trainer.

The administration of sport clubs requires a proactive approach to risk management in order to provide a safe environment for the participants and reduce the likelihood of injury and litigation. Although there may be no absolute protection from lawsuits, a well-trained staff, safe and well-maintained facilities and equipment, and carefully planned and executed risk management plans will reduce the likelihood of injuries and avoid legal entanglements. This can best be accomplished by having certified athletic trainers responsible for managing risk and providing medical attention at all sport club practices and home competitions. It’s paramount that recreational sports administrators take whatever steps are necessary to justify and provide vital medical coverage and services for our sport club athletes. The risk is too great for our sport club athletes and the legal responsibility and protection of our universities. Universities can no longer afford not to afford sport club athletic trainers, especially for contact and high risk sports.

One of the difficulties in attempting to seek support for sport club athletic trainers is the lack of a standard of care. Professional organizations and governing bodies are hesitant to provide a firm mandate beyond statements that recommend and suggest medical coverage be provided. High schools have accomplished what the colleges have been hesitant to do and are leading the way by passing legislation and mandating that the protection of student athlete’s safety is a priority. In recent years there has been legislation passed in several states mandating better concussion training and medical services including full-time certified athletic trainers at public high schools. In the state of North Carolina a task force is lobbying for mandated full-time certified athletic trainers at the state’s 381 public high schools. Unfortunately legislation often comes too late and only as a reaction to catastrophic injuries to athletes. In 2008, at least two North Carolina high school football players died from brain-related injuries. Their deaths were influential in convincing some schools, previously without full-time certified athletic trainers, to hire athletic trainers. Kevin Guskiewicz, a certified athletic trainer helping to lead North Carolina’s legislative change, makes the case for athletic trainers, “Trust me, this is not self-serving; it’s just what we know. If you have a certified athletic trainer who understands the signs and symptoms, that person can help the team – from the coaches to the players to the parents – better understand brain trauma. If you can’t have that, then you might want to give strong consideration as to whether or not your school should offer contact sports.” Oregon and Texas have joined North Carolina in mandating better concussion training and medical services at the high school level, and similar legislation is pending in other states, including California, Massachusetts and Washington.

In February 1998, the National Athletic Trainers’ Association (NATA), an association of nearly 30,000 members, created the Appropriate Medical Coverage for Intercollegiate Athletics (AMCIA) task force to establish recommendations for appropriate medical coverage to assist institutions in providing the best possible health care for all intercollegiate student-athletes. These guidelines are not intended to be a legal standard of care; they are a means for institutions to determine their own appropriate level of medical coverage based on a practical medical coverage model.
“The NATA guidelines are an effort to capture what is known about appropriate medical coverage and make it useful and easily available across the collegiate universe. It is no more than that, legally or substantively, but it is nevertheless a significant step forward for student-athletes and their colleges and universities”.

These NATA guidelines have served as the guiding principles for the NCAA and their Sports Medicine Handbook. The NCAA Sports Medicine Handbook consists of ‘guidelines for each institution to consider in developing sports medicine policies appropriate for its intercollegiate athletics program.’ The NCAA goes on to state that
“these recommendations are not intended to establish a legal standard of care that must be strictly adhered to by member institutions. In other words, these guidelines are not mandates that an institution is required to follow in order to avoid legal liability or disciplinary sanctions by the NCAA. However, an institution has a legal duty to use reasonable care in conducting its intercollegiate athletics program, and guidelines may constitute some evidence of the legal standard of care.”

High schools have taken bold steps to protect student athletes and make safety a priority by passing legislation and mandating better concussion training and medical services including full-time certified athletic trainers at public high schools. As a result, athletic trainers are becoming more commonplace at high school sporting events. The NCAA has managed to avoid the entanglements of legislation and mandates, and provide a set of guidelines that have been just as effective. Athletic trainers provide many valuable services to varsity athletes and are available at almost all NCAA athletic team practices and competitions. Sport clubs compete in many of the same sports as high school and NCAA programs. Sport club practices and competitions are often just as rigorous and physical. The university’s liability and assumption of risk are just as great and perhaps even more prevalent. So why no athletic trainers at sport club practices and competitions? What have our national governing bodies done to attempt to pass legislation and mandates, like the high schools, to provide better protection for our sport club athletes? What has our professional organization done to adopt and endorse the NATA guidelines, or similar guidelines, like the NCAA, to demonstrate the safety of our athletes is a high priority? What have administrators done at their respective institutions to improve and elevate the level of medical care and coverage for our sport club athletes? What more can our national professional organization, our national governing bodies, and our universities do to protect our sport club athletes and demonstrate that their safety is a high priority?

This is Part I of a two-part article. Part II will look at what our national professional organization, our national governing bodies, and our universities have done and what more can be done to protect our sport club athletes and demonstrate that their safety is a high priority. In addition, we’ll look at best practices in medical care and coverage, roles and responsibilities of athletic trainers, funding models, and provide some recommendations for how every university, regardless of their current level of medical care, can improve and elevate the level of medical care and coverage for our sport club athletes.

Research assistance provided by Becca Cooper, Projects Assistance University of Richmond Recreation and Wellness.

Sources Part I:
“Club Sports Safety Issues Addressed.” The Source 20 Feb. 2008: n. pag. Web. 29 Jan. 2010.,%202008

Klossner, David. 2009-10 NCAA Sports Medicine Handbook. N.p.: National Collegiate Athletic Association, 2009. NCAA Publications. Web. 29 Jan. 2010.

Popke, Michael. “Hit Hard: Heightened awareness of concussions is changing the culture of prep sports.” Athletic Business. N.p., Dec. 2009. Web. 29 Jan. 2010.

“Recommendations and Guidelines for Appropriate Medical Coverage of Intercollegiate Athletics.” National Athletic Trainers Association. N.p., June 2007. Web. 29 Jan. 2010.

“Virginia Rugby Union: Handbook 2010.” Virginia Rugby Union. N.p., 20 Jan. 2010. Web. 29 Jan. 2010.

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