Certified athletic trainers (ATs) play a key role in the identification and initial sideline screening for concussions in high school sports, as well as the critical return to play decision.
ATs are on the front lines in the concussion safety battle. According to a 2011 study [1], [1] while physicians were present at the time of injury in only 7.7% of cases of reported concussions suffered by high school athletes in the 2009-2010 school year,* ATs were on site for at least 70%. When present, they almost always were involved in the initial assessment of an athlete for concussion (94.4%).
The presence of an AT dramatically increases the chances that a concussion will be diagnosed, which is critical to avoiding not only a more lengthy recovery but the risk of permanent brain damage. A research paper [2] presented in October 2012 at the American Academy of Pediatrics National Conference and Exhibition in New Orleans, LA found that 8 times more concussions were diagnosed in girls' high school soccer and 4.5 times more in girls' basketball in high schools with ATs than those without ATs.
"This data shows the valuable role that [ATs] can play in preventing, diagnosing and managing concussions and other injuries," said Cynthia LaBella, MD, FAAP, the author of the paper presented at the AAP conference, told Science Daily. "Athletic trainers have a skill set that is very valuable, especially now when there is such a focus on concussions and related treatment and care. Concussed athletes are more likely to be identified in schools with athletic trainers and thus more likely to receive proper treatment."
There are a number of reasons why an AT is such an invaluable member of the concussion assessment team:
One of the most challenging aspects of game and practice coverage in sports is the response to injuries involving the head and cervical spine [11](neck). Knowledge concerning the clinical presentation and proper emergency care in the event a player suffers a potentially serious or catastrophic head or neck injury is required for athletic trainers and medical personnel.
The AT's role during games and practices is to prevent injury and provide immediate first-aid care and triage. To be properly prepared:
Two-thirds of parents of middle-school and high school athletes said in a 2010 surve [17]y [17] they supported a requirement that an AT be onsite for practices and games, athough there was no general agreement among the parents surveyed on how to fund the position, with less than half (43%) saying the money should come from the general school budget and 28% believing the money should come from team fundraising or athletic user fees.
The National Athletic Trainers' Association [18]recently released preliminary data [18] showing that approximately two thirds of U.S. secondary schools with an ongoing athletic program have access to athletic trainers (ATs), whether full-time or part-time. That's an improvement from its 2005 estimate[7] that only about 40-45% had such access. In some states, the number is much lower. (Over three-quarters of Nebraska high schools, for instance, are without ATs)
The fact that return-to-play intervals were found in the 2011 study [1] [1] to be the same between ATs and physicians, said its lead author, Dr. William P. Meehan, III, Director of the Sports Concussion Clinic at Children's Hospital Boston and a MomsTEAM concussion expert [19], "might help convince schools [that don't have ATs] of the importance of ATs."
* At high schools with at least one athletic trainer on staff.
1. Meehan WP, d'Hemecourt P, Collins C, Comstock RD, Assessment and Management of Sport-Related Concussions in United States High Schools. Am. J. Sports Med. 2011;20(10)(published online on October 3, 2011 ahead of print) as dol:10.1177/0363546511423503 (accessed October 3, 2011).
2. LaBella L. A Comparative Analysis of Injury Rates and Patterns Among Girls' Soccer and Basketball Players. Paper presented October 22, 2012 at American Academy of Pediatrics (AAP) National Conference and Exhibition, New Orleans, LA; High Schools with Athletic Trainers Have More Diagnosed Concussions, Fewer Overall Injuries. Science Daily http://www.sciencedaily.com/releases/2012/10/121022080649.htm (retrieved February 21, 2013)
3. Meehan William Paul, III, Kids, Sports, and Concussions at p. 2 (Praeger 2011).
4. Pleacher MD, Dexter WW. Concussion management by primary care providers. Br. J. Sports Med. 2006;40(1):e2, discussion e2.
5. McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players - Implications for prevention. Clin J of Sport Med 2004;14:13-17.
6. Lincoln A, Caswell S, Almquist J, Dunn R, Norris J, Hinton R. Trends in Concussion Incidence in High School Sports: A Prospective 11-Year Study. Am. J. Sports Med. 2011; 30(10), accessed January 31, 2011 @ http://ajs.sagepub.com/content/early/2011/01/29/0363546510392326.full.pdf+html, [20]
7. Waxenberg R, Satloff E. Athletic trainers fill a necessary niche in secondary schools. National Athletic Trainers' Association: 2009. Available at: http://www.nata.org/NR031209.
8. Harmon K, et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med 2013;47:15-26 (familiarity with an athlete is an important component in the sideline evaluation of a concussion, given the variability in the way concussions present).
9. Zonfrillo MR, Master CL, Grady MF, Winston FK, Callahan JM, Arbogast KB. Pediatric Providers' Self-Reported Knowledge, Practices, and Attitudes About Concussion. Pediatrics 2012;130(6). DOI: 10.1542/peds.2012-1431)(published online ahead of print)(accessed November 19, 2012).
10. Halstead ME, et al. Clinical Report: Returning to Learning Following a Concussion. Pediatrics doi:10.1542/peds.2013-2867 (epub October 27, 2013).
11. Kroshus E, Baugh CM, Daneshvar DH, Nowinski CJ, Cantu RC. Concussion Reporting Intention: A Valuable Metric for Predicting Reporting Behavior and Evaluating Concussion Education. Clin J Sport Med. 2014; Post Author Corrections: July 21, 2014
doi: 10.1097/JSM.0000000000000137.
12. Research Abstract. "The Reporting of Concussions Among High School Football Players, an Updated Evaluation." Minor JL, MacDonald J, Meehan WP. Presented at American Academy of Pediatrics National Conference and Exhibition, Washington, D.C. October 24-27. (most recently accessed October 23, 2015 at https://aap.confex.com/aap/2015/webprogrampress/Paper32146.html)
Originally posted on an earlier version of this site in approximately 2002. Continually updated since, most recently on October 23, 2015
Links:
[1] https://mail.momsteam.com/node/3935
[2] https://mail.momsteam.com/node/128
[3] https://mail.momsteam.com/node/149
[4] https://mail.momsteam.com/ab-2127/californias-updated-youth-sports-concussion-safety-law-steps-in-the-right-direction-says-sports-official
[5] https://mail.momsteam.com/node/2987
[6] https://mail.momsteam.com/node/5835
[7] https://mail.momsteam.com/health-safety/culture-resistance-self-reporting-concussions-study-finds
[8] https://mail.momsteam.com/health-safety/selecting-concussion-educator-robb-rehberg-thinks-athletic-trainers-best-suited-role
[9] https://mail.momsteam.com/node/205
[10] https://mail.momsteam.com/node/6780
[11] https://mail.momsteam.com/node/2672
[12] http://fast.wistia.com/embed/iframe/d6731e98cd?videoWidth=640&videoHeight=360&controlsVisibleOnLoad=true&autoPlay=true&popover=true&plugin[postRoll][version]=v1&plugin[postRoll][text]=For more on Advocates for Injured Athletes and Athletes Saving Athletes, click here.&plugin[postRoll][link]=http://www.injuredathletes.org/&plugin[postRoll][style][backgroundColor]=#080808&plugin[postRoll][style][color]=#509ef2&plugin[postRoll][style][fontSize]=36px&plugin[postRoll][style][fontFamily]=Gill Sans, Helvetica, Arial, sans-serif&plugin[socialbar][version]=v1&plugin[socialbar][buttons]=embed-email-twitter-googlePlus-facebook&plugin[socialbar][tweetText]=Beth Mallon (td)
[13] https://mail.momsteam.com/node/5792
[14] https://mail.momsteam.com/health-safety/concussion-safety/recognition-evaluation/neuropsychological-testing-for-concussions
[15] https://mail.momsteam.com/node/2579
[16] https://mail.momsteam.com/node/3015
[17] https://mail.momsteam.com/node/3092
[18] http://www.usatoday.com/story/sports/2013/06/24/national-athletic-trainers-association-athletic-trainer/2453827/
[19] https://mail.momsteam.com/node/3526
[20] http://ajs.sagepub.com/content/early/2011/01/29/0363546510392326.full.pdf html
[21] https://mail.momsteam.com/health-safety/parents-concussion-knowledge-limited-but-support-for-mandatory-school-policies-strong
[22] https://mail.momsteam.com/health-safety/standardized-assessment-of-concussion-a-valuable-tool-for-sideline-evaluation
[23] https://mail.momsteam.com/health-safety/sport-concussion-assessment-tool-evaluation-and-management
[24] https://mail.momsteam.com/sports/honest-self-reporting-concussions-symptoms-critical-for-athletes