Four High School Athletic Trainers Discuss the Evolution of Athletic Training at the Prep Level

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Athletic trainers serve an important role within any athletics program, at any level. On a daily basis, they keep athletes healthy by identifying injuries and prescribing maintenance and rehab modalities. In the event of extreme cases, theyā€™re even trained to save lives.

Historically, the athletic trainerā€™s presence at the high school level has been limited compared to the college level, with many schools relegating the role to a part-time position that is primarily required at games to attend to injuries. However, as athletic directors, coaches and athletes level up their understanding of what it means to truly treat the whole athlete and set them up for success, an increasing number of school districts are staffing full-time athletic trainers who work collaboratively with all athletic programs to ensure every athlete has the appropriate care they need to excel at their chosen activities.

AB spoke with four high school athletic trainers to understand how theyā€™re addressing the needs of a new generation of prep student-athletes. While many treatment modalities are timeless ā€” ice, heat and massage remain fundamental ā€” each athletic trainer offers an interesting take on how they approach their role in the modern era, utilizing modern techniques, equipment and facilities.

Kyle SouthallKyle Southall

High school rehab, college feel

Kyle Southall is president of the Alabama Athletic Trainersā€™ Association and director of Sports Science and Performance at Briarwood Christian School in Birmingham. He jokes that he has digressed in his career, as he started as an athletic trainer at a Power 5 university, then went to a Division III school and from there to his current position. That said, he admits that he has landed at a school with plenty of resources, which isnā€™t always the case at the prep level.

ā€œThe high school here where Iā€™m at now, weā€™re very fortunate,ā€ says Southall. ā€œWe have multiple athletic trainers, we have multiple transitioning coaches, so we have the personnel, and we also have the administration that supports us, which is very important.ā€ Briarwood currently supports about 650 student-athletes from grades 7 through 12, which is part of the reason the school has invested in ample facilities and equipment for its athletic training department.

ā€œWeā€™ve broken up our facility into three different areas or spaces,ā€ Southall says of the schoolā€™s athletic training square footage. ā€œWe have our traditional athletic training room, which has five treatment tables in it and three taping decks ā€” thatā€™s more our traditional training area. And then we have two different weight rooms. We have what you think of as a traditional weight room ā€” squat racks, weights, dumbbells, kettlebells, things like that ā€” and then we have what we call the auxiliary weight room, which is about half the square footage, and it does have three racks against the wall, but itā€™s primarily an open space that we utilize more for plyometrics, teaching and recovery-type stuff.ā€

Having served an NCAA D-I athletic department, Southall makes a distinction between schools that do athletic training ā€œreally wellā€ and those that ā€œjust do it,ā€ and he says that heā€™s seeing more secondary schools invest in some of the things that were previously only seen at the college level.

ā€œWe dedicate a lot of resources to recovery, both in space and time,ā€ he says. ā€œWe have a nutrition bar that we set up. Thatā€™s something that normally youā€™d see at the collegiate level, at the NFL level, but we have it at a secondary school. So, you do see those kinds of changes trickling down from the higher levels of sport.ā€

Southall says itā€™s all part of an increasing sophistication on the part of coaches, players and even playersā€™ families as to what is needed to keep athletes healthy. Nevertheless, Southall says traditionalists can be a stubborn group. ā€œYou have three different groups of people ā€” people who keep doing it the way theyā€™ve done it because theyā€™ve had success, the people who have more of that growth mindset, and then you have that little group of people who are marginalized right in the middle, and they may not be sure which way to go. The ones in the middle, those you can educate and move over. Weā€™ve been very fortunate here that all of our coaches have bought into what weā€™re doing.ā€

Megan OlsonMegan Olson

Limited (and outside) resources

As an athletic trainer in the La Crosse, Wis., area, Megan Olson has worked at schools big and small. Through the Gunderson Health System, Olson had previously worked in a small district of just 200 students. Today, she supports a student-athlete population of 250 at West Salem High School, which she says is a good fit for her, admitting that the resources available to her are modest but adequate.

ā€œMy space at the high school is like a renovated coachā€™s office slash mudroom area ā€” not super large, but it does the trick,ā€ says Olson. ā€œI have enough for two tables, an ice machine, some storage and some other wet room items.ā€ She also has a space at the recently built Panther Den facility, which supports hockey and gymnastics.

Olson says sheā€™s limited in terms of the modalities she can offer at West Salem, admitting that ā€œheat, ice and my handsā€ are the most common, but she thinks the overall care athletes receive at the high school level continues to improve as more resources emerge within the community.

ā€œThere are a lot more things popping up around the area treatment-wise and recovery-wise,ā€ she says. ā€œNormatec [compression therapy], red-light therapy, I have a lot of kids doing just things like that at home, things that I canā€™t provide at school yet. But itā€™s good that they can get it somewhere else.ā€

When a student does have a chronic issue that might need to be treated off campus on an ongoing basis with modalities not available at school, Olson says there are some hoops to jump through when dealing with a minor who is still under the legal care of a guardian. ā€œYou need to have informed consent from either a guardian or parent half the time, and just being sure that everyoneā€™s well-educated about the use of these things,ā€ she says. ā€œIā€™ve talked to some athletic directors who have voiced concerns about things like Normatec and red-light therapy being used outside of the time when the athletic trainers are around and being used improperly. I think thatā€™s a concern when they introduce new modalities.ā€

As Americaā€™s youths (and their parents) become increasingly sports-crazed, committing to school and club teams throughout the year, Olson says the need for athletic training has only grown. When student-athletes take on more sports, they risk overuse injuries either from being one-sport athletes or playing multiple sports throughout the year.

ā€œI have no problem with kids playing multiple sports ā€” three- and four-sport athletes. But it comes down to when kids are playing multiple sports at the same time, or playing the same sport year-round,ā€ she says. ā€œThatā€™s where you see the overuse kind of stuff. That trend ebbs and flows depending on what season weā€™re in and how long theyā€™ve been playing. But thereā€™s definitely more of these kinds of kids compared to 10 years ago, when I first started doing athletic training.ā€

Mitchell AndersonMitchell Anderson

Buy-in at all levels 

Mitchell Anderson supports student-athletes at Parkview High School in Northeastern Indiana. He sees the work of the athletic trainer as increasingly valued by the administration, and he says it shows in how his school has approached recent renovations of Parkviewā€™s facilities. 

ā€œWeā€™re just wrapping up our renovation, and we got two new athletic training rooms out of it,ā€ says Anderson. ā€œI think the administration that I work with at the school is probably willing to invest in new modalities or other things to help us with our athletes, but itā€™s a gradual progress there.ā€

In the past, athletic trainers may not have had the voice they have today when it comes to big purchasing decisions and capital improvement projects, but Anderson says thatā€™s changing. ā€œDuring our renovation, administration would come to me and ask what I think is best,ā€ says Anderson. ā€œBecause I was already here when the renovation began, I definitely tried to make my voice heard, to make sure that construction and admin understood those things that are absolute necessities.ā€

On the treatment side of things, Anderson says the biggest challenge for him is needing permission from the hospital he works for in order to implement novel modalities. ā€œWe need special orders from our physician in order to apply some of those methods. I have my own standing orders, and I am trained to administer these things, but I still need to get permission from my physician and from the parents, and then I can apply that modality.ā€

Anderson stresses that there are always limitations at the high school level, and cooperation among coaches, players and parents is key. ā€œI try to get the buy-in from coaches and parents immediately, and so far, itā€™s worked,ā€ says Anderson. ā€œAnd my coaches and administration know that for kids to get the best possible care, we have to work together as a team, but the kids and the coaches have to know and understand ā€” and the parents, as well ā€” that getting better takes effort. So coming in and doing stuff with me is great, but they also have to understand that because of the limitations of supplies that I have at the school, I canā€™t do everything. In some cases, it takes a whole healthcare approach, involving PT, maybe even a physician ā€” thatā€™s kind of the model I go by. They have to understand that I will do my best to do things in-house, but some things just require other forms of care.ā€

Michael PrybicienMichael Prybicien

 Lightyears ahead 

High school athletic training facilities have evolved significantly from the days of ice packs and ace bandages, though they still lag behind their collegiate counterparts. Michael Prybicien, an athletic trainer at Passaic High School in New Jersey, which supports over 3,000 students and 1,500 student-athletes, has witnessed this evolution over his 30-plus years in secondary school athletics.

ā€œWhile weā€™re light years ahead now at the secondary school level, weā€™re still not there,ā€ says Prybicien, who also serves as an adjunct faculty member at William Paterson University in nearby Wayne. ā€œWe donā€™t have hyperbaric chambers or the funding for those kinds of recovery rooms. But that doesnā€™t mean weā€™re not doing great things to prevent injuries and provide recovery.ā€

At Prybicienā€™s school, two weight rooms are strategically positioned adjacent to the athletic training facility, allowing for seamless integration of strength training with recovery and injury prevention. The facilities focus on providing non-weight-bearing exercise alternatives for athletes recovering from lower body injuries.

ā€œYou want to have exercise bikes and upper body cycles for non-weight-bearing activities,ā€ Prybicien explains. ā€œThen you need transitional pieces like ellipticals before athletes return to full-weight-bearing activities.ā€

The school has also embraced recovery tools that fit within a high school budget. ā€œWe have recovery tubs that we use year-round,ā€ says Prybicien. ā€œEven if itā€™s 60 degrees in early October, if my cross country runners or football team have had a hard week, the recovery tubs are out. While we canā€™t afford a hydrotherapy pool with jets, we can have affordable recovery tubs that become part of our facility.ā€

The weight rooms themselves offer equipment suitable for all skill levels. ā€œYouā€™re looking at it differently with a secondary school,ā€ Prybicien notes. ā€œYouā€™ll have kids from 13 to 14 years old whoā€™ve never touched a weight in their lives, to advanced athletes who are going to be Division I players.ā€

Like Anderson, Prybicien has noticed increased buy-in from coaches and athletes. ā€œCoaches now more than ever will come to us and say, ā€˜What do you think about our weight program? How can we make it better to not only improve our athletes but reduce injury risk?ā€™ ā€ Prybicien says.

Looking ahead, Prybicien sees technology playing an increasingly important role in high school athletic training. ā€œAs technology continues to get better, it also gets less expensive,ā€ he says. ā€œI really foresee biometric meters being used more frequently, integrating with film technology. Youā€™re going to have biometric markers showing athletes whether theyā€™re squatting correctly or getting the right amount of hip flexion, instead of the old-fashioned way of putting a weight bench behind them to touch.ā€

This technological integration extends beyond proper form to overall athlete wellness. ā€œAt the college level, theyā€™re using markers to track sleep patterns, determining exactly what time athletes should go to bed and wake up for optimal performance,ā€ Prybicien says. ā€œI think these things will start trickling down to the secondary school level as they become more affordable.ā€

As high school athletic training continues to evolve, the gap between secondary and collegiate programs is narrowing through strategic facility design, innovative recovery tools and increased use of affordable technology. While high schools may not match the sophisticated equipment of college programs, athletic trainers are finding creative ways to provide comprehensive care ā€” from recovery tubs to biometric tracking ā€” within budget constraints. 

The growing collaboration between trainers, coaches, administrators, athletes and parents, combined with the declining costs of new technology, suggests that high school athletic programs will continue advancing their capabilities to support student-athlete health and performance. This evolution reflects a broader shift toward treating the whole athlete and ensuring they receive appropriate care throughout their athletic careers, regardless of competitive level.

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