Source: NATA 


DALLAS, October 27, 2015 – As the country continues to address several recent reports of youth sports injuries and catastrophic outcomes, a new study sheds light on the barriers some athletic directors (ADs) face in hiring athletic trainers (ATs), whose job it is to help prevent injuries and manage them should they occur. Nearly two-thirds of high schools lack a full-time athletic trainer and almost 30 percent don’t have any AT services, according to the National Athletic Trainers’ Association (NATA).

Athletic Directors' Barriers to Hiring Athletic Trainers in High Schools will appear in the October issue of the Journal of Athletic Training, NATA’s scientific publication and is now online first:

“Three major themes emerged from the data,” said lead author Stephanie Mazerolle, PhD, ATC, assistant professor, director of the Athletic Training Professional Bachelor’s Program, University of Connecticut, and Medical and Science Advisory Board member of the Korey Stringer Institute (KSI). “The athletic directors who participated in the study clearly identified lack of power, budget concerns and non-budget concerns – including rural locations, misconceptions about the role of the athletic trainer and community interference – as major factors limiting their ability to hire athletic trainers in their school settings.”

More than 7 million high school students currently participate in organized sports; 1.4 million high school sport-related injuries occur each year; whereas most athletic injuries are relatively minor, potentially limb-threatening or life-threatening injuries can occur.

“Most deaths that occur in sport are preventable and result from a failure to have proper prevention strategies in place, immediately recognize the condition, and/or implement appropriate care,” added Douglas J. Casa, PhD, ATC, FNATA, chief executive officer of KSI and director of Graduate Athletic Training Education, Department of Kinesiology, at the University of Connecticut. “Prompt management of these injuries is critical to the patient’s positive outcome and should be carried out by trained health care personnel, such as the athletic trainer, to minimize risk.”

As reported in the study, in 2013, the Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletics Programs urged all high schools to have an AT on staff to take care of emergency situations and provide care for student athletes. Some schools rely on coaches, ADs or bystanders who are not trained in discerning the similar signs and symptoms of potentially fatal conditions.

Study Protocol

To facilitate organizational changes within secondary school athletics, researchers sought to assess the current environment and potential resistance to change. Schools that had previously participated in the

CATCH-ON (Collaboration for Athletic Training Coverage in High Schools, more recently referenced as the “Benchmark Study”), initiated by KSI and NATA, served as the initial recruitment pool.

Of the total 568 schools, the authors selected a random sample of those schools that did not have the medical services of an AT. Twenty full-time public high school ADs (17 men, three women), from four geographic regions of the U.S. (North, South, Midwest and West) participated. Data were collected by telephone interviews using a guided questionnaire. 

Study Results

Lack of Power:

Budget Concerns:

Non-Budget Concerns:

High school interscholastic leagues often mandate medical personnel only for football games. High schools that do not employ ATs may rely on their coaching staffs or others to act in emergency situations. Seventeen ADs reported that they had football teams and did not employ ATs. One AD said that because there was a hospital nearby, they didn’t have an AT on staff and that the hospital might bring someone by the field from time to time. “If minor injuries occur, you know, we handle that on-site ourselves,” said another. “Well, the hospital obviously has a person … I don’t know if it’s like a pure AT and it is probably more of a physical therapist type,” adds a third.

Recommendations Moving Forward

While continued research is needed, the authors hope that identifying these barriers will lead to the development of strategies to overcome them. Recommendations include:

“It is our goal that these findings are catalyst for change,” says Mazerolle. “We hope that all high school student athletes will someday have full-time athletic trainers and receive the gold standard of care they deserve.”

Additional Resources:

NATA High School Benchmark Study

Best Practices For Sports Medicine in High School and Colleges (consensus statement)

Preventing Sudden Death in Secondary School Athletics (consensus statement)

About NATA: National Athletic Trainers’ Association (NATA) – Health Care for Life & Sport

Athletic trainers are health care professionals who specialize in the prevention, diagnosis, treatment and rehabilitation of injuries and sport-related illnesses. They prevent and treat chronic musculoskeletal injuries from sports, physical and occupational activity, and provide immediate care for acute injuries. Athletic trainers offer a continuum of care that is unparalleled in health care. The National Athletic Trainers' Association represents and supports 43,000 members of the athletic training profession. Visit