When Kelly Hoke, fresh out of college in 1986, became the first athletic trainer in the Rome (N.Y.) City School District's history, she had one request: an ice machine. When cell phone technology emerged, she was the first district employee to ask for and receive a brick-like mobile device that allowed Hoke to be reached day and night while tending to student-athletes competing at various venues in grades 7 through 12. But nothing — not education or ice or state-of-the-art connectivity — could equip Hoke for the shock in 2015 of responding to her own son after he was knocked unconscious during an eighth-grade football game. AB senior editor Paul Steinbach asked Hoke, who is retired May 24 from the only professional position she's ever held, about that emotional day and the changes she has witnessed in athletic training over the past 33 years.
When did you know athletic training was the career for you?
The reason I got into athletic training was because of a traumatic injury at Alfred University. I had a lacrosse player come in my freshman year there. I was a student athletic trainer. It was a Sunday morning in the spring of 1982. I was the only person there, and he had a ruptured spleen. And I knew what to do for him. He went unconscious right in front of me, and I was able to handle the emotions and get the right things done. And I remember my head trainer saying to me afterward, "You need to do this, because you were so calm." And I am. But it doesn't mean that I don't go home and throw up. I have a stomachache when someone gets hurt because I know how bad it is but I can't tell them. When you know the bad thing that happened to them, my mind just keeps going on what they're going to miss. They're all kids that I care about. They come to me and tell me their fears and their dreams. And when a kid can't play sports, that's a big dream that's lost.
What's one thing about your job that was different in 1986?
When I came out of grad school, we didn't have to wear gloves to do anything. The OSHA regulations were not even in place for that. So just learning to keep a pair of gloves in my pocket all the time. The AIDS scare was out and people — especially in the smaller city that I'm in — didn't know anything about that. I truly remember being at a basketball game and a kid got elbowed in the face, and I pulled my gloves out of my pocket and there was a hush. The game had stopped, the kid was on the court, so people were just like, "What is she doing? Does she have AIDS?"
How else has athletic training evolved?
The evolution of having more people in high school settings, in clinic settings, and having more people understand what an athletic trainer does. Just being more accepted publicly and getting that identity has really evolved over the 33 years that I've been involved in it. Now, people in my town thinks it's mandatory, and still in New York State it isn't. Just being here all that time, the consistency has been a plus. They never got rid of me. I was up on the chopping block a couple times, as many people are in public schools, but the community rallied behind me and kept the position. It's just been wonderful.
What prompted your school district to hire an athletic trainer?
Unfortunately, there was a death in a neighboring school district. My athletic director who hired me was very progressive — a woman, which was unusual then — and she thought that an athletic trainer would have helped prevent that from happening. So, it was her push. She wanted it, and it happened. The fact that I was a woman, she didn't care. She wanted the best candidate.
How were you welcomed by coaches?
I started the day football started in Rome. So, I kind of just hit the ground running and kept my head down for a few years, really, to just try to stay on top of everything and establish what I was doing. It's a very big sports town, and it was a very male-oriented sports town when I got here. There were only four games played on our main stadium field the whole year and that was varsity football. Even though we had a woman athletic director and we had girls' sports, it was just such a male-oriented town that it took me a while to get accepted. I had one coach in particular who didn't speak to me the whole year. He would pass by me in the hall and not even look at me. They honestly didn't think I was going to stay. They all gave me the business to see if I could take it and if I was going to help their program. They were used to taking care of their own injuries, which was pretty much ignoring them. They didn't want someone coming in and saying, "That kid can't play." That isn't what they wanted. But I had a unique background where my father was a high school football coach in numerous football towns, and I knew when to approach a coach and what to say to a coach just from being around my dad.
What has emerged as the greatest challenge?
Concussions are a big, big topic and a worry for parents, especially in the collision sports. We've seen our numbers go down. That's the one people talk about the most, and it's one reason that I know it's time for me to go. We have to do continuing-education units, and as much as I can try to keep up on things, I think the younger people are coming out with a better understanding of the intricacies of the concussion protocols. They have changed and are going to keep changing.
In '86, when a player got his "bell rung," what was the response?
The way I handled it wasn't a lot different than what I do now — having them go to the doctor two times to get back in and go through a return-to-play protocol. That's all set in stone now, but what I was taught in school was "when in doubt, keep them out." I was very conservative. At the time, if you weren't as good as what you were before you got hurt, for any injury you had, you're not playing. It doesn't matter whether you had a headache or you couldn't run as well, if you couldn't perform and if your backup was better than you, you're not going in.
Can you describe what it was like to rush to the aid of your own son?
Everybody knows I cry a lot. I cry when I'm happy. I cry when I'm sad. Every senior night of every sport, I cry. But I really believe that I had some PTSD after that. It was pretty traumatic. I honestly thought my son was dead. He was running the football, and he hit the hole and a linebacker came up and threw my son like WWE. Instead of tackling my son and bringing him to the ground, he kind of picked him up and threw him. My son wasn't prepared for that. He was in eighth grade. He'd only been playing football since seventh grade. I think that's part of the problem. If you're not stabilized for the hit, you don't realize to keep your head off the ground. His head slammed down on the turf, and knocked him out cold for at least three minutes. I didn't even see it happen. I had my back to the field, taking care of someone else who was bleeding. My father was up in the stands, and he started screaming at me to go on the field. I was just screaming his name and pinching him under his shoulder pads to try to get him awake. He had his mouthpiece in and a facemask on, and I couldn't tell whether he was breathing.
Did he continue to play football?
After he got totally cleared, he finished the season, but that was it. He didn't play after that. Part of the trouble that I had with it was he, at that point, was a crazy downhill skier. He obviously wore his helmet and everything but absolutely put himself in worse situations than football did at the time, and I didn't know how to tell him he couldn't play football but he could ski. That didn't make sense to me.
Did you consider quitting after that episode?
I'm not a quitter. I didn't even consider retiring for a really long time, but I didn't consider quitting because I learned so much from it as a parent. I tried to have a son for eight years. He's a miracle. So for him to be put in that situation was bad, but becoming a parent, even before this happened, changed me as an athletic trainer, changed the way I looked at children — this is someone's baby. So when he got that really severe injury, I think it made me a better athletic trainer. I could talk to parents about the way they're feeling and calm their fears. I never said, "Well, it's not as bad as my kid." But I would just say, "I don't know if you know this, but I understand what you're going through, and these are the steps you need to take to get back to where we need to be."
If you had to argue why a high school should hire an athletic trainer, where would you start?
I would start off with, "When your school nurse goes home, who takes care of your students? She leaves the building at 2:30. You have practice until 9 o'clock. Who's offering healthcare?" And they'll say, "Well, the coach does." The coach is more worried about winning the game. That's what they get paid to do. They get paid to coach. An athletic trainer, especially a full-time athletic trainer, takes care of everything and let's the coach do their job. That's a great thing. When I have coaches come from other schools that don't have one, they cannot believe that they have all the time freed up by not having to hand out uniforms — I do that too — wash uniforms, fit helmets, give a band aid out during a game, fix a piece of equipment, care about insurance and clearances — all that stuff. All he has to do is coach kids, and that's a big deal for even my soccer coaches. Everybody. What a great thing to just say, "Kelly, come help me."
This article originally appeared in the June 2019 issue of Athletic Business with the title "A decades-long career of caring for kids." Athletic Business is a free magazine for professionals in the athletic, fitness and recreation industry. Click here to subscribe.