Athletic Trainers: Dealing with Injuries from Non-School Sports

High school athletic trainers wear many hats. They evaluate injuries, manage rehab plans, teach proper lifting and movement techniques, and coordinate with parents, coaches and other healthcare professionals. They may teach classes as well.

In today’s sports environment, however, they also face a challenge that has become more common with every passing year. Now more than ever, athletic trainers are faced with what to do when a student-athlete who attends their school gets injured in an activity outside of school, namely club, travel or select sports.

Whether it’s a sprained ankle from a weekend club soccer match or shoulder pain after a travel baseball tournament, more and more student-athletes show up at school Monday morning expecting the same care they would receive if the injury had happened during a high school game. That puts school-based athletic trainers in a tricky spot balancing professional ethics, liability and the overall health of the student.

A question being asked more frequently is how should the secondary school athletic trainers handle injuries that occur during club, travel or select-level sports? The answer lies in setting clear expectations, maintaining communication, and keeping student welfare at the center of every decision.

The Club Sports Dilemma
The modern high school athlete is often a year-round competitor. Many play for their school team in one season and a club or select team in another or depending on the sport even at the same time. For sports like volleyball, softball, soccer and swimming, club play is often viewed as essential for recruiting exposure and skill development and there is no real defined season as practices and tournaments happen in all 12 months of the year.

That constant activity comes at a cost. Overuse injuries, fatigue and conflicting training regimens are becoming more common. Because athletic trainers see these students daily at school, they are often the first to notice lingering pain, decreased mobility or signs of burnout even when the root cause comes from nonschool activity.

This “dual participation” creates blurred lines about who is responsible for managing care, especially when school facilities and medical resources are limited. Oftentimes, the student-athlete and or their parent may expect activity modifications for school sports yet do not want to follow those same modifications for their non-school team.

Clarifying the Athletic Trainer’s Role
A secondary school athletic trainer’s primary duty of care applies to injuries sustained during school-sponsored activities. That includes practices, games, conditioning sessions and team events under the school’s umbrella. However, athletic trainers are also licensed health-care professionals who must uphold ethical standards to act in the student’s best interest.

That means if a student-athlete reports pain or injury, even if it happened outside of school, the athletic trainer should perform an initial evaluation, offer their opinion on basic care, and help determine whether medical referral is needed.

Where athletic trainers must be careful is with ongoing treatment and rehabilitation of non-school injuries or conditions. If the injury occurred outside of school participation, the athletic trainer must ensure their actions align with district policy and liability coverage. Many schools provide athletic insurance policies that only cover injuries sustained during official school athletic events.

Continuing to treat an off-campus injury without approval could expose the athletic trainer and the school to unnecessary risk.

The best approach is transparency: explain to parents and athletes what the school athletic trainer can and cannot do under school policy, and provide a referral list for follow-up care. If the athletic trainer or athletic department is unsure of district policy, it is critical that they get a ruling from district central administration.

Communication is Essential
When dealing with non-school injuries, clear communication can prevent confusion and protect everyone involved. Trainers should:

• Gather details – When and how did the injury occur? Was it evaluated by a doctor or club athletic trainer? Are there existing restrictions?

• Document everything – Include in the student’s record that the injury occurred during non-school participation.

• Coordinate with outside providers – Request copies of medical notes, imaging results or treatment plans from external health-care professionals.

• Keep school coaches informed – Ensure that everyone understands the student’s current restrictions and returnto- play status.

The Student Comes First
When faced with club-related injuries, athletic trainers must remember that their ultimate responsibility is to the student, not the sport. An injury sustained at a weekend tournament may not be “school business,” but its effects often spill over into academics, activity level and general well-being of the student.

A student with a fractured ankle, for instance, may need classroom accommodations or modified athletic participation. The same can be said for a student who suffers a concussion in nonschool sports. Academic modifications will have to be in place to ensure that the student can return to their baseline. The athletic trainer can play a crucial role in advocating for those adjustments by coordinating with school nurses, counselors and teachers.

This holistic approach reinforces the idea that athletic trainers are not just athletic department staff, they are essential members of the educational team who safeguard student health and safety.

Setting Boundaries and Expectations
Establishing clear boundaries is critical. Athletic trainers may want to help every athlete who walks into their room, but without clear limits, their time and liability exposure can quickly become unmanageable. Here are a few best practices for setting and maintaining professional boundaries:

1. Develop written district policy. Schools should have a clear, written policy describing what the athletic trainer can and cannot do for injuries sustained in non-school activities.

2. Educate families early. Communicate these guidelines during preseason meetings, physical check-ins or through athletic handbooks.

3. Refer appropriately. Maintain a network of trusted local health-care providers for off-campus injuries.

4. Document and communicate. Record all interactions and clearly note that the injury was not school-related.

These steps protect both the athletic trainer and the school while still ensuring that the student receives appropriate guidance and care.

Turning Challenges into Education
Even if the athletic trainer’s formal responsibility ends with evaluation and referral, these interactions create excellent opportunities for education and prevention. Athletic trainers can use these moments to discuss:

• The importance of rest and recovery and this is not just from school sports

• The dangers of early specialization and overtraining

• How to balance club and school workloads

• Proper nutrition and hydration during heavy training cycles

At preseason parent meetings, discussing load management and injury prevention can go a long way toward reducing the frequency and severity of these outside injuries. By educating parents and coaches, athletic trainers help shift the culture toward a healthier, more sustainable model of youth sports participation.

Policy and Administrative Support Matter
While athletic trainers can manage day-to-day situations, administrators play a vital role in setting the structure. District athletic directors and principals should work with their athletic training staff to:

• Review insurance coverage for off-campus injuries

• Establish consistent district-wide policies

• Support professional development for athletic trainers

• Encourage collaboration with local club organizations

When administrators, coaches and athletic trainers operate under the same understanding, it reduces confusion and protects everyone involved especially the student-athlete.

The Bottom Line
The growth of club and select sports isn’t slowing down. That means secondary school athletic trainers will continue to see students bringing outside injuries into the school environment.

The solution isn’t to turn those students away, it’s to respond with professionalism, compassion and clear boundaries. By communicating openly, documenting carefully, and advocating for the student’s health first, athletic trainers can manage these situations effectively and ethically.

In a landscape where young athletes are constantly in motion between teams and seasons, the high school athletic trainer remains one of the few consistent voices focused on what matters most: keeping students safe, healthy and ready to learn.

Mike Carroll, M Ed, LAT, ATC, is assistant athletic director and head athletic trainer at Graham (Texas) High School, and he is a member of the High School Today Publications Committee.