More than Tape and Ice: Recruiting Athletic Trainers to High Schools

The importance of athletic trainer access for high school athletic programs has been well documented. The breadth of their training and skillset provides secondary schools with so much more than merely taping ankles or covering an athletic event. Athletic trainers safeguard our youth as they serve as their health-care advocate.

An athletic trainer not only promotes injury prevention policies and recommendations but the athletic trainer also appropriately responds to various types of injuries (whether physical or mental). The athletic trainer will also monitor return-to-play decisions, establish venue-specific emergency action plans (EAPs), while maintaining a standard of best practices within the secondary school activities programs.

Given the substantial participation and number of injuries in high school sports, coverage of athletic events by athletic trainers is a cost-effective means to safeguard the health and enhance the safety of high school student-athletes through injury prevention, emergency care and therapeutic rehabilitation. Athletic trainers also perform an essential role as a liaison between student-athletes, parents, guardians and the health-care system.”¹

Importance of Athletic Trainers
From a risk management standpoint, having a qualified and comprehensive health-care presence overseeing and safeguarding high school students makes sense. Some of the many functions the athletic trainer is uniquely positioned and qualified to provide:

• Venue-specific Emergency Action Plans (EAP) and encouraging the annual rehearsal of such plans.

• Training for coaches, players and administrators on best practices in responding to emergencies, such as sudden cardiac arrest, exertional heat stroke, etc.

• Ensures pre-event time-outs as EAPs are reviewed prior to the event.

• Acclimatization guidelines as well as continued environmental monitoring with appropriate recommendations for practice and game modifications.

• Weight and hydration monitoring, along with skin checks for wrestlers.

• Concussion management, return-to-play and return-to-learn guidelines.

• Facilitation between an injured student-athlete with school staff and coaches as they return to learning and return to sport.

• On-campus medical first aid care during afterschool hours.

• A relationship and environment of trust in caring for student- athletes.

• Guidance in working with coaches, athletic directors and administrators with regard to an injury prevention mindset.

• Appropriate medical referrals when indicated.

• Engage parents/guardians in their student’s care.

• Constructive relationships with local Emergency Medical Services (EMS) that provide high school event coverage

Many perceived reasons exist for not hiring a full-time athletic trainer. Lack of budget funds usually tops the list. When evaluating the depth and breadth of services provided by an athletic trainer, it should be apparent that an athletic trainer is worth the investment.²

Studies have demonstrated the impact that athletic trainers have in reducing the overall injury rate among high school student-athletes as well as improved injury reporting and rehabilitation.¹ Likewise, the overall cost to the medical system is reduced by avoiding unnecessary visits to the doctor’s office or to the emergency department with the appropriate, on-site treatment provided by an athletic trainer.

Yet, in the United States, only two-thirds of secondary schools have access to an athletic trainer and of those only 53% had access to full-time services.³ Following are some of the challenges in the recruitment of athletic trainers, examining the various models that currently exist in secondary schools and to suggest possible solutions.

The Problem/Challenge
Several challenges to hiring athletic trainers have been identified, including budget and financial concerns, rural locale, lack of community medical clinics nearby, and misconceptions about the role of an athletic trainer that led to a belief that coaches with firstaid training can provide medical care.⁴

The number of athletic trainers and employment settings has significantly increased. The degree for athletic trainers is now at the master’s level. Athletic trainers must pass a national competency exam, obtain licensure/registration in state of practice, and meet continuing education requirements.² Salaries should be comparable to health-care professionals. The number of work hours, days worked, and length of the athletic school year should be factored in when setting the salary.²

Employment Models
There are various employment models to consider for athletic trainers:

1. Direct hire for school or district

2. Outreach contracts via hospital, clinic or non-profit organization

3. Independent Contractors

An article published in May 2024 HST entitled: “Hiring an Athletic Trainer: Finding the Right Fit for Your School”⁵ outlined the pros and cons of various employment models.

Recruitment of Athletic Trainers

1. Job descriptions- accurate and detailed job descriptions are an important piece for recruiting athletic trainers. Hours, duties, and salaries should be included. Correct terminology such as athletic trainer instead of “trainer”, NATA and BOC not NATABOC. NATA is a membership organization and BOC is the certification entity. NATA has a career center where jobs for athletic trainers can be posted.

2. Local colleges and universities- Master of Athletic Training programs that are Commission on Accreditation of Athletic Training Education (CAATE) accredited are located nationwide. Program Directors and Clinical Coordinators of MAT programs can serve as a resource. A pipeline can be established in surrounding areas to give MAT students opportunities for future employment upon graduation and passing the BOC exam. Professors may also consider additional employment to provide athletic training services to local schools.

3. Career and Technical Education (CTE)- athletic trainers can be employed as CTE teachers in high schools. There are a wide variety of courses athletic trainers are qualified to teach under health sciences. Additional pay for healthcare during after school activities and sports is standard.

4. Legislative Grants – In Alabama, the Athletic Trainer Secondary School Incentive Program provides grants up to $7,500 for athletic trainers employed in rural and/or Title I secondary schools. Additionally, the Alabama Loan Assistance Program provides funding for student loan repayment for MAT graduates. It is funded by the Alabama Commission on Higher Education. Similarly, the Athletic Trainer Professional Development Program in Louisiana provides athletic trainers employed in rural secondary schools a loan repayment of $6,000 if MAT degree was awarded within the state, and $4,000 if degree was earned outside the state.

5. innovATe Project: The mission of UConn’s Korey Stringer Institute’s innovATe project is to increase access to medical care provided by an athletic trainer for secondary school athletes in under-resourced communities through the provision of funding, advocacy, education, mentorship, and strategic support to school districts and through partnerships with local medical services. https://koreystringer.institute.uconn.edu/innovate/

Summary
To promote and maintain safety for our youth participating in secondary school activities, an understanding by all stakeholders involved – students, parents, administrators, coaches, staff, and officials – of the vital role a certified athletic trainer provides to their organization, should be the standard expectation that each school district strives to achieve. Efforts to educate secondary school administrators on the training and education of certified ATs should be prioritized, and all school administrators should be encouraged to hire certified ATs.⁴ Engaging a certified athletic trainer in the care of student-athletes facilitates the needed synergy between all parties involved in mitigating the risks that are inherent in high school athletics and in providing best practices for the safety and wellness of each youth participating in high school activities.

References

1. Marcus Allen, et al. Variation in State Policies on Sideline Medical Coverage of High School Athletic Events, Orthop J Sports Med. 2025.

2. Jennifer D. Rheeling, MS, ATC, Athletic Trainers Play Important Role in Providing Health Care for Students, High School Today Mar 2023.

3. Robert A. Huggins, et al. Athletic Trainer Services in the Secondary School Setting: The Athletic Training Locations and Service Project, J Athl Train. 2019 Nov; 54(11): 1129-1139.

4. Christianne M. Eason, et al. Factors Influencing Athletic Training Services in California Secondary Schools: A 5-Year Update, J Athl Train. 2024 Nov 25;59(11) 1132-1138.

5. Frank Walters, PhD, LAT, ATC and Mike Carroll, M Ed, LAT, ATC, Hiring an Athletic Trainer: Finding the Right Fit for Your School, High School Today, May 2024.

Ciara L. Taylor, EdD, LAT, ATC is an athletic trainer at Oak Mountain High School in Birmingham, Alabama. She is also an adjunct professor at the United States Sports University. Dr. Taylor serves as the NATA Secondary School Athletic Trainers’ Committee Chair and is an ex-officio member of the NFHS Sports Medicine Advisory Committee representing the NATA.

Karl N. Weenig, M.D. is a primary care sports physician at Revere Health – Orthopedics and Sports Medicine in Provo, Utah. Prior to working as a sports medicine physician, he taught and coached high school students. Karl chairs the Utah High School Activities Association Sports Medicine Advisory Committee and is a member of the NFHS Sports Medicine Advisory Committee.