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    A new study has revealed that there is a greater percentage of public secondary schools than private schools in the United States offering athletic training services.

    The results of the study published in the Journal of Athletic Training state that while 37 percent of public secondary schools have a full-time athletic trainer to meet the healthcare needs of student-athletes, only 28 percent of private secondary schools do.

    According to the research, only 58 percent of private secondary schools provide some amount of athletic training services, compared to 70 percent for public schools.

    “Despite the documented benefits of having an AT on site for both practices and games, many schools, public and private, do not provide this critical medical service to their students,” writes lead author Alicia Pike, MS, ATC, the associate director of research at the Korey Stringer Institute at the University of Connecticut.

    For the study, researchers from the Korey Stringer Institute in the Department of Kinesiology at UConn conducted the survey that was funded in part by the National Athletic Trainers’ Association. School athletic directors (or principals, if no athletic director was employed) from 8,509 public secondary schools and 2,044 private schools responded by phone or email. The data was collected from September 2011 to June 2014.

    Despite the differences in athletic training services, though, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring trainers were seen as comparable between public and private secondary schools.

    For more on the study, you can read the study from the scientific publication of the National Athletic Trainers’ Association scientific here.


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    Panelists discuss best practices findings for youth sports at Youth Sports Safety Summit (Photo: Renee Fernandes, National Athletic Trainers’ Association)

    INDIANAPOLIS – Emergencies are rarely predictable and that’s why having a detailed plan matters, especially when it comes to the health and safety of young athletes.

    That was the underlying theme as health care experts released comprehensive emergency medical recommendations for youth sports leagues Tuesday at the 8th annual Youth Sports Safety Summit. The findings of a task force that originally convened in 2015 also were published in the Journal of Athletic Training on Tuesday.  The task force was led by the National Athletic Trainers’ Association and the Korey Stringer Institute.

    “Our kids deserved preparedness,” said Robert Huggins, the vice president of research, athlete performance and safety at the Korey Stringer Institute. “We need to be proactive. Sometimes our human nature is to be reactive and wait for something bad to happen …

    “We’ve seen too many parents have to say goodbye to their child. They deserve that preparedness. They deserve to be able to go home at the end of the day with their family.”

    The Sports and Fitness Industry Association says nearly 31 million children ages 6 to 14 participated at least once in sports or activities in 2015. Studies show 3.5 million children under 14 are treated annually for sports injuries.

    The guidelines cover creating emergency action plans for sudden cardiac arrest, catastrophic brain and neck injuries, exertional heat stroke, potentially life threatening medical conditions, environmental issues such as lightning and access to medical services.

    Beyond creating the plans, the task force called for youth organizations to develop training programs and education members on sports safety practices and create a reporting structure to monitor compliance.

    Huggins called the task force’s document “probably the most important document ever released at the youth sports level.”

    “There have been no safety documents to date at the youth sports level that have really focused on the emergency best practices,” Huggins said. “This is the first of its kind to comprehensively look at all of those together and identify policy change and procedures that we know will improve health and safety. It’s been shown at the NCAA level, the professional level and the high school levels are improving and getting better with their policies. … I think youth sports should follow suit. It’s a natural progression.”

    There is no one organization that rules all of youth sports; each sport has its own national governing body. The task force got commitments from national governing bodies on what key policies they would implement in terms of the emergency assistance plans and changes to their organizational structure. The national governing bodies would then disseminate the information to regional and local leagues.

    “Because the national governing bodies operate independently,  implementing best practice safety policies remains a challenge,” said NATA president Scott Sailor. “This document is the first of its kind to serve as roadmap for policy and procedures. …

    “We recognize some of this is aspirational. If there is not a policy in place or a policy that can immediately be implemented, we hope to move them in this direction. … Our document contains a lot of valuable information, but we will commit to following up and getting them information and disseminating it in format to get in the hands of policy makers and that might be the soccer mom. There is saying that nothing is more powerful than a soccer mom.”

    Huggins pointed out that the document is structured in an easier to use way than many medical studies or journal articles might be.

    “Every single bit of information in the text is also in checklist form —  tear it out, take it with you, write stuff in it and use it,” he said. “And then say, do I have this, do I have this or this?

    “No one is bigger than the checklist and that’s the head emergency room doctor or the person observing the surgery. The format is forward facing and marketable and easy to understand for parents. We’re really hoping the novel part of this is the check list that can be distributed to parents, coaches and medical personnel and everyone gets to see this document.”

    Alexandra Flury from Safe Kids Worldwide noted that education is among the best means to improve safety at the grassroots level.

    “We recognize it might be difficult to implement all of this, but the (document) can be a starting point,” she said. “This creates dialogue between parents, coaches and organizations and which items are appropriate.”

    A key point was that parents need to know about safety and policies in place rather than assuming they exist or that coaches and league officials have the proper training.

    “We have a very serious duty to make parents smarter consumers in youth sports,” said Jon Butler, the executive director of Pop Warner Little Scholars. “There’s become an elevated expectation of the volunteer youth sports coach.”

    Huggins noted that parents need to know that in many cases, “the simplest prevention strategies are not being taken to keep them safe from a health and safety standpoint.”

    Parents need to ask questions.

    “The (document) has many things that parents won’t think to ask of their school, their program or coaches,” said Dr. John Jardine, an emergency room physician. “You go to a physician, you know the level of training. Are the coaches trained? Is there a certain level of expertise? There is a level of training we want to ensure across the board.”


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    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    March is National Athletic Training Month, and with this year’s theme, “Our protection is your priority,” athletic trainers want to be sure you have the proper protective gear for your head and face as you participate in sports.

    Scott Sailor, president of National Athletic Trainers’ Association (NATA).

    Many injuries to the face and head – ranging from concussion to bruise, laceration, broken nose and eye or tooth injury – can be serious, and proper protection, whether mandated or recommended should be taken seriously.

    Athletes participating in spring sports that use a small ball such as baseball, softball, tennis, lacrosse and field hockey are particularly susceptible to head and face injuries due to the high velocity of the ball. It’s easier said than done, but be aware of your surroundings, and when appropriate wear protective gear that will help reduce injuries.

    Here’s a list of some of the protective equipment used to prevent injuries:


    • Helmets are mandatory in high school football, ice hockey, baseball, softball and men’s lacrosse. They are designed to prevent skull fractures, not prevent concussions.
    • It’s critical that helmets be properly fitted. Your athletic trainer can help ensure this and that all other equipment is appropriate for you and the position you play in the sport.
    • Helmets should display a NOCSAE (National Operating Committee on Standards for Athletic Equipment) sticker and should be recertified through standards on a regular basis – check with your school’s athletic director or head coach to be sure this is happening.


    • Facemasks are required in high school ice hockey, men’s lacrosse and football; in some states, they are required in softball.
    • The goal of a hockey and lacrosse facemask is to protect the eyes and the jaw; in football, the goal is to protect all of the facial bones.
    • Different positions necessitate different types of facemasks to offer a specific type of protection; for example, the helmet for a football lineman will have a more closed cage than one for a quarterback or receiver.

    Protective Goggles

    • In most sports, goggles are optional; however, in field hockey they are highly recommended and are mandated in some states.
    • In small ball sports, such as racquetball and tennis, it’s extremely important to wear goggles to protect your eyes and the bones surrounding them.
    • You’ll also want to wear protective goggles if you play basketball or football and have had a previous eye injury. In swimming, they can protect the eyes from chemicals or other irritants in the water and can facilitate better underwater vision.

    Ear Protection

    • Wrestling and water polo are the two sports with the strongest need for ear protection.
    • In high school wrestling, headgear is required during all competitions but many athletes choose not to wear it during practice. Unfortunately, this is the cause for many preventable ear injuries.
    • In high school water polo, caps are required throughout competition, as well as practice, depending on your school’s requirements. The cap prevents injuries to the scalp and ear as well swimmers ear, which can affect your hearing and increase the risk of infection.

     Mouth and throat protection 

    • Fitted mouthguards are required in high school field hockey, football, ice hockey, lacrosse and wrestling. They are only mandatory for wrestling if you wear braces or an orthodontic device.
    • Mouthguards are an easy, relatively inexpensive and effective way to help you prevent injuries to your teeth and mouth.
    • Throat guards are required for high school hockey goalies, softball and baseball catchers and lacrosse goalies. They serve as critical protection against potentially serious injuries ranging from contusions to lacerations and fractures.

    Make sure you protect your head and face from any injuries. Take the time to wear all appropriate equipment and be sure it fits properly. If you’re unsure about what protective gear you need for your sport, consult with your athletic trainer, equipment manager and coach. NATA has created an infographic handout on dental injuries and oral injuries. Visit for additional sports safety tips for athletes and parents.

    Sailor, ScottszankeSailor, Scottszanke

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    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    Scott Sailor, president of National Athletic Trainers’ Association (NATA).

    Many athletes of all ages encounter breathing difficulties during workouts, practice or sporting events. If you have asthma, there is no reason you cannot continue with your athletic career, just like the numerous well-known athletes who control their illness and continue to compete with great success.

    Here are some important tips regarding asthma:

    • Major signs and symptoms of asthma include coughing, wheezing, tightness in the chest, shortness of breath and breathing difficulty at night, when waking up in the morning or when exposed to certain allergens or irritants such as perfumes or other strong odors.
    • If you have asthma, your athletic trainer may work with your coach to provide alternative practice sites. Indoor facilities that offer good ventilation and air conditioning should be considered for at least part of the practice.
    • If your asthma is under control, exercise will strengthen muscles, improve respiratory health and enhance endurance and overall well-being.
    • A structured and gradual warm-up protocol may decrease the risk of complications of asthma. Your athletic trainer can help you develop a plan.
    • Your athletic trainer will help make sure you are properly educated about your condition, including the importance of taking medications, proper use of inhaler equipment and how to recognize “good or bad” breathing days.
    • If you have been prescribed fast-acting medication for your breathing condition, it’s important that it be near you at all times, especially during exercise.

    RELATED: Read more past columns from Scott Sailor

    While asthma is often the cause of breathing difficulties, there are some lesser-known conditions that are more difficult to diagnose. One such ailment, vocal cord dysfunction-exercise induced laryngeal obstruction (VCD-EILO), is triggered by exercise. It has some similar symptoms to asthma; however, it is managed differently. If you have never been diagnosed with a breathing disorder and are having breathing difficulties, be sure to talk to your athletic trainer and see your physician who will determine the proper diagnosis and management.

    Asthma and VCD-EILO both include shortness of breath, but the sound of the breath is different. VCD-EILO has a high-pitched, grating sound and asthma has a wheeze. There are other differences as well. Those with VCD-EILO struggle while inhaling, and those with asthma struggle while exhaling. Athletes with VCD-EILO will experience tightness in their throat, not in their chest like those with asthma. Also, VCD-EILO has a rapid onset and rapid recovery while the onset and recovery of asthma is gradual.

    If you have VCD-EILO, you may likely be referred to a speech language pathologist. If you have asthma, you may be treated by your primary care physician or specialist such as an allergist or immunologist. It’s important that you have follow-up exams with your physician at least every six to 12 months. Once you have a diagnosis, your athletic trainer will play an important role in supervising your treatment to help prevent and control symptoms.

    To help understand the differences between asthma and VCD-EILO, NATA has created an infographic handout. Visit for additional sports safety tips for athletes and parents.

    Sailor, Scottjabarnett13Sailor, Scottjabarnett13

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    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    Scott Sailor, president of National Athletic Trainers’ Association (NATA).

    Does this sound familiar? An athlete continues with a strenuous daily exercise routine, yet feels as if he is not improving in overall physical conditioning. His running time is lengthening, and he feels as if he cannot lift as much weight as he had just a month ago without feeling physically taxed. He struggles to recover from the previous day’s workout. The athlete is starting to have sleep issues, feels moody and is having trouble with schoolwork and relationships. Often, athletes, coaches and parents believe this scenario suggests anemia, lack of sleep, depression, dehydration or an underlying viral infection, when the athlete may in fact be suffering from burnout as a result of continued physical conditioning and the pressures of being a student.

    Studies show that the most ambitious and talented athletes run the greatest risk of burnout and may even consider quitting their sport without realizing the options they have to stay in the game and become re-energized. While there is a physical component to athlete burnout, the mental stress involved is more problematic since mental health concerns may be subtle or the athlete may attempt to hide them for fear of being stigmatized. Since May is Mental Health Month, this is a good time for parents and coaches to learn about the signs and symptoms of burnout, identify how athletes can help themselves and seek information on risk factors to identify burnout early and prevent its debilitating effects.

    Burnout is a result of prolonged response to chronic stress – physical and/or mental – and may be brought on by others (coaches, parents) or by the athlete. Burnout may also result from exercise addiction.

    Signs and symptoms of mental burnout include:

    • Emotional exhaustion
    • Feelings of frustration, anger, failure or ineffectiveness
    • Impaired relationships and schoolwork
    • Withdrawal from others or activities previously enjoyed by the athlete; this includes quitting the sport.
    • Disconnect from others; emotionally detached from teammates, coaches and even parents. The athlete doesn’t get too excited over a victory or show any emotion to a sudden and crushing defeat.
    • Fatigue or frustration that lingers or worsens during or after a long season.

    Important steps to take if an athlete feels burned out:

    • Stay connected (and have a support system): Studies show that when athletes feel autonomous, competent in their ability and connected to their support system (family, friends, coach, teammates), they should feel a lower sense of burnout. This balance of psychological needs is a good step in preventing burnout, even during a long, and at times grueling, season.
    • Sleep, eat and hydrate: It is important for student athletes to get at least 7-8 hours of sleep, stay hydrated (going to the bathroom 8-10 times daily is a reliable indicator of good hydration) and eat balanced meals.
    • Set aside time: Encourage athletes to establish a daily routine, and take some “personal time” every day to enjoy a hobby or do things away from the pressures of being a student and an athlete.
    • Be smart about alcohol and drugs: Talk to athletes about not using alcohol, only taking medication prescribed by a licensed medical professional and not using illegal drugs or abusing prescription drugs. The opioid abuse epidemic is a real concern today, and athletes are not immune.
    • Speak up: Athletes who feel burned out should talk with a parent, the school’s athletic trainer, coach or other trusted adult about feelings and concerns. Referral to a licensed mental health care professional may be recommended to provide the care to best manage the athlete’s mental health and wellness.

    Check out these resources for risk factors and additional information on burnout:

    For additional information on athlete burnout and mental health, NATA has created an infographic handout. Visit for additional sports safety tips for athletes and parents.

    Sailor, ScottEvanSailor, ScottEvan

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    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    Athletes engage mentally and physically in their training and practice so that they will be the most competitive during games. Practicing a skill over time builds muscle memory so that athletes do not have to think about doing a task; their bodies just do it.

    It is important that skills are done correctly and that the athletes use proper form so the movement becomes part of muscle memory and reduces risk of injury. Remember that muscles work best when they are not over-stretched or shortened.

    Activities at home or outside of a sport during downtime can also affect muscles and the muscle memory of a skill. For example, sitting in front of a computer with shoulders slumped can cause strain on muscles. Similarly, playing video games using that posture can lead to the same results. Shortened muscles can become tight so proper posture can help to stretch those muscles. On the other hand, lengthened, or over-stretched muscles can become weak. Finding the proper muscle balance is the key to success.

    Another increasing concern caused by downtime activities is trigger thumb. When individuals text frequently using their thumbs, the thumb joints are kept in a flexed posture and can lead to overuse or inflammation. Additionally, the thumbs may lock and become painful. Hand function can be limited, affecting athletes involved in sports that require gripping such as crew, lacrosse and tennis.

    As previously mentioned, here are some of the more common non-sport causes of muscle imbalance that interfere with optimal athletic performance:

    • Slumped posture (e.g., working on a laptop while sitting on the floor)
    • Excessive gaming
    • Excessive texting
    • Texting using only thumbs

    It is also important to keep in mind that If athletes spend more time gaming and on their laptops than they do at practice, poor posture and muscle imbalances will be reinforced and repeated.

    Here are several imbalance prevention tips:

    • Maintain good posture, especially during “downtime”; sit with your back supported with an upright posture
    • Limit texting, and use a swipe feature or multiple fingers (not just your thumbs)
    • Limit gaming time to 20 minutes per sitting
    • Maintain good balance between flexibility and strength of your trunk and upper extremity

    Almost all sports involve the upper extremity. Even running speed is enhanced by optimal shoulder function, and all athletes use their hands during their normal day. Paying attention to a few activities performed during downtime can affect athletic performance. For best advice on proper form, consult with an athletic trainer or other member of the school’s sports medicine team.

    Visit for additional sports safety tips for athletes and parents.

    Sailor, ScottEvanSailor, ScottEvan

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    With the start of school nearing and thus the beginning of fall sports, the National Athletic Trainers’ Association (NATA) offers these key questions to ask schools to ensure the best training practices are in place.

    “Nothing is more important than the safety of our student athletes as they prepare for fall sports and activities,” NATA President Scott Sailor, EdD, ATC., said “Ask the right questions of your child’s school. Ensure protocols are in place and confirm who is on the sports medicine staff, including athletic trainers, to prevent and manage injuries should they occur. We can then collectively help provide an environment where young athletes can excel at sport and know their safety is paramount.”

    1. Who comprises the school’s sports medicine team? Find out who will provide care to your child in case of an injury, and ask to review their credentials. Many schools and sports teams rely on athletic trainers or parents with medical and first aid training and certification to keep kids safe. NATA also recommends that any medical decisions are made by the school’s sports medicine professionals (physicians and athletic trainers) and not the coach to avoid conflict of interest. Coaches and even the athletes themselves may unconsciously make decisions that favor winning over safety.
    2. Does the school have an emergency action plan? Every team should have a venue-specific written emergency action plan (EAP) for managing serious and or potentially life-threatening injuries. It should be reviewed by the athletic trainer or local Emergency Medical Service, and individual assignments, emergency equipment and supplies need to be included. If an athletic trainer is not employed by the school, other qualified individuals need to be present to render care.
    3. Is the equipment in working order? Make sure all equipment ranging from field goals, basketball flooring, gymnastics apparatus and field turf are in safe and working order. This also includes emergency medical equipment such as spine boards, splint devices and automated external defibrillators (AEDs) – which should be checked once per month; batteries and pads need consistent monitoring and replacing. Accidents can occur in every activity, and that is why the AT should be on site after school to help ensure all equipment is safe and in good order.
    4. How qualified are the coaches? A background check should always be performed on coaches and volunteers:
    • Coaches should have background and knowledge in the sport they are coaching. They should be credentialed if that is a requirement in the state, conference or league.
    • All coaches should have cardiopulmonary resuscitation (CPR), AED and first aid training.
    • Coaches should strictly enforce the sports rules and have a plan for dealing with emergencies.
    1. Are locker rooms, gyms and shower surfaces cleaned on a regular basis? With the advent of MRSA and related bacterial, viral and fungal skin infections reported in recent years, it is critical to keep these surfaces routinely cleaned and checked for germs. Athletes must be discouraged from sharing towels, athletic gear, water bottles, disposable razors and hair clippers. All clothing and equipment should be laundered and/or disinfected on a daily basis.
    2. Does the school have an AED and someone who knows how to use it? AEDs can save a life and stave off a catastrophic situation. Ensure that the sports medicine team and other personnel know where they are located and how to use them. They should be readily available within three minutes (preferably one minute) during both practices and games.

    Preparing kids for sports participation

    1. Get a pre-participation exam: All athletes should have a pre-participation exam to determine their readiness to play and uncover any condition that may limit participation. A young athlete’s underlying medical condition can be exacerbated with vigorous, sustained physical activity.
    2. Physical and mental preparation is paramount: Parents, with input from coaches and athletic trainers, should determine whether their children are physically and psychologically ready for the sport/activity level they’re playing. A young athlete should not be pushed into something he/she does not want to do. If an athlete has been injured and is returning to sport, it’s critical for him or her to have the right mindset and confidence to return to play and avoid repeat injury. If an athlete does shows signs of mental distress, the athletic trainer, coach and school mental health professional should work together to provide that athlete the best care.
    3. Share an athlete’s medical history: Parents should complete an emergency medical authorization form that should ask for parent contact information, the athlete’s medical history and permission for emergency medical care for that athlete. Check with your school to obtain the forms.
    4. Get educated on reducing risk of injury: NATA has launched a public service campaign including a website,, to provide comprehensive information on reducing risk of injury in work, life and sport. The site includes interactive state-by-state maps, risk assessment quizzes, sports health specific educational material and resources for parents, coaches and others.

    Individual athlete concerns and considerations for the sports medicine team

    1. Beat the heat: Acclimatize athletes to warm weather activities over a 7 to 14-day period. This includes heat acclimatization, hydration and modifying exercise based on environmental conditions, among other criteria. It is suggested that for the first two days in sports requiring protective equipment, only helmets should be permitted (this includes goalies as in the case of field hockey and related sports); during days three to five only helmets and shoulder pads should be worn; beginning on day six, all equipment can be worn.
    2. Use your head: According to the Centers for Disease Control and Prevention, there are between 1.6 million and 3.8 million brain injuries occurring in sports each year and 63,000 occur in high school sports alone. Be certain the medical team is well educated on concussion prevention and management and that the school provides education to the athletes as well. Some state concussion laws require schools to educate parents too. The athlete should be encouraged to speak up if he or she is hit in the head and suffering from any related symptoms such as dizziness, headache, loss of memory, light headiness, fatigue or imbalance.
    3. Be smart about sickle cell trait: All newborns are tested at birth for this inherited condition, and those results should be shared during a pre-participation exam. Red blood cells can sickle during intense exertion, blocking blood vessels and posing a grave risk for athletes with the sickle cell trait. Screening and simple precautions may prevent death and help the athlete with sickle cell trait thrive in his or her chosen sport. Be aware of warning signs including fatigue or shortness of breath that may indicate an athlete is in danger.
    4. Build in recovery time: Allow time for the body to rest and rejuvenate in between seasons. If the athlete has just finished the basketball season and has his or her sights set on baseball, make sure there is rest time built it to recover from the rigors of grueling months on the court. If athletes don’t make time for recovery, injury can occur. Acclimatizing to the next sport, with appropriate strength, flexibility and balance training, and the supervision of an athletic trainer, will help ensure a healthy season ahead.
    5. Pay attention to sport specific injury prevention: Any repetitive motion can lead to overuse injury. With baseball, it may be the turning of the torso and impact on the hip or the repetitive motion a pitcher goes through each time he or she throws a ball. These motions can put added stress on the joints, muscles or ligaments with sudden movement or rigorous activity increasing the chance of injury. Following a protocol of flexibility and strength training is integral to a young athlete’s participation.


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    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    Generally, athletes strive to perform at their optimal best both physically and mentally to achieve success in their sport. Sometimes achieving that goal can take a toll on the body and particularly for female athletes who may be at risk of or have a condition called the Female Triad. The Triad involves three (triad) factors that include

    1. Low bone mineral density (thin or weak bones)
    2. Disordered eating (not consuming enough calories to sustain the energy needed to perform at practice or competition); and
    3. Menstrual dysfunction (when a female has fewer than nine periods a year).

    There are many reasons and possible medical conditions why someone has missed her period – this does not automatically mean she has the Female Triad but it is a consideration.

    There are many reasons why female athletes may be at risk:

    • Body image issues: Due to peer pressure and a desire to “be the best” at all costs, along with pressure from parents and/or coaches.
    • Low energy availability (using more calories than what is taking in): Restricting calories will strongly affect an athlete’s health, fatigue level and athletic performance.
    • Inappropriate weight loss: Most girls with the Female Triad try to lose weight because they think it will improve their athletic performance. This is a myth. Attempting to lose weight may lead to a decrease in muscle strength, low energy availability and potentially eating disorders (a lifelong health issue). These are all factors that will decrease athletic performance.

    Symptoms of the Female Triad can include:

    • Weight loss
    • Irregular periods or absence of a period
    • Fatigue and decreased ability to concentrate
    • Depression
    • Increased number of injuries (i.e. fractures of the weight bearing bones)
    • Decreased athletic performance

    If you are experiencing any of these symptoms, confide in your athletic trainer, others on your sports medicine team or your primary care provider who may refer you to a specialist in this area. It takes a team to help with the emotional and physical effects of the Female Triad. Professionals who should be included are:

    • Physician: will perform an extensive physical exam including a medical history and lab work. You will be asked questions about why you may be losing weight or missing your period, as well as other related issues.
    • Registered dietitian: Will help you reach and maintain a healthy weight while consuming adequate calories and nutrients for your health and athletic performance.
    • Psychologist: can help you deal with depression, pressure from coaches or family members or low self-esteem, and can help you find ways to deal with problems other than by restricting food intake or exercising excessively.
    • Athletic Trainer: Once you have a diagnosis, your school’s athletic trainer will play an important role in supervising treatment to help prevent and control symptoms.

    Here are some important tips regarding the Female Triad:

    • Keep track of your periods; know what a normal period is for you.
    • Pack and eat “travel foods” such as bananas, muffins and bagels, in-between classes, meals and practices to avoid going without food during the day.
    • Talk to friends, parents or those who are close to you if you are feeling pressure to compete or to lose weight.
    • Participate in a sport because you want to compete, not because of pressure to compete.

    With proper nutrition and monitoring of activity levels, the Female Triad may be prevented. If a friend, sister, or teammate has signs and symptoms of the Triad, discuss your concerns with her and encourage her to seek treatment. If she refuses, mention your concern to the athletic trainer, school nurse or coach. For additional sports safety tips for athletes and parents, visit

    Sailor, ScottEvanSailor, ScottEvan

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    Regardless of your sport, all athletes are likely to encounter a skin injury at some point. Injuries that commonly occur during athletic participation include blisters, lacerations, abrasions and puncture wounds. When they are properly treated, these wounds typically heal faster and with a lower risk of infection and adverse reactions.

    Your school’s athletic trainer can evaluate your injury and will have supplies available to manage it. Here are some basic treatment tips to keep in mind when you do sustain a skin injury:

    • The wound and surrounding skin should be thoroughly cleansed with tap water or saline irrigation as soon as possible. Be cautious when using antiseptics to clean wounds since they can be toxic to skin tissue.
    • After an initial thorough cleansing, further cleansing should only be done if the wound becomes contaminated or infected.
    • Scrubbing or swabbing of the wound should be avoided because it can damage the healing skin and will not reduce the bacteria.
    • Debris should be removed from the wound before dressings are applied. Have your athletic trainer or other health care professional take care of this for you.
    • Until fully healed, the wound should be covered, rather than left uncovered, with occlusive dressings (films, foams and hydrocolloids) or nonocclusive dressings (sterile gauze, nonadherent pads, adhesive strips and patches). Occlusive dressings, available at pharmacies, are preferred because they create an optimal environment for healing, lessen the risk of infection and adverse reactions and can stay in place over wounds for longer periods than nonocclusive dressings.

    As you heal, have the wound checked every day. Your athletic trainer will look for:

    • adverse reactions that can come from some cleaning solutions, topical antimicrobial agents and dressings: rash, white discoloration, tenderness or burning
    • signs of infection: fever, pain, swelling, warmth, or delayed wound healing
    • how the wound is healing: you will be advised on how often to change dressings

    You should be seen by a physician as soon as possible if your skin injury:

    • is deep and requires sutures or staples
    • is heavily contaminated
    • involves tendon or nerve injury
    • becomes warm
    • develops drainage
    • is painful
    • forms a rash
    • is slow to heal

    For more advice on skin injuries, talk to your athletic trainer and check out NATA’s infographic handout. Visit for additional sports safety tips for athletes and parents.

    Sailor, ScottEvanSailor, ScottEvan

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    Tips for staying properly hydrated during competition.


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    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    It is always rewarding to watch a young athlete participate in a sport that he or she truly enjoys. From teamwork and commitment to sportsmanship – the benefits can be far reaching. However, if the athlete specializes too early, the results can also lead to injury or even burnout. With athletes often participating on high school teams, leagues and clubs, there is even more demand on the body and the wear and tear that comes with possible year-round participation and specialization.

    I know many believe that sports specialization can lead to more opportunities on the playing field – from youth to college to elite sports; however, it is important to remember that young athletes who participate in cross training and in different sports may have the greatest benefit. They are exposed to a wider range of skills and get rest from repetitive, single-sport activities. I recommend a protocol that includes that variety along with supervised flexibility and strength training.

    RELATED: The facts behind early sport specialization and injuries

    Here are some additional tips:

    • Avoid burnout: Sports that go year-round may not provide adequate time for rest and recharging that may lead to athlete burnout. Studies have shown that athletes who focus on one sport tend to develop burnout and quit sports altogether, leading to inactivity in their later years. Those who take longer periods of rest tend to recover easier and have a longer, healthier career in sports. Taking two to three months off from a single sport every year to participate in supervised strength and conditioning allows injuries to heal and the mind to refresh.
    • Repetitive motion can lead to overuse injuries: Specializing in one sport may lead to increased stresses placed on specific body parts, leading to increased chances of injury. Common chronic conditions seen in athletes include tendinitis, inflammation and stress fractures. These overuse injuries often go undiagnosed for long periods of time and may become more serious. Injuries may lead to loss of playing time and function as well as increased mental exhaustion. Taking a break from a sport may decrease stresses placed on the body, thus decreasing the chance of injury.
    • Get plenty of rest and watch for signs of fatigue: When the body is tired, it is more susceptible to sustain an injury. Limit training in a single sport to no more than five days a week with at least one day off from any organized physical activity. Preparing for a sport each season through proper strength, flexibility and balance training is essential to decreasing chances of injury.

    A goal of all athletics should be to have fun and learn lifelong physical activity skills. Participating in multiple sports throughout the year provides numerous benefits. Consult with your school’s athletic trainer for additional tips to reduce the risk of injury. The National Athletic Trainers’ Association has created a resource to help reduce the risk of overuse injuries. Also, visit for additional sports safety tips for athletes and parents.

    Sailor, ScottEvanSailor, ScottEvan

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    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    Does this scenario sound familiar? A high school athlete complains to her parents, coach or athletic trainer about chronic fatigue, headaches, poor performance on the field and lack of focus in the classroom. She thought the symptoms would pass in time, but finds that her health and schoolwork are suffering. She does not appear ill, nor has she sustained an injury that would bring on these types of symptoms. After undergoing a thorough exam including medical history to rule out an illness or injury, perhaps the adage, “sometimes the simplest answer is the correct one” applies: This athlete may be experiencing sleep issues.

    Sleep is vital to health and function for everyone. For student athletes, the stress of physical performance and schoolwork may create an environment that affects their sleep. Here are three areas that are influenced by the lack of restful sleep; all play a role in sports performance:

    Physical Health

    • The lack of sleep interferes with healing and recovery of injuries and physical conditioning. Cells grow, repair and rebuild during sleep, making it essential to athletic performance, as well as injury recovery and prevention.
    • Any disruption in sleep affects metabolism. Sleep controls insulin and glucose functioning, secretion of metabolic hormones and the way fat and muscle cells use energy.
    • Healing that takes place during muscle growth occurs during sleep. In order for the student athlete to recover and build muscle during weight training, proper amounts of sleep are required to allow hormonal secretion to take place.
    • Poor sleep quality and short sleep durations can lead to weight gain and obesity, especially in adolescents and young adults. Proper sleep helps stave off unwanted fat gain.

    Mental Health

    • The body’s ability to control stress and emotions depends on sleep to maintain proper function, and without it, the body has a hard time processing mentally stressful events, resulting in a possible increase in anxiety and depression.

    Cognitive Health

    • During sleep, the mind sorts, filters, evaluates, consolidates and integrates information taken in during the day, especially in class. A lack of effective sleep interrupts the brain’s ability to learn.
    • Poor sleep negatively affects decision-making and clouds one’s judgment.
    • Not getting enough sleep negatively affects the ability to focus and maintain attention, which are important components to learning in the classroom or in sports.

    Here are some simple suggestions to enhance your sleep. Reach out to your athletic trainer for additional assistance:

    • Create a “sleep friendly” environment. This includes a room that is dark, cool and comfortable.
    • Get on a sleep schedule. Try for seven to eight hours of sleep per night, including weekends.
    • Put away electronic devices at least an hour before bedtime, if possible. The blue light of a cell phone can stimulate the brain and prevent it from going into a sleep cycle.
    • Manage stress. Everyone experiences stress, but how you manage it is important. If you feel that you handle stress in a negative way or very differently than other students, speak with a mental health professional to learn coping skills. Developing effective stress management skills and establishing healthy sleep habits will help you live a happier life.

    If you continue to experience sleeping problems, contact your physician for further evaluation and care. The National Athletic Trainers’ Association has created a resource that provides tips on the power of sleep. Also, visit for additional sports safety tips for athletes and parents.

    Sailor, ScottEvanSailor, ScottEvan

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    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    One of the great concerns that parents have is for their child’s health. If a child experiences a sports-related injury or an illness that impairs health, well-being or performance on the field or classroom, a parent would seek the assistance of a health care professional such as a physician or athletic trainer. However, parents should be just as vigilant about the mental health and wellness of their child.

    Studies show that one in every four to five adolescents and adults met the criteria for a mental health disorder within the past year. These disorders are across the spectrum of mental health challenges, but primarily anxiety and depression. Certainly, adolescence is a challenging time for a teenager for many reasons, and being a student athlete does not make one immune to experiencing the stressors or exposure to being that one in four to five who is affected by a mental health issue.

    The thought of suicide is one area of mental health that has many people concerned. Suicide is the second leading cause of death for youths age 10-24, with approximately 4,700 young people dying of suicide annually in the United States. Unfortunately, secondary school student athletes are among these statistics. Adding to this concern is the stigma that is still somewhat attached to those experiencing a mental health challenge. So, how do we address the public health issue that has many parents of all walks of life concerned?

    One of the first places to start is acknowledging that there is a problem and trying to address mental health issues early in the disorder. If you notice signs and symptoms, it is important to encourage intervention early so that depression or anxiety can be managed and does not progress to a more advanced stage where the student athlete may be contemplating or acting on suicide thoughts. In other words, do not let a mental health disorder progress and worsen when early detection and care could make a positive difference. What indicators might signal that an adolescent may be experiencing a mental health challenge? Part of the answer lies in observing the student athlete for behaviors that may indicate any thoughts of suicide.

    The teenage years are challenging. Add in the stress of competitive athletics, and a student athlete may be at increased risk for developing a mental health disorder or exacerbating an existing condition. Being injured, demoted from the first-team, pressure from a well-meaning coach or parent or simply not living up to unrealistic personal athletic expectations can all be triggers for a mental health concern, including suicidal thoughts. Athletic trainers, coaches, school nurses, team physicians, guidance counselors and parents are in positions to observe and interact with students on a regular basis. It is important to ensure a team approach – the athletic trainer, school nurse, school counselor and team physician should collaboratively identify a potential psychological concern and refer the athlete to the appropriate mental health professional (clinical psychologist, psychiatrist or licensed social worker).

    The pre-participation physical examination is an optimal time to ask about a history of mental health problems and to screen for related conditions.

    Here are some of the behaviors to monitor when there is a concern for someone’s mental health and well-being:

    • Anger
    • Purposelessness
    • Hopelessness
    • Anxiety
    • Depressed mood
    • Withdrawal
    • Recklessness, including alcohol and substance use
    • Anorexia, over-exercising, or over-concern with weight
    • Forgetfulness, poor grades
    • Insomnia
    • In extreme conditions, self-harm such as cutting oneself, or harming others through assaults on family members, teammates, friends or classmates
    • Talking of death or suicide.

    If these behaviors are observed, the next step would be to approach the student athlete, especially if he or she has expressed such thoughts. Simply asking, “How are you doing today” is an effective open-ended question to get the conversation started. You can also follow up with questions regarding your concern based on the behaviors observed. If the student expresses concerning thoughts, know how to access mental health referrals through the school or primary care physician.

    While seeking assistance, here are three important points when having a discussion with someone who has thoughts of suicide:

    1. Ask the student athlete if he or she is having thoughts of committing suicide.
    2. If the person expresses these thoughts, ask about “TIPA”: Thoughts of suicide; Intention of harming themselves; Plan of self-harm; and Access to things to harm themselves. Someone who has these “TIPA” items in place is at greater risk of self-harm.
    3. Do not leave the person alone. Stay with him or her until an ambulance, security or police arrives, or take the person to the hospital or mental health care facility. Know the mental health care emergency plan at your school.

    Talking openly and honestly with student athletes and adolescents about mental health and wellness is an important step in preventing suicide or thoughts of it. While approaching the student athlete with a concern may be uncomfortable, remember that the health and wellness of that individual is critical. Be sure to have accurate facts before meeting with the student, and remain empathetic when the meeting occurs. Encourage the student to talk about his or her situation and to have a mental health evaluation. Discussing that stress is a normal expectation in life, and developing effective coping mechanisms to deal with it are important.

    Sports participation is a great avenue to develop positive characteristics in an adolescent. Athletic trainers, among other sports medicine team members, are on the front lines of this public health problem, working daily to educate and refer student athletes with mental health issues. They help them work towards identifying and preventing events that threaten the athlete’s life and well-being.

    The National Athletic Trainers’ Association has created a resource that offers additional information on suicide awareness. Also, visit for additional sports safety tips for athletes and parents.

    Sailor, ScottEvanSailor, ScottEvan

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    Scott Sailor, president of National Athletic Trainers’ Association (NATA).

    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    Throughout March Madness, staying injury-free was likely on the minds of many of the players and coaches as their teams moved closer to championship games. Teams capitalize on peak performance during the postseason, but unfortunately, injuries, especially those to the knee, can be devastating.

    The knee is the most commonly injured joint in sports, and the anterior cruciate ligament (ACL) is one of the most frequently injured knee ligaments. Damage to the ACL can happen to athletes in any sport, but basketball, soccer and football players are particularly susceptible. The injury can occur when an athlete suddenly pivots or stops, quickly changes direction or lands after jumping. Half of ACL injuries are accompanied by damage to other ligaments or cartilage in the knee, and surgery is generally recommended when dealing with a combination of knee injuries.

    An ACL injury is painful and can be detrimental due to the loss of time away from play, a lengthy rehabilitation process and potential long-term health consequences such as osteoarthritis. Half of those diagnosed with an ACL injury will develop osteoarthritis within 10 to 20 years after the injury.

    What can be done to help prevent an ACL injury? An injury prevention training program can help reduce the risk of ACL and other knee injuries as well as improve performance. This type of program is ideal for all athletes and those who are physically active. It is highly recommended for anyone participating in sports that involve landing, jumping and cutting tasks (e.g., basketball, soccer, team handball) and those with a previous ACL injury. Because numerous research studies suggest that female athletes are at greater risk of an ACL injury, those involved in sports that involve a lot of jumping or sudden changes of direction should strongly consider a prevention training program.

    The school’s athletic trainer can help develop an injury prevention training program tailored to each individual athlete’s needs. Here are some guidelines:

    Exercise Selection and Training Intensity

    • The program should comprise at least three of the following exercise categories: strength, plyometrics, agility, balance and flexibility. The athletic trainer will provide feedback on movement techniques.
    • Injury prevention training exercises should be performed at progressive intensity levels that are challenging and allow for excellent movement, quality and technique.

    Frequency and Duration

    • The program should be performed year-round at least two to three times a week.
    • To maintain the benefits of reduced injury rates and improved neuromuscular function and performance over time, multicomponent training programs (preseason, in season and offseason) should be performed each year. This should not be discontinued after a single season.

    Program Adoption and Maintenance

    • The program should be regularly supervised by athletic trainers, physicians or other sports medicine professionals.
    • Multicomponent training programs are effective when implemented as a dynamic warmup or as part of a comprehensive strength and conditioning program. If time constraints are a concern, evidence shows they can be performed 10 to 15 minutes before the start of practices or games.

    Research suggests that when done correctly, injury prevention training programs help reduce the risk of ACL and other traumatic knee injuries by more than 50 percent. The National Athletic Trainers’ Association has created a resource on 10 things to know about ACL injuries. Also, visit for additional sports safety tips for athletes and parents.

    Sailor, ScottEvanSailor, ScottEvan

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    Scott Sailor, president of National Athletic Trainers’ Association (NATA).

    USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

    With preparation for summer activities around the corner, there is good news for those with sickle cell trait. Although being involved in sports poses some risk, those carrying the sickle cell trait are often able to participate with proper education and precautions. Athletes with questions about how this blood disorder may affect them should check with the school’s athletic trainer.

    Sickle cell trait and sickle cell anemia: What’s the difference:

    Sickle cell anemia and sickle cell trait are both blood disorders that can be harmful for athletes. Here is the difference:

    • Sickle cell trait is the inheritance of one abnormal gene for sickle hemoglobin and one gene for normal hemoglobin. During intense or extensive exercise, the sickle hemoglobin can change the shape of red blood cells from round to quarter-moon, or “sickle.” This change, known as exertional sickling, can pose a grave danger for some athletes. The abnormal blood cells can “logjam” blood vessels, blocking proper oxygen flow to the heart and other muscles, which can cause serious complications.
    • Sickle cell anemia is when the body produces abnormal hemoglobin, causing an inherited form of anemia. This means that the body’s red blood cells tend to break apart and die, causing a lack of oxygen being carried in the blood. Periodic episodes of pain and fatigue are common. Athletes with sickle cell anemia are often discouraged from participating in sports due to the serious health risks.

    Sickle cell status should be confirmed during a pre-participation physical exam since every child is screened at birth. All athletes with sickle cell trait should know their status. It is important that their coaches, other players and parents be educated and aware of exertional sickling and the potential for collapse. Athletes who are unaware of their status should ask their pediatrician for their newborn screen results.

    To help prevent a sickling collapse, athletes with the sickle cell trait should follow these recommendations:

    • Follow a pace-progression training program with longer periods of rest and recovery between repetitions
    • Set their own pace
    • Avoid performance tests such as mile runs, serial sprints, etc.
    • Stop activity at the onset of symptoms and report immediately to the athletic trainer or coach, in case no athletic trainer is on site.
    • Adjust work-rest cycles to accommodate environmental factors such as heat or change in altitude
    • Check with the athletic trainer about the availability of oxygen in the event of an emergency 

    Exertional sickling symptoms:

    Because a collapse from sickling can be mistaken for cardiac or heat collapse, it is important to know the symptoms that are specific to exertional sickling. They include:

    • Possible collapse during the first 30 minutes of exertion
    • Fatigue
    • Difficulty breathing
    • Leg or lower back pain
    • Sudden weakness in the muscles causing the athlete to slump to the ground
    • Core temperature is not greatly elevated

    Additionally, environmental heat, dehydration, uncontrolled asthma, acute illness and newness to altitude can predispose athletes with sickle cell trait to potentially traumatic conditions.

    What to do if a sickling collapse occurs:

    An emergency action plan and appropriate emergency equipment should already be in place for all practices and competitions. A sickling collapse should be treated as a medical emergency, and the athletic trainer or other medical professional will do the following:

    • Check vital signs
    • Administer high-flow oxygen, if available, with a non-rebreather facemask
    • Cool the athlete, if necessary
    • If the athlete appears to have slowed mental responses, or as vital signs decline, call 911, attach an AED and transport the athlete to the hospital fast
    • Tell the physicians to expect serious complications due to muscle breakdown and byproducts in the bloodstream and kidneys

    Knowledge, education and simple precautions may help athletes with sickle cell trait thrive in their favorite sports. The National Athletic Trainers’ Association has created an infographic handout on sickle cell and athletes. Also, visit for additional sports safety tips for athletes and parents.

    Sailor, ScottEvanSailor, ScottEvan

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    According to new research published by the National Athletic Trainers’ Association (NATA), high school baseball pitchers who also play catcher suffer three times more upper-body injuries than pitchers who play other secondary positions.

    The study was published in the NATA’s scientific publication, the Journal of Athletic Training.

    The NATA reports that pitchers account for 73 percent of injuries in high school baseball players, approximately 10 percent of which require surgery.

    “Clinicians, coaches and parents can use this information to determine secondary positions for pitchers to decrease injury risk,” NATA member and lead author Elizabeth E. Hibberd, PhD, ATC, an assistant professor in the University of Alabama Department of Health Science, says in the study. “Our findings suggest that pitchers should consider not playing catcher as their secondary position in order to allow adequate time for recovery and to decrease their overall throwing load.”

    RELATED: Study: 50 percent of high school pitchers report pain in throwing arm

    While pitch counts are enforced state to state, and informally on a team-by-team basis, the results of this new study indicate that a 2.9 times greater injury risk may result from cumulative throwing load between both pitching and non-pitching activities. On each play, the pitch and catcher is involved, adding to strain on the arms of each.

    Per the NATA report, the objective of the study was to compare the rate of throwing-related upper extremity injuries between high school baseball pitchers who also play catcher as a secondary position (pitcher/catcher) and those who do not play catcher (pitcher/other). Researchers studied 384 male high school baseball pitchers from 51 high school teams over three years. Of those athletes, 352 (97 percent) played a position in addition to pitcher, and 32 (8.3 percent) of them played catcher as their secondary position.

    While the researchers reported 24 throwing-related shoulder or elbow injuries among pitchers during the study period, five occurred in the pitcher/catcher group, resulting in an injury rate of 15.6 percent. Meanwhile, 19 injuries occurred in the pitcher/other group spread among seven other positions, resulting in an injury rate of 5.4 percent.

    As the study found, the proportion of pitchers who developed a shoulder or elbow injury during the three-year study period was 2.9 times greater in pitchers who also served as catchers versus those who did not.

    “Players and adults monitoring their play should use the results of our study and previous research and work with athletic trainers to determine the injury prevention techniques to keep athletes in the game,” Hibberd said in the study.

    According to the NATA, Pitch Smart (an initiative of USA Baseball and Major League Baseball) recommends not playing catcher as a secondary position. Also, Little League baseball prevents pitchers who throw more than 41 pitches in a game from entering as catchers.


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    As athletes prepare for summer sports camp, here are a number of safety tips that parents should consider to ensure a great experience for their children.

    Before they leave for camp

    • Make sure your child has had a pre-participation physical examinations (required by most camps) and that you have completed any questionnaires about existing medical conditions and medications.
    • If your child is on medication, find out who will be in charge of administering it. Make sure the medication will not cause adverse side effects from sun exposure or strenuous exercise.
    • Find out if the camp has medical insurance so you will be prepared in case of an injury, illness or accident.
    • Check any required protective equipment for proper fit and condition, and be sure to pack any ankle or knee braces or other sport-specific equipment your child needs.
    • Be sure that new shoes and equipment are broken in.
    • Pack a water bottle so your child can stay hydrated during activities and in the dorm at night during overnight camp.
    • Pack towels and flip-flops for showers, and remind your child not to share water bottles and towels to prevent spreading illnesses.

    Who will be providing medical care

    • Find out who will provide care to your child in case of an injury or illness. A dedicated healthcare professional, ideally an athletic trainer, should be at the camp to reduce risk and provide emergency care. It is important that medical decisions are made by a healthcare professional, rather than a coach or camp counselor. This eliminates any potential conflict of interest.
    • If your child has a medical condition (i.e., asthma, epilepsy, diabetes, allergy), meet with the athletic trainer or other healthcare professional to discuss the condition and emergency treatment.
    • Determine the parent/guardian notification process in case of injury or illness.
    • Coaches should have proper training and education on key health and safety issues in case an athletic trainer is not available. They should also have CPR, automated external defibrillator (AED) and first aid training.
    • Make sure the camp has an emergency action plan (EAP) specific for every practice and game facility. These plans are developed to manage serious and/or potentially life-threatening injuries and should be reviewed by the athletic trainer or local emergency medical service. Individual assignments, emergency equipment, and supplies need to be included. If an athletic trainer is not employed by the camp, other qualified individuals need to be present to render care.
    • The camp should have AEDs onsite and staff trained in their use. The AEDs should be readily available within three minutes (preferably one minute) during practices and games.

    Heat safety and hydration

    • Before camp starts, gradually acclimatize athletes to warm weather activities over a seven- to 14-day period. They need to work out in the same conditions they will experience at camp. If they will be outside in the heat at camp, they need to progressively phase-in heat exposure and intensity of activity in the heat throughout the acclimatization period. The workouts should be at a similar time and intensity as will be experienced at camp.
    • Have athletes keep water or sports drinks nearby. Individual containers are ideal so drinking is quick and easy during breaks. This will also offer easy access to beverages in the evening, which will help prevent dehydration.
    • A great way to avoid dehydration and hyponatremia is to ensure campers are properly hydrated before they begin an activity by checking these three things: 1) if urine is darker than the color of lemonade – it does not have to be clear; 2) if they are thirsty; and 3) if they are urinating less frequently than normal. If they notice more than one of these inadequate fluid intake indications, they are likely dehydrated and need to increase their fluid intake.
    • Campers should choose their flavor or type of drink and, whenever possible, keep the beverages on ice. They are likely to drink more if they like the flavor and it is chilled.
    • Food and rehydration beverages should include sufficient sodium (enough to replace losses but not an excessive amount) to prevent or resolve imbalances that may occur as a result of sweat and urine losses during physical activity.

    Sun protection

    • For outdoor sports, campers should use a sunscreen with a sun protection factor (SPF) of at least 30. Apply sunscreen to dry skin 15 minutes before going outside.
    • Sunscreen should be applied even if the sun is not out. UV rays can be strong, even on a cloudy day.
    • If campers are swimming or sweating, make sure their sunscreen is water and sweat resistant and reapplied during breaks.

    Lightning safety

    • For outdoor camps, ask who is in charge of monitoring weather conditions and what weather system or app is being used.
    • After the first lightning strike or boom of thunder, whoever is in charge of monitoring should make sure the activities immediately stop; everyone, including campers, staff, and spectators, must seek a safe facility.
    • Once indoors, everyone should stay clear of water (showers, sinks, indoor pools, etc.) as well as appliances, electronics, open windows, and doors.
    • After the final “clap” of thunder and/or flash of lightning, everyone must wait at least half an hour before venturing back outdoors. Every time thunder is heard or lightning is seen, the 30-minute clock restarts.

    Just as parents don’t drop off their children at a pool without a lifeguard, they shouldn’t send young athletes to camp without this vital information. The National Athletic Trainers’ Association has created infographic handouts on sun safety, lightning and hydration and heat illness. Also, visit for additional sports safety tips for athletes and parents.