A study recently showed that more than half of California schools either don’t have an athletic trainer who’s fully qualified or don’t employ one at all.

Another recent study reveals that this issue is not just prevalent in California.

It found that 34% of public and private high schools in the U.S. have no access to an athletic trainer. Also, 47% of schools that have access to athletic trainers only received part-time services.

“School districts, school education boards, state legislators and state athletic associations continue to take a reactive, rather than proactive, approach to addressing safety concerns,” Robert Huggins, the lead author of the study, said in a statement.

Similar to the study conducted for California, across the United States there is a difference in care between private and public schools. Among private schools, 45% had no access to an athletic trainer. For public schools, that number is at 31%.

“The safety of student athletes must be the top priority for schools with athletic programs, not just in rhetoric, but in allocation of resources to put the appropriate personnel in place,” NATA President Tory Lindley said in a statement.

The study was conducted by the Korey Stringer Institute. It was published in the Journal of Athletic Training, the National Athletic Trainers’ Association’s (NATA) scientific publication.

For many programs throughout the country, August represents the beginning of another promising season for young athletes. However, as temperatures continue to rise in many regions, so does the chance of heat-related illnesses that can vary in severity from heat cramps to heat stroke, which can be fatal. While not always preventable, even in the fairest of climates, exertional heat stroke can be 100% survivable.  This includes prompt recognition and immediate cooling of the individual to a safe temperature within the first 30 minutes following collapse.

It is important that parents and athletes are informed and ask the right questions to reduce the risk of heat-related illness.

• Does the team follow heat acclimatization guidelines? All athletes need to become accustomed to exercising in the heat. Heat acclimatization involves phasing in activity (duration and intensity) over seven to 14 days to help the body physically adapt to better cope with heat stress.
• Does the team monitor environmental conditions? A medical professional, such as an athletic trainer, should monitor heat-stress conditions with equipment such as a Wet-Bulb Globe Temperature (WBGT) device, which measures ambient temperature, relative humidity, wind speed and radiation from the sun. WBGT readings may warrant immediate adjustments to the team’s practice such as changing work-to-rest ratios, increasing water breaks, modification to equipment (i.e. removing excess clothing), change in length and/or intensity of activity and moving practice times to a cooler part of the day.
• How do I know if my athlete is properly hydrating? Water should be freely available during any sports activities. However, hydration shouldn’t end there, make sure your student hydrates adequately before, during and after activity. If an athlete goes to practice dehydrated, they are already putting themselves at risk for heat-related issues. Tracking urine color can be a good indication of hydration. Pale yellow usually indicates proper hydration.

In addition, all schools or teams should have protocols for the prevention and treatment of exertional heat stroke. Anyone providing sports-related oversight should be familiar with them.  Here are lifesaving measures that the school should have in place:

1. Emergency action plan (EAP). Appropriate personnel (medical staff, coaching staff and athletic administrators) should be familiar with the EAP for exertional heat illnesses and be prepared to immediately activate the plan if an emergency occurs.
2. Cold-water immersion (CWI) tub onsite.  Once exertional heat stroke is suspected, decreasing the athlete’s core body temperature to a normal range via cold-water immersion within the first 30 minutes after collapse is critical. A cold-water immersion tub should be onsite and filled with water prior to the start of activity. Ideally this would be located in the shade or under a medical tent.
3. Medical personnel readily available. Having an athletic trainer or other appropriate medical personnel onsite and available to respond to emergency situations, such as an exertional heat stroke, will ensure timely recognition of the condition and initiation of treatment. The risk of long-term or permanent complications, and even death, is directly related to the number of minutes an individual remains hyperthermic. The presence of an on-site medical professional will ensure proper emergency measures are in place and that an athlete with EHS is cooled promptly and effectively.

Below are different signs and symptoms of the spectrum of heat illnesses.

• Heat cramps: Characterized by painful muscle spasms, sweating, dehydration, increased thirst and fatigue.
• Heat syncope: Fainting in hot environments, usually during the initial days of heat exposure. Other symptoms may include dizziness, light-headedness, weakness, pale or sweaty skin and weak pulse.
• Heat exhaustion: The inability to continue exercise or physical activity in the heat. Signs and symptoms include headache, dizziness, light-headedness, fainting, fatigue, nausea and/or vomiting and weakness.
• Exertional heat stroke: An emergency condition characterized by extreme hyperthermia (body temperature above 104°F/40°C taken with a rectal thermometer) and central nervous system dysfunction (e.g. altered consciousness, combativeness, seizures, confusion, emotional instability, irrational behavior, decreased mental acuity). Other signs and symptoms include nausea, vomiting, or diarrhea, headache, dizziness, or weakness, increased heart rate, decreased blood pressure and dehydration.

Visit National Athletic Trainers’ Association (NATA) for additional information and resources available on hydration, preventing heat illness and exertional heat stroke.

From pre-participation exams to managing season schedules, the to-do list for the average sports parent can be extensive. What may not be on the checklist, but should, is inquiring about your school’s emergency action plan. Every 25 seconds a child visits the emergency room for a sports related injury, so knowing that your school is prepared can provide additional peace of mind that your child is in safe hands.

What is an emergency action plan (EAP)?

An emergency action plan is a written venue-specific plan that outlines what to do and who to call in the case of an emergency — medical, weather-related, active-shooter or otherwise. More specifically, it describes the personnel involved and their roles in an emergency, the communication process, emergency equipment location, transportation guidelines, and response times, among other things. Your school may have more than one EAP.

Whether practicing or playing a home game or on the road, every team should be able to easily access their venue-specific EAP, which needs to be reviewed and maintained by a medical professional, such as an athletic trainer, as well as the school and any other institutions involved.

Why are EAPs important?

EAPs are critical to providing a quick, appropriate and coordinated response in the wake of an injury. Athletic trainers, EMTs, school administrators and coaches should all work together to practice what to do in case of an emergency at least once a year. This preparation ensures that everyone knows their role and correct actions in managing the situation.

What are the important components of the EAP?

• Easy to Find – It should be posted and quickly accessible in the case of emergency.
• Who is in charge – It should have the names and numbers of the people executing the plan along with their qualifications and role once the plan is activated.
• Equipment needed – It should list the equipment needed to carry out the tasks required in the case of an emergency, along with the location where the equipment can be found.
• Communication – It should have an emergency communication plan that identifies who to call in the case of an emergency and where easy access to a telephone can be found. This should also include a plan B in case the designated phone is not working.
• Directions for Transportation – It should have specific directions on how to get emergency services to the activity venue. There should be a map included.
• Where to Go – It should also list the emergency care facilitates where the injured person will be taken. Appropriate personnel at this location should also be included in the creation of the document.

Questions to ask when your sign up your child

• Is there an emergency action plan? If so, where is it posted?
• Will there be a medical professional, such as an athletic trainer, at all practices and games that will be in charge of activating the EAP if needed? If not, who in charge?
• Has the emergency action plan been rehearsed by medical professionals and the local emergency medical service (EMS)? Has it been within the last year?

If the answer is “I don’t know” or “no,” then advocate for an EAP to be created and adopted ASAP. It’s critical that schools understand the critical role they play in providing appropriate care in the event of an emergency. Having a plan helps key members coordinate their roles, responsibilities, and information in a quick, appropriate and coordinated manner, a manner that could very well save a child’s life.

To learn more about sports safety guidelines that should be in place at your school, check out https://pass.nata.org/standards

A series of studies in the Journal of Athletic Training about the effects of being a specialized athlete at a young age left researchers with a distinct takeaway:

Focusing on one sport at too early an age increases the risk of major, career-threatening injury later in life.

“The theory here is that repetitive activity, performing these repetitive sport-specific tasks over and over again, will stress the tissue … and then eventually lead to a breakdown in that tissue overtime,” Dr. David Bell, a professor at the University of Wisconsin who led one of the studies, said in a press conference.

This week, the National Athletic Trainers’ Association is holding its Youth Sports Specialization Awareness Week to raise awareness of the impact of focusing too heavily on one sport and one group of muscles while the body is still developing.

In girls basketball, soccer and volleyball, specialization increased the risk of hip- and knee-joint injuries, according to a study led by Christopher A. DiCesare. In baseball, pitchers who specialized early had a higher risk of elbow and shoulder injuries, according to a study led by Amanda J. Arnold.

“From a developmental standpoint, you need to build the athlete, you need to build overall athleticism, and get kids moving well. This concept of physical literacy – getting them to move well before you’re getting them to move more and at higher intensities,” said Dr. Michele LaBotz, a professor at Tufts University who led one of the studies, said in the press conference with Bell.

“Because if you don’t have that foundation, when you start to build those very specific skills, they’re not going to be able to adapt and they’re going to break down a lot quicker.”

A study also warned that there’s little evidence suggesting sports specialization leads to full-ride college scholarships or professional opportunities. There are outliers, including some who go on to be all-time greats, such as tennis star Roger Federer, but “no data supports” specialization leading to a higher likelihood of doing either, according to a paper in the journal written by NCAA Chief Medical Officer Brian Hainline.

NATA president Tory Lindley, who moderated the press conference with Bell and LaBotz, said a question he frequently hears from college coaches, in fact, is if the athlete of interest played multiple sports in high school.

In a Q&A with parents, Bell acknowledged that youth sports culture makes it tough to get adequate time in multiple sports. Whether it’s a select league like travel baseball or AAU basketball, or coaches’ summer leagues that varsity players often need to play in to prepare for that season, there are other components at play.

“When we talk to young athletes and we survey them, they say, they perceive a lot of benefit from specialization,” Bell said.

Bell recommended playing the sport for eight months a year and taking three to four months off throughout the year. The child should should be active, but taking time off from the specific sport will allow those body parts to relax and recover.

Researchers also recommended playing multiple sports to build different muscles while learning abilities that could apply to the main sport, too.

Jamie Reed, the senior director of medical operations for MLB’s Texas Rangers, was part of the Q&A. He has spent 38 years in baseball athletic departments focusing on elbow, shoulder and spine injuries.

He said the Rangers annually get medical risk assessments of about 575 to 600 draft targets. In 2014, 41 of the players they looked at had a Tommy John surgery in their history. That number rose each year, hitting 109 in 2018, before spiking all the way to 308 in 2019.

Reed said the focus on travel baseball and sports specialization is a cause of this, comparing those body parts to “literally tread on a tire” wearing out the more athletes use them without resting.

“When we’re talking about 5-, 7-, 12-year-olds, it’s gotta be fun first,” Reed said. “Wait until talent is needed before really specializing in anything.”

A study recently showed that more than half of California schools either don’t have an athletic trainer who’s fully qualified or don’t employ one at all.

Another recent study reveals that this issue is not just prevalent in California.

It found that 34% of public and private high schools in the U.S. have no access to an athletic trainer. Also, 47% of schools that have access to athletic trainers only received part-time services.

“School districts, school education boards, state legislators and state athletic associations continue to take a reactive, rather than proactive, approach to addressing safety concerns,” Robert Huggins, the lead author of the study, said in a statement.

Similar to the study conducted for California, across the United States there is a difference in care between private and public schools. Among private schools, 45% had no access to an athletic trainer. For public schools, that number is at 31%.

“The safety of student athletes must be the top priority for schools with athletic programs, not just in rhetoric, but in allocation of resources to put the appropriate personnel in place,” NATA President Tory Lindley said in a statement.

The study was conducted by the Korey Stringer Institute. It was published in the Journal of Athletic Training, the National Athletic Trainers’ Association’s (NATA) scientific publication.