As Concussion Anxieties Rise, So Do Athletic Trainers’ Ranks

By Jay P. Goldman/School Administrator, August 2015


At the same time concussions among scholastic athletes are receiving heightened attention, a new study indicates just over a third of high schools in the United States have at least one full-time athletic trainer.

The study conducted by the National Athletic Trainers’ Association, “Athletic Training Services in Public Secondary Schools: A Benchmark Study,” appeared in the February issue of the association’s Journal of Athletic Training. (The study is accessible at

 Goldman photo
A recent national survey found 37 percent of high schools nationwide employ full-time athletic trainers. Photo courtesy of National Athletic Trainers' Association.

The trainers’ association, which deemed the results “encouraging,” says 70 percent of U.S. public high schools have athletic training services while 37 percent have full-time trainers. Forty-seven percent of the schools reported providing full practice coverage each afternoon.

By comparison, the group’s 1994 study showed only 35 percent of the schools used athletic training services.

Athletic trainers worked most commonly at interscholastic games and competitions rather than at practices, placing athletes at substantial risk for injury during a large portion of sport participation, the authors noted in their report. According to Safe Kids Worldwide, 62 percent of organized sports-related injuries occur during practices.

That realization is commanding nationwide attention. The National Federation of State High School Associations, the governing body for the rules used in interscholastic athletics competition, convened a concussion task force whose strongest recommendation called for reducing the amount of full contact in practice sessions during the high school football season, including the pre-season. (A summary of the task force report can be found at

During the past five years, the national federation has revised its guidelines for managing a student exhibiting symptoms or behaviors consistent with a concussion and has promoted an online training course for high school coaches on handling serious head injuries. The federation, which reports that more than 1.1 million students played high school football last fall, believes its preventative and treatment measures leave the sport “as risk-free as it has ever been.”

A few states have gone further to protect scholastic athletes. California recently passed a law that limits full-contact practices in football, and Massachusetts mandates specialized training for coaches and collection of concussion data.

However, the biggest disruption to the way school sports operate may come through litigation. The family of a high school football player in suburban Chicago who was allowed to remain on the playing field after sustaining a concussion is suing the Illinois High School Association, which oversees football at 600 high schools. The legal action, according to an account in May in The New York Times, makes it “the first state association that could face class-action scrutiny.”

The suit seeks mandatory baseline testing for all high school football players statewide, stricter guidelines on resuming competition and the presence of medical personnel at practices. The family’s attorney also wants the state association to create a medical monitoring fund to examine Illinois football players who have competed since 2002 for post-concussion symptoms.

Leaders of scholastic sports organizations fear such litigation will spread to other states and will require expensive measures be applied to all sports, not just football.

The wave of attention to the incidence of serious head injuries to scholastic athletes isn’t likely to subside anytime soon. The Colorado School of Public Health is tracking injuries for the National High School Sports-Related Injury Surveillance Study, and a traumatic brain injury research center in North Carolina has taken a special interest in high school sports.

Superintendents can expect to make some unpopular decisions this fall if the recent past is any indication. Last fall, according to news media accounts, high school football games and entire seasons were cancelled in Cherry, Minn.; Colorado Springs, Colo.; Caro, Mich.; and Portland, Ore., because of concerns over the dwindling roster of healthy players. The same drastic actions had to be taken by administrators during the previous few seasons in West Seattle, Wash.; Bay City, Mich.; Lincoln, Mont.; and Plattsburgh, N.Y.

The bleak prospects are most pronounced in small, rural school districts, where limited rosters can be quickly thinned by a few injuries. Participation is reduced further by parents keeping their sons out of high school football because of concussion worries. Rolf Sivertsen, superintendent of the Midland Community Unit School District in Sparland, Ill., told The New York Times: “I worry about the future of football in all rural schools, not only in Illinois but across the country. Every time you turn on the television, all you hear is bad things about youth football.”


Jay Goldman is editor of School Administrator magazine. E-mail: Twitter: @jpgoldman