A safer approach to
work, life and sport


All youth athletes deserve a safe environment to play sports. Without a full time athletic trainer, your child might be at increased risk.

Keeping Athletes Safe

Each year, more than 25 million children ages 6 to 17 participate in school sponsored youth or recreational sports.1 There are countless benefits to participating in sports including improved physical health, better grades, higher chances of going to college and overall greater well-being. And while there is the possibility for an athlete to get hurt while playing sports, 85% of parents  believe the benefits outweigh the potential risks.

In high school athletes, there are an estimated 1.4 million injuries sustained during athletic activity annually.2 Studies have found that 40% of life-threatening injuries that occur in children between 6 and 18 years are sports-related. The National Athletic Trainers’ Association (NATA) estimates that there have been nearly 200 sports-related fatalities in youth athletes between 2013 and 2018 alone.3

Minor injuries and illnesses, such as a dislocated finger or sprained ankle, come naturally with participating in physical activity. Serious health concerns, like heat illness, second impact syndrome, exertional sickling and sudden cardiac arrest, can be catastrophic to student athletes (and potentially avoided with appropriate health care). Relying on a coach, school administrator or parent to act in these situations can be, and often is deadly.

Who Is Taking Care of Your Athlete

Athletic trainers are the ideal health care professionals to provide daily medical care for student athletes. Athletic trainers are skilled in the diagnosis, emergency care, treatment and rehabilitation of various injuries and illnesses including concussion, heat stroke, asthma, skin diseases, diabetic emergencies, sudden cardiac arrest and exertional sickling. Athletic trainers are valuable resources in the referral for specialized health care, often expediting the process and making it easier for both the parent and patient. One component  that sets athletic trainers apart from other health care providers is their training in preventative services. Athletic trainers spend countless hours each week ensuring that athletes have the safest environment possible in which they can practice, train and compete. These preventative services include emergency planning; weather monitoring; injury documentation and data analysis; collaboration with coaches; facility and equipment inspection; and patient education.  When athletic trainers are employed full time at a school, they interact with the student athletes on a daily basis and develop a unique patient-provider relationship. This perspective is unique in health care and allows athletic trainers to notice potential health care concerns that may require intervention, such as eating disorders, substance abuse, anxiety, and bullying or hazing.

Most coaches and school administrators do not have the time, education or experience to provide these types of services. This can be detrimental to the well-being of student athletes. This, however, is the reality in many schools across the country. The latest Athletic Training Location and Services (ATLAS) research shows that 34% OF SECONDARY SCHOOLS HAVE NO ATHLETIC TRAINER.4 This means that student athletes at 6,800 public and private schools are currently participating in sports at an increased risk relative to their peers. All student athletes deserve a safe environment to participate in sports – regardless of the school location, schools size, participation numbers or budget. If a school provides athletics, it should provide appropriate health care for athletes as well.

Access Does Not Equal Appropriate

Some might argue that most athletes are safe; technically 66% of schools have some access to an athletic trainer.4 But access isn’t enough in many cases.


  • Provide health care for the 62% of injuries that occur during practice.
  • Provide equal access to health care for boys’ versus girls’ sports.
  • Provide equal access for freshmen versus varsity level.
  • Develop and rehearse emergency action plans.
  • Foster critical relationships with student athletes, parents, coaches, school nurses, school administrators and local emergency services.
  • Facilitate or collaborate with others on the return to play and return to learn protocols for concussed athletes.
  • Track injuries and work with coaches to make necessary changes to practices and training drills.
  • Monitor the weather and environmental conditions to make adjustments for the athletes’ health and safety.
  • Inspect the field and equipment for potential dangers.
  • Assist with preseason conditioning.
  • Serve as an unbiased medical opinion and advocate for the student athlete.

ATLAS defines “full time” as an athletic trainer providing health care services at a school for more than 30 hours per week, more than 5 days per week, more than 10 months per year. This is the minimum amount of time needed to provide appropriate medical care, and often times, for large schools with numerous sports and hundreds of student athletes, multiple full time athletic trainers are necessary in order  to provide this level of care.4 “Appropriate medical care of the secondary school aged athlete individual involves more than basic emergency care during sports participation. It encompasses the provision of many other health care services.”5

In the ideal situation, athletic trainers oversee and ensure all of the following as part providing appropriate health care services:6

  • Determine athlete’s readiness to participate in activity though a pre-participation physical examination
  • Facilities and equipment are safe and clean.
  • Equipment is fitted appropriately and the athlete receives instructions on how to use it safely.
  • Appropriately and safely use tape and other proactive materials to prevent athletic injuries.
  • Monitor weather and environmental conditions to make necessary adjustments to keep athletes safe.
  • Works collaboratively with coaches and the athletic director to develop appropriate policies and procedures.
  • Educates athletes, coaches, staff and parents on important health and safety information.
  • Develops and implements wellness programs aimed to support long-term health.
  • Develops and practices venue specific emergency action plans on a regular basis.
  • Provides on-site health care services with appropriate referrals.
  • Develops, evaluates and/or implements therapeutic intervention plan of health care for athletes.
  • Ensures there is a management plan for at-risk athletes with psychological concerns.
  • Ensures there is a comprehensive athletic health care administration system in place – this helps to protect the health and safety of the student athlete and reduces overall risk for the school.

Solving the Problem

Athletic trainers strive to provide the highest level of health care to their patients in schools across the country. The impact of an athletic trainer simply cannot be duplicated by any other health care provider, however athletic trainers are often limited by time, resources or administrative support.  The student athlete to athletic trainer ratio is hundreds to one in many schools, while the national student to teacher ratio is 16:1, unfortunately leaving the athletic trainer to make the tough decision to prioritize which athletes will receive health care. Athletic trainers are often abreast with the latest research and best practices related to sports safety, but encounter challenges from coaches or school administration when it comes to implementing these policies. Often, athletic trainers do not have the funds needed to properly manage their sports medicine program.

All of these things can increase the risk of injury for student athletes.

We read countless news stories about student athletes who have tragically died because appropriate medical care was not provided, supplies were unavailable, or those in charge did not know the signs and symptoms of the medical emergency. Student athlete lives matter and their health and safety should be a top priority for schools.  Tragedies shouldn’t have to be the catalyst for change. Perhaps more troubling is the fact that, despite the increasing media attention and legal cases holding schools liable for the death or injury of a student athlete, there has been VIRTUALLY NO PROGRESS in the provision of appropriate health care for student athletes in public or privates schools across the country.


Research reveals minimal change in the employment of athletic trainers in public and private schools in the United States from 2016 to 2019.

  • Full time athletic trainer:  35% (2016), 36% (2019)
  • Access to athletic trainer: 67% (2016), 66% (2019)
  • No athletic trainer: 33% (2016), 34% (2019)

Parents, coaches, school administrators and community leaders, don’t wait for a tragedy to occur at your school or in your community to get involved. BE INFORMED, ASK QUESTIONS AND BE AN ADVOCATE FOR SPORTS SAFETY. 

Want to learn more?


The National Athletic Trainers’ Association (NATA) partners with the Korey Stringer Institute to conduct and produce research related to the Athletic Training Location and Services (ATLAS) project. This partnership commenced in 2015 with the groundbreaking “Athletic Training Services in Public Secondary Schools: A Benchmark Study” which described the level of athletic training services in public schools across the country for the first time. This watershed research lead NATA and KSI to collaboratively develop the ATLAS project in order to improve the health and safety for student athletes. The latest published manuscript “title and link to article” shows the slow change in landscape for student athlete health and safety.


  1. Sport & Fitness Industry Association. 2015 Sports, Fitness and Leisure Activities Topline Participation Report. Silver Spring, MD; 2015:26
  2. Rechel JA, Yard EE, Comstock RD. An epidemiologic comparison of high school sports injuries sustained in practice and competition. J Athl Train. 2008;43(2):197–204
  3. Brad D. Endres, Zachary Y. Kerr, Rebecca L. Stearns, William M. Adams, Yuri Hosokawa, Robert A. Huggins, Kristen L. Kucera, and Douglas J. Casa (2019) Epidemiology of Sudden Death in Organized Youth Sports in the United States, 2007–2015. Journal of Athletic Training: April 2019, Vol. 54, No. 4, pp. 349-355.
  4. Robert A. HugginsKelly A. ColemanSarah M. AttanasioG. Larry CooperBrad D. EndresRonald C. HarperKasey L. HuemmeRachel F. MorrisAlicia M. PikeBart C. PetersonRiana R. Pryor, and Douglas J. Casa (2019) Athletic Trainer Services in the Secondary School Setting: The Athletic Training and Locations Services Project. Journal of Athletic Training In-Press. https://natajournals.org/doi/pdf/10.4085/1062-6050-12-19
  5. Appropriate Medical Care for the Secondary School-Age Athlete Communication, 2004.
  6. Appropriate Medical Care Standards for Organizations Sponsoring Athletic Activity for the Secondary School Aged Athlete, 2019.