Taking Care of the New Kids

You work hard to provide coverage to your department. How do you keep up as the department brings in new sports?

By Dennis Read

Dennis Read is an Assistant Editor at Training & Conditioning.

Training & Conditioning, 10.6, September 2000, http://www.momentummedia.com/articles/tc/tc1006/kids.htm

The official word always seems to come in the middle of another 12-hour day in the middle of another 80-hour week—your school is adding a new sport. While everyone else is full of smiles and good cheer, you’re trying to figure out how to cover the additional games and practices while envisioning the few open areas still left in the athletic training room filling up with the influx of new bodies.
If you’re lucky, you’ve been involved in the discussion and planning from the beginning, so the announcement is no surprise. Since we don’t live in an ideal world, however, this might be the first you’ve heard of the plan.
Regardless of when you find out about it, adding a new sport will mean changes in your department. Before you can plan for those changes, you’ll probably have to do some learning. For example, it’s imperative that you be up-to-speed on topics such as the common injuries associated with the sport and how they can be treated and prevented, the equipment used, and the supplies you will need.
Few athletic trainers have experience with every sport, and the way sports are constantly evolving, what you learned about a sport 10 years ago may not apply today. So, it’s vital that an athletic trainer first learn as much as he or she can about a sport, then determine what his or her needs will be, before implementing any changes. After all, it’s hard to tell others what you will need and why before you fully understand that yourself.

Education
Even if you have working knowledge of a sport, it’s usually a good idea to confirm your impressions. And don’t make assumptions. For example, you might expect men’s lacrosse and women’s lacrosse to be similar, but they share little except for the ball and the goal. Other sports, like field hockey or water polo, have traditionally been played mainly in certain regions of the country, leaving many athletic trainers in other areas with little exposure to them.
There are many ways an athletic trainer can learn about a new sport. One obvious source would be those colleagues currently dealing with the same sport at their school.
“When we started men’s lacrosse, I called Dave Perrin down at Virginia,” says Brad Jacobson, MA, ATC, the Director of Athletic Training Curriculum at Mercyhurst College and previously the school’s Head Athletic Trainer for 15 years. “Since I know Dave, I told him we had a couple of questions about men’s lacrosse, like ‘How do you handle airway management and what specific injuries do you look for?’ We also contacted other certified athletic trainers who have worked with the sport for years.”
In addition to fellow athletic trainers, coaches can be a good resource for information about a sport and can provide a different perspective than an athletic trainer. “If there’s a local college, you can contact the coach first and then the athletic trainer,” says John Honcharuk, ATC/L, CSCS, Head Athletic Trainer at New Trier High School, in Winnetka, Ill. “I think the coach will be able to tell you the demands of the sport and if there’s a certain mentality [to someone who plays that sport]. I don’t know that an athletic trainer will be as in tune to that only because I have 152 million sports and a coach only deals with one.”
“Our lacrosse coach was a very good resource to help us understand the nature of injuries that may result from the sport,” adds David Webb, ATC, Head Athletic Trainer at Nantucket (Mass.) High School. “But you run the gamut with coaches. Some are very attuned to the care of the athletes and their injuries, and others just leave that job to the athletic trainers.”
It’s not necessary to become an expert in the new sport or learn enough to take over as a coach, but a basic understanding of the hows and whys behind a sport is needed to fill the players’ healthcare needs. “You have to be familiar with the biomechanics of the sport in order to know what’s happening when athletes are injured and to know what’s good technique or bad technique,” says Mark Casterline, ATC, Associate Athletic Trainer at St. Lawrence University. “Because, if you’re trying to simulate functional training or functional rehab and you’re doing something that’s not functional to the sport, it may be counterproductive to the rehab process.”
In many programs without a strength and conditioning coach, the athletic trainer will also need to bone up on the training demands for that sport. But even where there is such a coach, it pays to be well-versed in this area.
“The coaches generally deal with all the strength and conditioning, but I’m looking at it from an injury-prevention standpoint,” Casterline says. “Strength and conditioning coaches are great with respect to that—really addressing areas so we won’t see athletes in the training room all the time for the minute chronic things or acute musculoskeletal types of injuries.”
“Some coaches even give me their offseason conditioning plans,” Honcharuk says. “Those are a great resource because they indicate what the coach demands from the athletes. From that, you can learn the kind of conditioning drills they like to do and what you’re going to see in the body physiologically.”
Regardless of your information sources or the specific sport, the type of information you will need to obtain remains fairly consistent. The most important involves the staple of day-to-day life for an athletic trainer: injuries.
“The primary focus is critical-injury management,” Jacobson says. “From there, we get into the secondary stuff or what non-catastrophic injuries have to be dealt with.”
“You need to look at the injury rate and whether they’re overuse or acute injuries,” Casterline adds. “Crew, for example, is notorious for being a huge overuse sport.”
Then there is the toll a new sport will take both on time and materials. “I want to know what the demands are going to be on supplies and staff during the course of a season,” Webb says. “How many boxes of tape am I going to need? What am I going to need for athletic coverage during game time? What kind of supplies should I have on hand? What are the most common and frequent injuries that we’re going to see? What should we be prepared for regarding the scope of injuries? Those were our concerns.”
In addition to anecdotal information from colleagues and coaches, there are some sources for objective information. The National Athletic Trainers’ Association has developed guidelines for determining the appropriate levels of medical care for college athletes. (This is available at its Web site, .) The worksheets recommend staffing levels based on the sports offered within a program, roster sizes, season lengths, and outside duties.
Even though the guidelines were designed for college programs, some high school athletic trainers are using them to gauge the needs of their programs. “The athletic trainers in our conference who are adding sports have said this is a great tool to take a look at,” Honcharuk says. “The first argument out of most people is that if you’re not a Division I school, you can’t really use this. But while the injury incidence rate might be a little bit different, it does give you an outline from which to work.”
The NCAA Injury Surveillance System was used extensively in creating the NATA guidelines and is another helpful resource for athletic trainers looking for objective injury information. It is available at the NCAA’s Web site, at .
Numbers provide only part of the picture, however. Most sports have their own little idiosyncrasies that only an experienced athletic trainer can tell you about. For example, people unfamiliar with lacrosse may incorrectly assume the helmets used are similar to football helmets and can be treated the same way.
“With a football helmet, you can remove the mask very easily to access the airway,” Jacobson says. “With a lacrosse helmet, it’s a different situation because of the way the mask is attached to the helmet. There’s always the controversy of, ‘Do you leave the helmet on or take it off?’ So that was our biggest concern with lacrosse.”
There are other ways that equipment, including helmets, is a concern when a program adds a new sport. “I may not have to fit the equipment, but I am still responsible for it,” Honcharuk says. “So when I first looked at lacrosse equipment, I asked about the intricacies and subtleties there: Does the school provide all the equipment? Is it something that has to be NOCSAE (National Operating Committee on Standards for Athletic Equipment) certified on a regular basis? Is there a maintenance schedule?”
Obviously, the earlier you find out about a new sport, the better you will be able to deal with it. It pays to keep an ear to the ground, and check in with the decision-makers regularly.
“It may even be wise for the head athletic trainer to go to the athletic director and ask, ‘What’s in the making for next year?’” Jacobson suggests. “‘Are there any ideas of adding new sports?’”
Fortunately, few sports are added out of thin air. Usually, a sport has had some presence on campus before joining the athletic department fold, often on a club or intramural basis. This provides an athletic trainer with the opportunity to learn about the sport first-hand before taking full responsibility for it.
“Prior to becoming a varsity sport at our school, it must have been a club or intramural-type sport within the school environment for the previous three years,” Webb says. “Although we might not be working directly with the club teams, we have the opportunity to observe and learn. At times, during the growth stages, we would be hired to cover a game. So when the lacrosse club presented its proposal to the school, we were able to sit in on it and learn the needs as it was developing.”
“When we found out the sports that were going to be added, we started clearing their players under our umbrella during the final club season and working into their first season under the athletic department,” Casterline says. “That way, we could start becoming aware of who they were and get to know them a little better.”

Communicating Your Rules and Needs
Working with a club team headed for varsity status, even on a limited basis, can be an effective way to absorb a new team into your day-to-day operations. But don’t overlook the importance of laying out the athletic training program’s guidelines in detail as the sport joins the athletic department. Training room access and game coverage will be new to these players and coaches, so don’t assume they know what your rules are.
Since players and coaches coming from a club environment have done without athletic training services for so long, they may need a little coaxing to avail themselves of all the services that are available. “We explain what our services are, what our hours are, when we’ll see what, and what will be covered,” Casterline says. “But you really have to educate them, because oftentimes they don’t know what to do. They’ve always just gone down to the general health center for an ankle injury.”
Of course, new teams usually mean new coaches. So, in addition to learning a new sport, athletic trainers are getting to know new people. “There has to be a game plan for educating the coaches,” Jacobson says. “At Mercyhurst, the primary focus is on the in-season sports, which we cover on a day-to-day basis. During any non-traditional practices or events, the coach is the first-aider and will call us via walkie-talkie if our services are needed.
“It’s also important that coaches understand there is an emergency action program they have to follow and they have to understand what that protocol is,” Jacobsen adds. “Because if they’re going to be a first-aider, they have to know what to do. And they have to be first-aid and CPR certified.”
“The biggest thing is to have a real open relationship with the coach and be able to share knowledge between the both of you,” Casterline suggests, “and sometimes, that’s tricky. But the smart coaches today are utilizing the athletic trainer to the fullest extent for more than just plain athletic training services. Each person is different, so you might have to approach him or her with a different tack.”
While communicating with new coaches and players will be a priority, the most important exchange will occur with the athletic director. Once you’ve determined the impact a new sport will have on your operation, it’s time to present those findings to your boss and lobby for whatever extra resources you may need.
“Before we added the new sports, we sat down with the administration and discussed the budget increases, increases in medical kits, and increases in supplies that we would need,” says Casterline, adding that the school hired another ATC when the new sports came aboard. “That was all taken care of through the administration, and I think they did a pretty good job. But I’ve talked to people where the school has added teams and forgotten about the athletic training room or equipment room.”
An important part of the discussion will be how other parts of the program may be affected by the addition of the new sport. Will it mean cutting back on coverage for other sports? Or possibly opening the athletic training rooms a couple of hours less to account for an increased number of night games?
“It’s important that the administration know that if it’s a high-risk collision sport being added, like lacrosse, it may warrant direct coverage,” Honcharuk says. “And that baseball, softball, badminton, or whatever, even on a varsity level, might lose out to a j.v. lacrosse game. It may be a great time to say, ‘Imagine all the sports I just named that are used to having someone there, and now they won’t get anyone. Maybe it’s time to get another athletic trainer.’ There’s an opportunity there.”
Not all schools will be able to add a new athletic trainer along with new teams, but there’s probably no better time to ask. To make your case, be sure you have plenty of evidence. Hard facts from the NCAA Injury Surveillance System and the NATA guidelines will likely carry more weight than plaintive cries, regardless how justified, of ‘Now I have to work even more.’
“That doesn’t give them any numbers,” Honcharuk says. “It’s better to say, ‘I’m looking at 14 extra evenings this spring, which means fewer hours the training room is open during the day.’”
Don’t forget the ancillary expenses as well. It’s easy to overlook the effects a new sport will have on the team doctor or ambulance services, but those also need to be factored in. “Our team doctor added a partner because he was getting overwhelmed trying to cover all the home events,” Jacobson says. “He’s at 95 percent of our home events and he was just getting swamped.”
Anyone planning for the future should also keep in mind that new teams are often dynamic, especially in sports with open-ended rosters, such as track and field or fencing. “You may think with adding a crew team that you’ll have only 20 new athletes,” Casterline says. “But if a coach comes in and is knowledgeable and a good recruiter, 20 athletes could turn into 60 in a couple of years. So, plan ahead—look at not just the staff today, but also the staff two to three years down the road, because your numbers could increase substantially.”
Despite the headaches and demands a new sport can create, most athletic trainers support adding them, at least in theory. When theory meets reality, though, it can often be hard to remember the benefits of having more teams under the athletic department umbrella.
“I don’t think there is an athletic trainer out there who is going to deny that the kids are safer in an [organized] event than not in such an event,” Honcharuk says. “So most athletic trainers would like to see sports and activities added. The challenge becomes accommodating that sport.”
But it’s a challenge worth meeting.