By Dennis Read
Dennis Read is an Associate Editor at Training & Conditioning. He can be reached at: dr@MomentumMedia.com.
Training & Conditioning, 15.6, September 2005, http://www.momentummedia.com/articles/tc/tc1506/answers.htm
Coaches sometimes say the best thing about freshmen is that they become sophomores. That’s because there are certain lessons that only experience can teach. Fortunately for athletic trainers, that experience doesn’t always have to be their own.
During this year’s NATA Annual Convention in Indianapolis, we asked athletic trainers what advice they would like to get from those who have been in the profession longer than they have. We passed these questions on to respected veteran athletic trainers, including NATA board members and Hall of Famers. Their answers are presented below.
How do you avoid burning out?
Marjorie Albohm: It’s important to pace your work and always make time for yourself and family. Sometimes you actually may need to block out time in your schedule for you. The hours of athletic training are extremely demanding. You have to carefully plan your schedule and talk with your supervisor about release time before it becomes a critical issue.
Mike Sahm: You have to budget your time well and learn to say “no.” If someone asks you to work late or do something extra, and you don’t have time to do it, you have to tell them “no,” even though that may be hard to do.
Jenny Moshack: One of the most important things is to have balance in your life—you cannot survive on athletic training alone. You need to get out of the work environment and find some different activities—go see a play, visit a museum, go hiking, anything that takes you completely away from athletic training. Sometimes the best time to do this is while you’re traveling with a team. There’s a lot of wasted time on the road that can be used to take care of yourself.
Another thing that helps is to learn as much about counseling as you can. Not only will this help your student-athletes and staff, but it will allow you to do some self exploration. Athletic training is a high-burnout profession, and if you’re not taking care of yourself mentally and emotionally, you can’t effectively take care of others.
Tara Lepp: Learn to recognize the symptoms of burnout so that you can do something about it before it consumes you. Some typical symptoms are: depersonalization, which is a lack of concern for the people you work with; emotional exhaustion; and lack of personal accomplishment. In other cases, it may be your job becoming your life instead of being part of your life.
And then take steps to address the problems. You might have to change some of your behavior or meet with your administration and see what you can do about changing your hours. You should also make sure you have a life outside of athletic training and take time to exercise and relax so you can maintain your health.
Joe Iezzi: You have to prioritize family and work—in that order. Otherwise, you will become consumed by the profession. When I was working at the collegiate level, I tried to keep a healthy balance by being with my children at times when other fathers couldn’t be with their children. Since I had a different schedule, I could spend some time with them before I went to work.
You can also look for a job that fits your situation. For example, I went from college to high school and now I have Sundays off and don’t travel as far as I used to. I have no overnight trips and weeks away from my family.
James Thornton: One of the most important ways that helps prevent burnout is to educate administrators about what athletic trainers do. They need to know that the athletic training room is open at 7 a.m. for rehabs and we’re there until 10 at night. The bottom line is we have to educate our administration so they can have realistic expectations of what can and cannot get done.
How can you learn to interact with higher-ups in administration?
Rod Walters: You should always be professional, as this carries so much weight. Regardless of how busy you are or what the situation is, be poised and communicate well. In addition, always maintain ethics, as this is what guides us and keeps us doing the right things.
Jenny Moshack: One of the challenges in our profession is that no one teaches you how to be a supervisor. Instead, an administrator recognizes that you’re very good at your job, you’re promoted, and suddenly you’re a supervisor and a manager. My advice is to take advantage of human resources courses that are offered within your institution, whether they’re on time management, efficiency, leadership, or supervision skills. A lot of these courses also explain the inner workings of the university and help you speak the language of your administrators. Once you start speaking about budgets, hiring and firing, management of people, and performance reviews in their language, you’ll be operating on the same level as those administrators.
James Thornton: The main thing is to act like a medical professional, because that’s what you are. When you act professionally, it is much easier to approach and interact with administrators. To do this, you also have to truly think of yourself as an administrator. Once you’re comfortable with being an administrator, approaching other administrators will be much easier.
Maria Hutsick: Find someone who is willing to mentor you, which can be your Head Athletic Trainer, an athletic trainer at another school, or even a coach or athletic administrator. Call them when you have a question and discuss it with them. People are very willing to offer advice or share their experiences. I looked up to the older athletic trainers in my conference and always called them when I had questions. I also got involved with the NATA on a national level and then with CATS. The people I met mentored me and taught me how to operate in a political realm.
How do I know what products to buy and where to buy them?
Jenny Moshack: So much of purchasing depends on university rules, but the biggest thing you can do is establish relationships with vendors. Those folks can often lead you in the right direction and really work with you, whether that means giving you a deal or taking shipping charges off your orders. Once you find vendors who are good to you, you’re golden.
Keeping up with all the products out there can be difficult, but if you pay attention you might see something different at another institution that works better. It might be something as simple as good ice bags that never leak. Your colleagues can serve as your product testers and let you know what works and what doesn’t.
James Thornton: A lot of it is dictated by budget, as well as bidding processes that athletic trainers have no control over. If athletic trainers want a specific brand of product and have to send it out to bid, then they must spec out that product and make sure that it cannot be replaced or substituted with something else.
I make a lot of the decisions about who I ask to bid based on whether or not they are involved in the development of my profession. The NATA is there to promote the profession of athletic trainers, so I support companies that support the NATA.
Apart from working at a college athletic department, what other career options should athletic trainers consider?
Bill Prentice: Right now there’s so much diversity in job opportunities for athletic trainers. There are many opportunities in high schools, which can be better places for athletic trainers in terms of pay and the number of hours that they’re required to work. Many athletic trainers are also working in sports medicine clinics in the military and in private medical offices as physician extenders.
There are also a lot of possibilities in education, because the number of accredited programs is growing and there’s a need for faculty members. Most institutions are looking for people who have a terminal degree, either an EdD or a PhD, but right now there’s not enough of those individuals. So many institutions are hiring individuals who have a masters degree to function as a program director and encouraging them to seek their terminal degree in the future.
Marjorie Albohm: I’ve been in a clinical setting, specifically a physician-owned orthopaedic practice, for 23 years. Although there will always be things that I miss by not being in an academic environment, I have learned so much about the business of health care and have grown so much personally and professionally. As a senior administrator, I am in a key decision-making position that allows me to develop clinical models for athletic trainers that can be shared nationwide.
Joe Iezzi: When I came out of school, there was basically the collegiate level and maybe the pros. Now there are so many other options, such as high schools, physician extenders, sports medicine clinics, and different sports such as rodeo and auto racing. Or you could be an entrepreneur and start your own business.
If people aren’t sure what they would like to do they can observe or go to grad school and see if one setting fits them as far as time and commitment and family. Some people say they couldn’t work in a clinic 9-to-5 because they have to be out on the field. Others don’t want to be on the field and working nights and want to be in a clinic working one-on-one with patients. Explore what options work for you.
Justin Miller: Don’t be too picky when you’re looking for a job and think you have to work in one particular setting. Go out and get the job that seems most interesting. Then you can get some experience and have a better idea of exactly what settings you like. And if you have an interest in working at the high school level, get your teaching license. It will make getting a job that much easier.
How do you learn to manage your time?
Bill Prentice: Today’s athletic trainers need to think of themselves as time managers. It’s critical to establish priorities based on doing the job you’re hired to do. The key is to figure out, “This is something I really need to take care of, and that is something I can let slide a little bit.”
Marjorie Albohm: Organizational skills are critical to time management. That means organizing your work place and your schedule. You also must try to manage and minimize interruptions. That’s difficult for athletic trainers, but we really don’t have to be everything to all people, all the time.
Jenny Moshack: I think the biggest thing is setting up a system. We’re always going to have things that interfere with our time, like emergencies and practices that get rescheduled. But you still need to plan as much as possible. There are athletic trainers out there who are more than willing to share information about their written policies and procedures, or talk about how they do things. See what fits within your system and then tailor that plan to work for you.
It’s also important to use time as productively as possible. I take my laptop to practice so I can get some work done while the team is watching film or before they start practice. This way I’m being productive, instead of sitting there waiting for them to come out of the locker room.
Andy Paulin: I was once told, you can’t “manage time,” it marches on whether you are ready or not. I have found you must start your day with a few quiet minutes to prioritize your day, and rate your tasks A, B, or C. Then you’ll have a much clearer picture of your day and your ability to manage your tasks, not time.
Maria Hutsick: I learned to delegate my duties and work on eliminating those tasks that really don’t belong in a healthcare setting. I listened to The Seven Habits of Highly Effective People, which gave me a framework in dealing with people and setting my own goals. I also follow the One Minute Manager, which helps me manage staff, students, and coaches.
When it comes to rehab and strength training, are there simple exercises that are just as effective as those requiring elaborate machines?
James Thornton: Weight machines often isolate individual muscles and have an athlete work out in the sagittal plane only. We use multi-planar exercises such as single-leg squats or lifting and chopping movements in the front, sagittal, and transverse planes. These are drills that require nothing more than dumbbells, and they are specific to the way athletes move every day.
I do not recommend using machines for isolated strength movements because increases in strength don’t always result in increases in performance. An offensive lineman who improves his bench press by 30 percent can still fail when he’s standing on two feet and trying to push back a defender. I’m going to train a lineman standing up using tables or pulleys so he can activate other musculature in his body in different planes of movement and increase his performance and not just his strength.
Young athletic trainers who are looking to supplement the wonderful education they get in our curriculum programs should look at the National Academy of Sports Medicine’s Performance Enhancement Specialist certification. I think it’s the single most effective course for showing how to take advantage of exercises that do not require a lot of equipment.
Bill Prentice: We are really getting away from using elaborate machines. We have found that when you’re performing athletically you have to be able to adjust and adapt to a variety of different forces and stresses coming at you from all different angles, and you have to be able to balance yourself while doing that. If you’re working on a weight machine, the design constraints limit what kind of forces you have to exert and it doesn’t simulate a real-life situation.
For example, one of the things that everyone is doing right now is core stabilization. Instead of putting athletes on a machine for a resistance exercise, we have them working on a ball in multiple planes using a variety of different types of resistance simultaneously. They have to balance and maintain some postural stability while they’re doing those exercises.
What direction would you like to see the profession of athletic training go in?
Rod Walters: I am so proud to be an athletic trainer. I want to see this profession continue making a positive impact in the healthcare arena. Athletic trainers are key components of the entire healthcare team—and I only want to see this continue to improve.
Andy Paulin: I strongly support the path we are taking in creating jobs and placing certified athletic trainers in environments where they have never been before. I also support the more formal educational process that is in place. What I would like to see is a little more of what the quality internship programs used to do—really expose students to the good and bad of all of the clinical rotation sites and show them more about what is not in the textbook.
Dan Wathen: I like the direction that our profession is going. I see more evidence-based decision making now, which is refreshing and less frustrating to those of us who always think about why we do things the way we do.
Maria Hutsick: I would like to see the next generation of athletic trainers continue to build the profession into a strong and well-respected vocation. This means we must continue to play an important role in the health and welfare of the athlete. We also need to keep educating administrators that our profession helps keep them out of the courts and is a vital part of an athletic department. As this happens, they will start to pay us more money and allow us to work more humane work schedules. However, we have to continue to demand respect and maintain a high level of professionalism, which includes not taking jobs that pay less than an unskilled laborer would make.
Scott Sailor: I want athletic trainers to continue to gain recognition for the outstanding contribution we make to the health care of society. I also want to see athletic training salaries fall in line with the high level of training we possess. I believe this is occurring and will continue to get better as the profession continues to grow.
How should functional screening be used in return-to-play decisions?
Dan Wathen: Functional testing and screening is just one element of the return-to-play decision-making process. But it is a critical element, as no matter how well an athlete is doing clinically, they must be able to perform functional activities that are germane to their sport prior to being cleared.
Scott Sailor: I believe the athletic trainer is the individual best suited to evaluate athletes regarding return-to-play decisions. We will constantly consult with the individual’s physician but no other professional is as well-versed in the demands of activity as we are—especially athletic activities. Other rehabilitation professionals often lack the biomechanical background and kinesiological preparation of the athletic trainer.
Jenny Moshack: First, make sure you establish functional screening criteria with your physicians. Will they leave the decisions up to you or do they need to be involved? Do they want some iso-kinetic testing to back anything up? The biggest things are getting as sport-specific as possible and not letting athletes go full-bore in practice too early. Get them into controlled practice situations first and go slow. For example, have them do every other drill instead of every drill. Then keep an eye on them, and if it looks like they’re in pain, pull them.
How do you continue to make the job exciting? How do you have fun?
Dan Wathen: For me, it’s always a challenge to keep abreast of new findings in the field and then to educate those I work with and for about those findings. Our profession, like others, is a journey to seek truth. That’s exciting to me. I also try to bring a sense of humor to most situations, which allows me have fun and bring joy to others.
Maria Hutsick: I learned that if you have a good staff and a good administration, then the job is what you make it. Who you work for can be more important than how much money you make. The number one thing I say to a young person is to pick a place to work where the head athletic trainer is interested in developing their assistants and will fight for them.
If those things are in place, athletic training is an exciting and very rewarding profession. I enjoy working with the athletes and my staff and watching younger athletic trainers develop. To keep it fun, I try to stay current, challenge myself, and look for new ways to stay in step with the profession.
Scott Sailor: I have fun by trying to learn new things every day. I constantly look for ways to get better at my job. One of the great things about athletic training is that it’s so practical. It’s great to find out something new and then use it to help someone else.
Mike Sahm: You always have to be ready to learn in this profession, because there’s always something new. Either you’re moving ahead or falling behind, and it’s more fun to be moving ahead.
The following athletic trainers served as our panel of veterans.
Marjorie Albohm, MS, ATC, LAT, is Director of Business Development and Orthopaedic Research at OrthoIndy and The Indiana Orthopaedic Hospital in Indianapolis. A 1999 inductee into the NATA Hall of Fame, Albohm is a past Vice-President of the NATA.
Maria Hutsick, MS, ATC, LAT, CSCS, is Head Athletic Trainer at Boston University. Hutsick has been involved in athletic training since 1976 and has served on the NCAA Competitive Safeguards Committee.
Joe Iezzi, MS, ATC, NASM-PES, is Head Athletic Trainer at Downington (Pa.) High School West. Iezzi is a past member of the NATA Board of Directors.
Tara Lepp, ATC/R, is an Associate Professor, Head Athletic Trainer, and Athletic Training Program Director at Linfield College. She made a presentation titled “Strategies to Avoid Burn Out and Enjoy Work” at the 2005 NATA Meeting in Indianapolis.
Justin Miller, ATC, LAT, CSCS, is Athletic Trainer for St. Vincent Sports Medicine and serves as Head Athletic Trainer at Lawrence Central High School in Indianapolis.
Jenny Moshack, MS, ATC, LAT, CSCS, is Assistant Athletics Director for Sports Medicine for the University of Tennessee women’s athletic department. Moshack is entering her 15th year at Tennessee where she works directly with the six-time national champion women’s basketball program.
Andy Paulin, ATC, is Athletic Trainer at Mt. San Antonio College. He is also an Athletic Trainer for USA Track and Field and the District 8 Representative to the NATA Board of Directors.
Bill Prentice, PhD, PT, ATC, is Professor and Coordinator of the Sports Medicine program at the University of North Carolina. A member of the NATA Hall of Fame, Prentice serves as athletic trainer for the 18-time NCAA champion Tar Heels women’s soccer team in addition to his duties as an educator.
Mike Sahm, ATC, is Head Athletic Trainer at Roncalli High School in Indianapolis. Sahm works closely with the Roncalli football team, which has won three straight state titles.
Scott Sailor, EdD, ATC, is Assistant Professor in the Athletic Training Education Program at California State University, Fresno. Sailor is the NATA District 8 Secretary.
James Thornton, MS, ATC, NASM-PES, is Head Athletic Trainer at Clarion University. Thornton has been at Clarion since 1990 and recently became the District 2 Representative on the NATA Board of Directors.
Rod Walters, DA, ATC, is Assistant Athletic Director for Sports Medicine at the University of South Carolina. A 2005 inductee into the NATA Hall of Fame, Walters has overseen the athletic training department at South Carolina for 16 years after serving as Head Athletic Trainer at Appalachian State University for 11 years.
Dan Wathen, MS, ATC, CSCS, NSCA-CPT, is Head Athletic Trainer at Youngstown State University. Wathen has been at Youngstown since 1976 and was President of the National Strength and Conditioning Association from 1998-2000.