Athletic training

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Athletic training is an allied health care profession recognized by the American Medical Association (AMA)^[1] that "encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of emergent, acute, or chronic injuries and medical conditions."^[2] There are five areas of athletic training listed in the seventh edition (2015) of the Athletic Training Practice Analysis: injury and illness prevention and wellness promotion; examination, assessment, diagnosis; immediate and emergency care; therapeutic intervention; and healthcare administration and professional responsibility.^[3]

Athletic trainers (ATs) generally work in places like health clinics, secondary schools, colleges and universities, professional sports programs, and other athletic health care settings,^[4] usually operating "under the direction of, or in collaboration with a physician."^[1]

According to the National Athletic Trainers' Association, there are more than 58,000 athletic trainers around the world.^[5] The U.S. Department of Labor Statistics projects that employment of the athletic trainers is estimated to grow by 19% between 2018 and 2028.^[6]

The traditional setting for athletic trainers is embedded within a sports team.^[7][8][9] In the United States, over 40% of athletic trainers work at an educational institution, including universities, secondary schools, and middle schools, providing health care to student athletes.^[10][11] Athletic trainers in this setting are commonly present at practices and competitions to be able to serve as first responders and deliver care as needed.^[9] Providing care at practices and competitions commonly leads to long working hours, including nights and weekends.^[7]

Also, in the United States, approximately 18% of athletic trainers work in a clinic setting.^[10][11] This includes sports medicine clinics, outpatient ambulatory rehabilitation clinics, emergency departments, physician clinics, and assisting in surgery, among others.^[9][12]Job duties and responsibilities vary in this setting.

In recent decades, athletic trainers have been expanding into additional settings such as the performing arts, occupational medicine, and public security.^{[9][10][11][12][13]}

The Board of Certification serves as the national certifying body for athletic trainers, and its Standards of Professional Practice outline the roles and responsibilities of certified athletic trainers. The standards include expectations such as "The Athletic Trainer renders service or treatment under the direction of a physician". State law determines the setting, limitations, and restrictions on what athletic trainers can and cannot provide.

In certain instances, patients and clients may require treatment or consultation that falls beyond the scope of an athletic trainer's expertise. In such cases, the athletic trainer's responsibility is to make appropriate referrals to other healthcare professionals. Various supporting health services may be utilized, including school health services, nurses, physicians, dentists, podiatrists, physician's assistants, physical therapists, strength and conditioning specialists, biomechanists, exercise physiologists, nutritionists, psychologists, massage therapists, occupational therapists, emergency medical technicians, paramedics, chiropractors, orthopedists, prosthesis experts, equipment personnel, referees, or social workers.^[4]

"The National Athletic Trainers' Association Code of Ethics states the principles of ethical behavior that should be followed in the practice of athletic training. It is intended to establish and maintain high standards and professionalism for the athletic training profession."^[14]

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The content of the courses will vary based upon the institute and professor, but there are some general subject matters that any AT should know including human and exercise physiology, kinesiology, anatomy, and nutrition. These subjects are commonly studied to increase knowledge regarding athletic training.

Physiology "is the scientific study of functions and mechanisms in a living system".^[15] More in-depth studies of physiology is between human and exercise physiology. Human Physiology is more anatomical structures, exercise physiology is physical exercise conditions and treatments. Kinesiology "identifies stress in our muscles and uses relaxation techniques to release tension and improve our mood, health, and overall well-being" Used in athletic training, focuses more on muscle anatomy and sport focused rehabilitation.^[16] Human anatomy studies the structures on the body including muscular systems, organs, respiratory, bone anatomy, veins, and arteries. This also includes physical examinations of the extremities. Which will include injury recognition, treatment, taping, bracing, and care. After the examination an AT might have to perform acute care of injury. This is implemented when dealing with trauma and illnesses sustained during sport participation. This includes field evaluation of medical emergencies, such as cessation of breathing or circulation, shock, concussion, and spinal injury. After performing care, somewhere down the road athletic trainers may have to provide rehabilitation strategies to go through with the athlete. ATs need to know about basic nutritional principles and concepts that lead to an athlete's personal health, relationship with food and overall optimal health. How a student eats is influential on their recovery time and overall athletic performance.^[17][18]

The Commission on Accreditation of Athletic Training Education (CAATE), under the Council for Higher Education, is the accrediting body for athletic training education programs in the United States.^[19] Only individuals who successfully complete an accredited program are eligible to sit for the certification exam to become an athletic trainer.^[20] CAATE lists all the accredited programs in the United States on their website.^[19] It provides the college's name, contact information, and a link to the institution's website.

An entry-level master's program is a two-year program that covers the material required for an athletic training degree. Standard prerequisite classes are human anatomy, human physiology, kinesiology, biomechanics, exercise physiology, nutrition, personal health, and a certain number of observation hours completed under a certified athletic trainer (ATC).^[19]

There are 15 schools in the US with an accredited athletic training master's program for those with a bachelor's in athletic training who want to pursue further education.^[21] These programs are typically two years in length. While enrolled in one of these programs, the athletic trainer may gain clinical experience and receive a stipend through a graduate assistant internship.

Typical responsibilities for graduate assistant interns include administering daily medical care to selected intercollegiate athletic teams, evaluating and documenting athletic injuries, completing administrative duties, serving as an approved clinical instructor or clinical instructor in a CAATE-accredited ATEP, and assisting the head athletic trainer. Other internships may include working at a high school or clinic, teaching, or researching. Graduate assistant positions are generally around 10-month appointments that may be renewable after the first year and sometimes include additional summer work.^[22]

CAATE evaluates athletic training programs to ensure that they follow the standards for entry-level athletic training programs. Evaluations may take place every three to seven years. Completing the CAATE accredited education program is a part of the criteria that determines a candidate's eligibility for the Board of Certification (BOC) examination.^[23][24]

The National Athletic Trainers Association (NATA) is the professional organization for athletic trainers in the United States. NATA is divided into 10 geographical districts which each appoint their own agendas and board members. Each district consists of about 3-6 states/territories which have a director that serves on the NATA Board of Directors.^[25] Every state has its own state athletic training association that acts similar to the district associations with their own board members. The state associations answer to the district associations and NATA.

Before the formation of NATA, athletic trainers occupied a somewhat insecure place in the athletic program.^[26] Since then, considerable professional advancement has been made in the field.^[4]

As well as the NATA, there is also the World Federation of Athletic Training & Therapy (WFATT) which began in 1998 but was founded in 2000. The WFATT's mission statement includes "Athletic Training & Therapy will be recognized as an essential part of multidisciplinary healthcare teams worldwide". Across 4 continents, 12 countries and in 42 member associations, there's well over 50,000 athletic trainers registered. To start the WFATT, the US and Canada (Canadian Athletic Therapists Association) went and promoted athletic training in various countries through workshops.^[27]

• Media related to Athletic training at Wikimedia Commons