California remains lax on athletic trainer certification


California ranks second to last in high school sports safety and is the only state that does not require certification for athletic trainers

By Patrick Dillon @PDillon_SGN

EXETER – The Exeter Monarchs were playing the McLane Highlanders in a non-league game in Fresno in 2018. Three plays into the third quarter, Exeter’s running back was removed from the for fear of a concussion.

Fortunately the Monarchs have a certified athletic trainer, Nikki Bentley, on staff. She rushed over and provided a sideline evaluation and found no indication of an injury. She went to check the player back in, but was met with a referee barring him from playing.

“The referee told me, ‘you are not a professional,’ and ‘you don’t make those decisions,’” Bentley said.

In fact, Bentley is the medical professional, and is currently in her third year with the Monarchs. She has a bachelor’s degree in Athletic Training from Point Loma University. She also holds a certificate in Athletic Training from the Board of Certification, and works for Pro-PT to provide service to Exeter’s sports teams.

Troubling though, what happened in Fresno that Friday night was not an isolated incident. It was acutally just the latest example of the state-wide lack of education on the importance of certified athletic trainers on the sidelines.

Athletic trainers at high school sporting events is still a new concept, but California seems to be falling far behind everyone else in providing safety to more than 800,000 student athletes—the most of any state. In an article released by The San Diego Union-Tribune titled “Schools falling short in hiring full-time trainers” in 2017, 80 percent of high schools do not employ an athletic trainer full time. There has been little indication that number has declined much in recent years.

The lack of athletic trainers has tarnished the state’s gold standard. Every year, the University of Connecticut’s Korey Stringer Institute ranks every state’s sports safety policies. In 2018, California ranked second to last with a score of 26 percent out of 100. The state that ranked behind California isn’t really a state at all, it is the District of Columbia. To Bentley, the lowly statitic is startling.

“It’s scary that we are still putting our kids in those types of situations,” Bentley said.

Things only get worse from there. California is the only state in the U.S. that does not require an athletic trainer to be certified in order to practice. As many as 20 percent of all athletic trainers are not certified.

“It’s the wild west in California,” said Eric Post, assistant professor at San Diego State University.

Post received his master’s in athletic training from Illinois State University in 2014, and recieved his Ph.D. in kinesiology from the University of Wisconsin-Madison in 2018.

When Post came to California, he was shocked about the lack of barriers in the state.

“There isn’t much stopping someone who isn’t an athletic trainer from praticing,” Post said.

While in Wisconsin, Post was involved in a study that showed residents in largely rural areas have a difficult time accessing the care of an athletic trainer. When they did, it was usually 24 hours after the injury. One problem is that the trainers were only avaliable a few hours a week. The lack of availability can lead to misdiagnoses, or mismanagement of an injury according to Post.

Some of the same difficulties can be seen here in Tulare County. A total of 18 sports programs gave information to the California Interscholastic Federation’s 2017-2018 State Wide Participation Census. Half of the 18 schools reported having athletic trainers on staff. The upside was that all but one, Orosi High School, were certified.

A salary for an athletic trainer would be difficult to work into any district’s budget. Thankfully there are companies like Pro-PT that are beginning to find ways of providing the services of a certified athletic trainer to multiple schools. Besides Exeter, Pro-PT provides athletic trainers to four other schools in the county: Tulare Union, Tulare Western, Mission Oak, and Dinuba High Schools. Visalia Unified employs their own for their four high schools.

As compared to Pro-PT, Visalia Unified’s program only allows a single trainter to service one school, leaving the remaining high schools trainer-less.

“We have the consistency for return to play and communicating with a parent,” said Lacey Harris, Pro-PT’s lead athletic trainer. “I think it is a really good program we have here compared to other areas.”

The consistency and communication are key since the trainers are the first ones to respond if an injury occurs. Athletic trainers are trained to provide emergency care. Then to evaluate, and provide rehabilitation. They sometimes will defer to another practice, but the basic information will already have been gathered.

The upside of an organization like Pro-PT is the insurance that all trainers providing care are certified regardless of state regulations. Bentley has a certificate from a nationwide nonprofit credential agency that provides certification for any entry level athletic training job. it is a process that helps ensure student athletes are treated appropriately, and groups are lobbying to make certification the legal standard.

The California Athletic Trainers Association has been trying to pass legislation for the past 30 years. In 1986 the bill reached Governor George Deukmejian’s desk, but was vetoed. That was the last time the bill had gone that far.

While it is undeniable that parents would rather have a certified athletic trainer than a stand-in with no credentials, it is unlikely trainers will e making the call to return their kids into the game in the future.

According to CIF Constitution 503H: any official, coach, or trainer can remove a player from the field of play if an injury is suspected, and they are not allowed to return until they see a medical doctor, or a doctor of osteopathy.

CIF Central Section commissioner Jim Crichlow says he is doing a favor for trainers by taking on that portion of the game.

“I don’t think that any trainer would want to take on the responsibility of re-entering a kid into a game, and have something more serious happen no matter how trained they are,” Crichlow said.

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