Sep 7, 2017
A Good Defense
Bryan Grimley

There are many buzzwords that catch the attention of those in the athletic training community. In recent years, one has drawn more attention than most: MRSA. Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterial infection caused by the Staphylococcus aureus germ. It is highly contagious and can cause serious skin/wound infections, pneumonia, or infections of the blood. MRSA, however, is only one of many infectious diseases that can plague an athletic facility. As athletic trainers, we must use a variety of antimicrobial products to protect our athletes from all of them.

What are infectious skin conditions?

First, let’s examine infectious skin conditions. In general, infections can be broken down into three broad categories: viral, bacterial, and fungal.

Viral infections cannot be treated with antibiotics and are caused by ultramicroscopic organisms that require a host cell for survival. Common examples found in the athletic setting are the herpes simplex virus and Molluscum contagiosum.

For disinfecting personal equipment — such as football pads — ensure that the product you are considering is EPA-approved as a viral, bacterial, and fungal disinfectant and that it is safe to use on commonly contacted surfaces or sports equipment.

Bacterial infections are caused by single-celled microorganisms. Many common bacterial infections in the athletic setting are the result of a Staphylococcus aureus germ, or what many people refer to as a staph infection. These can present as many different conditions, but common manifestations of staph infections seen in athletes include impetigo and folliculitis.

Fungal infections are often the result of organisms derived from yeast or mold. Fungal infections are fairly common in the athletic setting and can present as tinea corporis (ringworm), tinea cruris (jock itch), and tinea pedis (athlete’s foot).

Prevention is Key

In athletics, a single case of a viral, bacterial, or fungal infection can quickly spread to multiple participants if left untreated. The best way to address infectious skin diseases is to prevent them before they occur. The NATA recommends a team-based approach for this. No matter the setting, communication is key among all parties. Here are some best practices for preventing infectious diseases:

• Discuss the importance of regular hygienic practices with all staff, including custodians.

• Have a plan for systematic and regular disinfection of your setting, especially of commonly touched surfaces, such as floors, door handles, tables, equipment, showers, etc.

• Have a plan for reporting, documenting, and tracking infectious skin diseases.

• Provide antimicrobial liquid hand soaps in restrooms and at all sinks to encourage frequent hand washing.

• Provide antimicrobial instant hand sanitizers around your facility to encourage hand disinfection when soap and water are not readily available.

• Have guidelines for managing patients/clients/athletes with suspected infectious skin conditions.

• Document safe return to activity.

• Ensure proper treatment and management of the condition once the athlete returns to sport, such as covering the affected area with a dressing.

• Design a management plan that meets clinical standards and protects patient confidentiality.

Selecting the Right Disinfectant

A multidimensional approach to disinfecting an athletic facility is another crucial step in preventing the spread of infectious diseases. When it comes to selecting the appropriate disinfecting agent for your athletic training room, there are many different choices, and it can become a bit overwhelming.

The Centers for Disease Control recommends that any disinfecting agent be approved by the Environmental Protection Agency (EPA) and that all manufacturers’ guidelines for the amount used, its dilution ratio, and contact time be strictly followed. For disinfecting personal equipment — such as football pads — ensure that the product you are considering is EPA-approved as a viral, bacterial, and fungal disinfectant and that it is safe to use on commonly contacted surfaces or sports equipment. If your facility requires the laundering of fabrics, there are also EPA-approved disinfectants that can be used for this task. Simply read the product label, ensure that it is EPA-approved, and follow all the manufacturers’ recommendations for use.

A common cost-saving technique for facility disinfection is the use of household bleach diluted with tap water. The recommended bleach to water ratio is 1:10 (one part bleach to 10 parts water). Although cost-effective, studies have shown that contact with bleach solutions can cause skin irritation. In addition, it is recommended that EPA-approved disinfectants be used instead of homemade remedies, as they are safer and more consistent in combating infectious skin disease-causing agents.

Lastly, ensure that all disinfectants are labeled appropriately and that emergency contamination/exposure/ingestion information is readily available. As a standard precaution, all cleaning solutions should be stored in a secured location that is inaccessible to children.

Following these steps can stop the spread of infectious diseases before it starts. Using the correct antimicrobial products in the correct manner will keep athletes safe and healthy.


1. Prentice, William E., and Daniel D. Arnheim. Arnheim’s Principles of Athletic Training: A Competency-based Approach. Boston: McGraw-Hill Higher Education, 2009. Print.

2. The Centers for Disease Control and Prevention:

3. The National Athletic Trainers’ Association:

4. The Environmental Protection Agency:

Image by Carola K.

Bryan Grimley, ATC, VATL, is Athletic Trainer at Fauquier High School in Warrenton, Va. He can be reached at: [email protected].

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