Jul 19, 2018
Call to Action
David Csillan

From 2015 to 2017, under the precise planning of Douglas Casa, PhD, ATC, FNATA, FACSM, Chief Operating Officer of the Korey Stringer Institute (KSI), the NATA and the American Medical Society for Sports Medicine hosted three straight “Collaborative Solutions for Safety in Sport” meetings. These meetings brought together state athletic association representatives from all 50 states and Washington D.C., in addition to prominent individuals in the sports medicine field, with the sole purpose of discussing sports safety in secondary schools across the country.

The meetings focused on the four leading causes of death among secondary school athletes: sudden cardiac arrest, exertional heat stroke, traumatic head injuries, and exertional sickling. Attendees were provided with a safety punchlist in order to evaluate and work on improving their state’s safety policies over a three-year period.

Some states expressed difficulty with getting things off the ground. So, in May 2018, the KSI announced its Raise Your Rank campaign, which targets those state athletic associations looking for assistance with improving and implementing current safety policies. Reducing the number of catastrophic sports injuries in secondary schools is the ultimate goal. Following three steps will put a state well on its way to improving the health and safety of its secondary school athletes.


State athletic association health and safety policy improvements can take place only after thorough evaluation of current policies. Presently, no state meets 100 percent of the minimum best practice standards.

The New Jersey State Interscholastic Athletic Association (NJSIAA) prides itself on staying ahead of the curve when it comes to the health and safety of New Jersey’s secondary school student-athletes. Although ranked fourth nationally in following best practice standards, the NJSIAA Sports Medicine Advisory Committee (SMAC) utilized the KSI punchlist to re-evaluate its health and safety policies. Upon noting several deficiencies, the NJSIAA accepted the KSI invitation to participate in the Collaborative Solutions for Safety in New Jersey Sports meeting. In one productive day, our Traumatic Head Injury Policy was improved and three new ones (Heat Participation Policy, Immersion Tub Policy, Strength and Conditioning Policy) were created. Surely, this will increase New Jersey’s national ranking and, more importantly, decrease the risk of catastrophic injury to the state’s secondary school athletes.


Once health and safety policies have been improved or established, state athletic associations should inform and educate member schools through e-mail notifications, webinars, and website “How To” videos on policy implementation. State athletic associations should also collaborate with state athletic training associations to inform secondary school athletic trainers throughout the state.


Now comes the all-important “m” word. New policies can choose the softer route of a “recommendation” or “advisement,” but policies are less likely to get full compliance until they are “mandated.” When a state athletic association issues a “recommendation” or “advisement,” implementation is left up to individual school districts. Unfortunately, if school administrators do not fully understand the need, they are less likely to enforce recommendations/advisements. Also, if coaches are aware that other schools are not following a recommendation/advisement, they will be less likely to comply. A mandate makes everything equal across the board since a penalty is usually attached for non-compliance.


As with any attempts at making policy changes, there may be pushback by state association administrators, secondary school coaches, and old-school parents throughout the state. However, secondary school athletic trainers have a responsibility to maintain a safe environment for their student-athletes. With this in mind, athletic trainers are asked to review and highlight the areas in which their state is deficient. Request an invitation to present best practices at state athletic association and SMAC meetings and present solutions to these deficiencies.

Let’s face it — when playing sports, we all want to win. But when parents sign the consent to permit their son or daughter to participate in interscholastic athletics, they expect the athletic trainer, their school, and their state athletic association to ensure that health and safety is held at the highest regard. For this reason, it is imperative that these three groups understand their role in working together to provide best practices and mandate policies. The state association creates the policies, the high school implements the policies, and the athletic trainer ensures they are enforced.

I understand, as the sole athletic trainer in a secondary school, it’s difficult being an army of one. So I’m asking all secondary school athletic trainers to start at the grassroots level. Educate your athletes, parents, coaches, and administrators. Request invitations to speak at state interscholastic athletic association and SMAC meetings. I once had someone from the media state, “We have approximately eight million students participating in secondary school athletics across the country. Having one die isn’t a bad ratio.” Mathematically speaking, no that isn’t bad – unless it’s your son or daughter. Try explaining that to those parents who dropped their child off at practice one morning, not knowing they would never see them again.

Now that I have your attention, I charge all secondary school athletic trainers, coaches, school administrators, physicians, and state athletic associations to do your part in changing state policies. It will be a difficult task to accomplish alone. So, start by mobilizing the appropriate stakeholders in your state and become active in the Raise Your Rank campaign. Together we can make a difference in decreasing the catastrophic injuries of our secondary school student-athletes. To paraphrase Mahatma Gandhi, “Be the change you want to see.” It must start with you, and it must start now.

For more information, please visit https://ksi.uconn.edu/raise-your-rank-campaign/.

David Csillan, MS, LAT, ATC, is Athletic Trainer at Ewing (N.J.) High School and the Chair of the NATA District Secretaries/Treasurers Committee. He also serves as a member of the Korey Stringer Institute Medical and Science Advisory Board, New Jersey State Interscholastic Athletic Association's (NJSIAA) Sports Medicine Advisory Committee and the NJSIAA Liaison with the NATA and NFHS. Csillan was inducted into the Athletic Trainers' Society of New Jersey Hall of Fame in 2008 and received both the NATA's Most Distinguished Athletic Trainer Award and Athletic Trainer Service Award in 2016. He can be reached at: [email protected].

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