Jan 29, 2015

Full Coverage

Do club sport athletes warrant the same quality athletic training coverage as their varsity peers? More schools are saying yes.

By Jennifer Chadburn

Jennifer Chadburn, EdM, ATC, is the Head Athletic Trainer for Club Sports at Boston University and an Adjunct Instructor in BU’s Sargent College. She can be reached at: [email protected].

An ankle sprain is an ankle sprain. A quad contusion is a quad contusion. No matter who the injury happens to, treatment is necessary in order for that athlete to return to their previous level of function.

When I took the position as Head Athletic Trainer for Club Sports at Boston University over 10 years ago, this was the answer I gave people who asked, “Why do you want to cover club sports?” In my mind it was just that obvious. And as the years have gone on, my response has remained the same.

After being appointed at BU, it became clear that club sport athletes need athletic trainers just as much as the varsity athletes do. The types of injuries I see now are no different than those I saw during my undergraduate clinical education training that had me working with varsity athletes at NCAA Division I and II schools.

Still, the position proved to be a challenging one–especially early on in my career. Sure, I travel with our club teams to opposing schools, but unlike our varsity athletic trainers, I’m not greeted by the home team athletic trainer, nor is there a cart full of supplies waiting for me. I was forced to become self-sufficient very fast.

With all the good and very little bad, providing coverage for club sports at BU has been a great experience. As more colleges find the same answer I did when it comes to their club sport athletes, I think more positions like mine will become available.

PART OF THE CLUB

When I started here at BU, a graduate assistant athletic trainer was providing coverage for club teams–me. I was trying to juggle both school and my position working with all the club sport athletes. I think this is still a common scenario at colleges across the country, but it’s certainly not an ideal one.

With the support of my supervisor, the Director of Physical Education Recreation and Dance (PERD), I was elevated to a full-time position after obtaining my master’s degree and demonstrating to the department that the large workload I was taking on by myself could not be carried by just one person. Communicating the needs of our club athletes helped prove that it wasn’t working as a one-person job.

I kept track of the number of patients I saw each day, and I made sure the director of PERD knew how many injuries I was diagnosing and treating. I was also in constant contact with our coordinator of club sports, who oversees the daily operations of the club teams.

Educating these two individuals went a long way in helping to establish the need for a full-time athletic trainer. My main selling point wasn’t necessarily the sheer number of patients I was treating, but how increasing the quality of care BU could offer its active student population would create positive value for the university. More students may want to attend BU if they knew there were lots of opportunities to play club sports in a safe environment and with access to an athletic training department.

And then there were two. My arguments were persuasive enough that I was also able to get PERD to support keeping the graduate assistant position in addition to my new full-time spot. Our primary goal was to make sure that the collision sports were covered: men’s and women’s rugby and men’s lacrosse. Besides giving these three teams full coverage, we were also able to accommodate more of the other club athletes during expanded walk-in office hours.

With three collision sports and only two athletic trainers–just one full-time–I felt the quality of care was still lacking. And as the need for more services continued to grow, so did my concerns.

During my first year as a full-timer, there was talk of BU building a large recreation complex that would house PERD (and our athletic training room). But that was years off, so in the meantime, our demand for more space had to be met by altering some basement offices. The club sport athletic training room went from a small room with two tables to a large enough space for several more treatment tables and a rehabilitation area.

With a bigger room, we were able to accommodate more patients, which was great, but as a result, we were in need of more clinicians. If you build it, they will come, right?

We were then able to demonstrate our need for a second full-time position by providing the department with details on the large number of patients we were seeing and pointing out the number of practices and games that were going on with no medical supervision. However, it was a bit more difficult this time around because most of the final decision makers didn’t really know what an athletic trainer did, let alone the role we play in preventive care.

I was able to help the director of PERD do some convincing by writing a letter of justification explaining why I thought there was a need for more athletic trainers. Using treatment data and detailing a few examples of excellent care that were initiated by our services, we were eventually given approval for the second position. After only two years, club sports now had the support of two full-time athletic trainers and a part-time graduate assistant.

ONE UNIT

The most recent development in how we cover club sports here at BU occurred two years ago when there was a move to house all athletic training services under one umbrella. Now, all of BU’s athletic trainers work under one medical director (one of our team physicians).

Our unit is technically housed in student health services, yet athletic training is still its own entity with a separate operating budget. Combining our departments has resulted in better access to athletic training services not only for our club sport athletes, but also for our varsity athletes.

The welcome change was a vision from our director of athletic training services and director of the athletic training education program. They both wanted to move all of BU’s athletic training services under a medical supervision model as they thought it was best for the quality of care we offer our athletes. After a year of lobbying, the partnership was approved.

Since then, I no longer report to the director of PERD, but to the director of athletic training services and a physician. Altogether, BU now has two head athletic trainers (including myself), one senior athletic trainer, five staff athletic trainers, and seven graduate assistants.

One of the best things to come out of the move is that I can now collaborate with or seek the opinions of a dozen fellow athletic trainers if I want to. If I’m stuck on a diagnosis in an athlete who is experiencing back pain, I can go to our athletic trainer who specializes in back injuries and say, “I really need a second opinion on this diagnosis. What do you think?”

Another major benefit is that we’ve all been able to obtain a better work/life balance. With more athletic trainers available for coverage, we are able to balance the workload, grant people days off in the middle of a season, and keep our average hours worked at a reasonable level.

If our graduate assistant who coordinates coverage for club men’s lacrosse has been at every team practice in a certain week and really needs to take Thursday afternoon off to study, she can. One of the other 14 athletic trainers can do it. In the past, that would have been really tough to finagle because there were only three of us to cover club sports.

And besides the staff, the benefits for our club sport athletes have been phenomenal. When I started as a graduate student, I was only able to hold athletic training room hours for two to three hours a day. As we grew, we were able to expand to five hours per day before heading out to practices and games. Now, our open hours are very similar to most other varsity athletic training facilities.

Over the years, BU’s club sports program has grown from a dozen to a total of 32 teams (including co-ed squads). Luckily for our club sport athletes, our coverage system has grown and developed right along with their programs.

CLUB VS. VARSITY

I often get asked whether working with a club sport athlete is any different than working with a varsity athlete. My answer is usually no. Do they want to get back to their respective sport and playing level? Do they want to be pain free? Do they play because they love it? Do their coaches want to win? Of course!

There are no scholarships available for club sports, so it may be true that there is less pressure on the athletes as a result. But in the same way as it is for varsity athletes, club sport athletes often play because it’s part of how they relieve the stress associated with attending a rigorously academic school. Club sport athletes were likely playing in high school, and a lot of them take their games just as seriously as our varsity athletes.

One major difference between club and varsity athletes is access to strength and conditioning. Club sports don’t have their own strength training staff, and I believe that’s why I see plenty of injuries that could have been prevented with maintaining a regular strength and conditioning program.

At BU, we are aiming to improve this situation. We have an athletic enhancement center, which is a strength and conditioning unit run by BU’s college of health and rehabilitation sciences, Sargent College. Though there is a cost associated for anyone who uses the athletic enhancement center, a number of the club teams have joined over the past few years and subsequently seen an improvement in injury rates and boosts in performance–including the men’s rugby team, which in its second year utilizing the strength and conditioning services has seen its injury rate dramatically lowered.

One of the downfalls when it comes to covering club teams is their scheduling. Club sports are lowest on the totem pole, so gym space and turf time comes at a premium. Men’s lacrosse practices are often from 8 to 10 p.m., so our graduate assistant who covers the team sees some pretty late nights in the spring. When this sort of scenario occurs, we make sure to schedule the grad assistant’s morning off to give her a break. We don’t work longer hours than the varsity athletic trainers, just later hours sometimes.

It’s also not uncommon to see a last-minute game schedule change, or have a game delayed because a referee is late. This is a very rare occurrence during an NCAA team’s season. For the covering athletic trainer, we just have to be willing to roll with the punches. It can be easy to forget that not all schools employ a full-time club sports director who does all the teams’ scheduling–it’s often the students doing their own scheduling, and mix-ups do happen.

I will also add that our club sport athletes don’t take the athletic training staff for granted one bit. Most varsity athletes expect they will have access to athletic training services when they arrive on campus, but club sport athletes don’t.

When our athletes see an opposing team has no athletic trainer on its sideline, they take note. It’s a regular occurrence for an athlete I’m treating on a Monday morning to just say, “Thank you for being here.” That’s all I need to know we make a positive difference for these athletes.

Sidebar: OUR CLUB TEAMS

We have quite the variety of club teams here at Boston University. Though some are obviously much more physically intense than others, we do see athletes from all of the following programs.

Badminton Ballroom Dance Baseball Cycling Dance Theater Group Equestrian Fencing Figure Skating Golf Gymnastics In-Line Hockey Jiu Jitsu Kendo Kung Fu Lacrosse Rugby Sailing Shotokan Karate Ski Racing Snowboarding Squash Synchronized Skating Synchronized Swimming Table Tennis Triathlon Ultimate Frisbee Volleyball Water Polo

FEEDBACK: This article identified much of the same process that we went through when attempting to establish an athletic training staff at Colorado State University in our Club Sports program. We had a wonderful [athletic] trainer who worked hard with the contact sports, but conducted office hours for all sports to be seen.

– Marsha Smeltzer