Jan 29, 2015Q&A with David Andrews
Gig Harbor (Wash.) High School
To say David Andrews, LAT, ATC, has a wide-ranging body of experience would be an understatement. Since graduating from Washington State University in 1984, Andrews has been honing his skills at almost every level of the athletic training and rehabilitation world.
As Head Athletic Trainer at Gig Harbor (Wash.) High School for the past 10 years, he not only provides coverage for hundreds of athletes and oversees athlete rehabilitation at the school, but also runs an athletic training student aide program. Outside of the school, he has spent over 20 years working as an Aide and Clinical Manager at Northwest Sports Physical Therapy, which Gig Harbor contracts its athletic training coverage from.
Andrews has also served as a certified examiner for the NATA clinical boards exam for the past dozen years. Prior to arriving at Gig Harbor, he spent almost a decade as Head Athletic Trainer for two different professional soccer teams.
In what little free time Andrews has left–which even he admits isn’t much–he makes sure the country’s top soccer players are prepared to compete on the international stage. Andrews has been an athletic trainer for the U.S. men’s soccer team since the 1998 World Cup and has traveled with the team to the last three Cups. He also worked as Head Athletic Trainer for the U.S. Olympic team at the Beijing Olympics in 2008.
In this interview, Andrews talks about his many roles and how he sees the athletic training profession evolving in the future. He also addresses the recent spotlight on two major issues facing athletic trainers at all levels: concussions and heat illness.
T&C: How did you get started as an athletic trainer?
Andrews: I was an athlete in high school, so I was around athletics a lot from a young age. When I got to college, I walked onto the baseball team and met the athletic trainer. After watching him, I thought it would be an interesting career, especially since I didn’t think I was very good at baseball–so I went with it.
What are the differences between working with high school and professional athletes?
The way you progress athletes returning from injury is very different. All athletic trainers worry about sending athletes back to play too soon, because you never want to put them at risk for re-injury. But with high school athletes, this concern is magnified.
I’m more conservative with that age group, because we all know there’s more to their lives than athletics at that level, and the chances of a high school athlete going pro are slim. I know that if I push kids into situations they’re not ready for, there’s a greater chance they’ll get hurt.
What do you do when a parent disagrees with your return-to-play timeline?
I have to rely on my confidence, experience, and reputation when I make my decision. I communicate my timeline to the athlete and their parents early, so it doesn’t become a “me vs. them” situation. I let them know I’m not there to stop their child from playing. I’m there to keep them healthy and safe so they can continue to play. If you don’t assure them of that, they can lose confidence in your abilities, and it can turn into a confrontation.
I ask parents what their expectations are for their child’s return, and explain to them that together with their child, they need to balance risk and reward. If a player has an ankle injury and the parents want to push them to return sooner than I think is safe, I tell them I think they’re putting their child’s safety in jeopardy.
Sometimes, I’ll go so far as to film an athlete doing a sport-specific drill. I’ll show the athlete and their parents how they look doing the drill, which drives the point home when they see that they can’t do something they need to do to play effectively.
Has athletic training changed during your time at Gig Harbor?
At the high school level, athletic training has become very popular. If you’re the only athletic trainer at a school, especially if there is a high number of athletes like we have here, you get incredibly busy. It used to be that the athletic trainer put bandages on players, did some rehabilitation, and covered a football game once a week. People didn’t view us as a critical part of athletics. Now, the word is out that athletic trainers are here to treat the athletic population and prevent injuries.
Where do you see athletic training at the high school level in 10 years?
It’s going to continue to grow, especially with the recent spotlight on concussions and heat illness. High school athletic training specifically is also going to benefit because there aren’t as many employment opportunities at the collegiate and professional levels. At those levels, there is generally a head athletic trainer who stays with the school or organization for a long time. I also see many high school athletic trainers taking on additional responsibilities, such as teaching.
How do you work with coaches to prevent heat illness?
Coaches and athletic trainers have to work together because one person can’t keep an eye on 100 kids at once. You need to discuss preventative measures with coaches early in the season, like the importance of taking frequent water breaks and having cold tubs on the field. You also need to make sure coaches are aware of the signs and symptoms of heat illness so they take out players who are exhibiting those signs.
What are the challenges in dealing with concussions?
The main concern I have is making sure kids realize how serious they are, because at this age they often hide their injuries so they can continue playing. The other challenge is with diagnosing concussions. It seems like any time a kid goes to a doctor with a head injury, it’s automatically diagnosed as a concussion without any diagnostic testing.
This is often because the tests are expensive, which I understand. But it means doctors are giving kids who just have some symptoms of a concussion a diagnosis, and the kids are coming back to me asking what they should do and what their limitations are. Those are difficult situations. If I think an athlete has indeed had a concussion, I have to reiterate to them that I’m not trying to be a bad guy and keep them off the field. I’m just trying to keep them safe.
What can an athletic trainer do to help with diagnoses?
We have to objectively evaluate cognitive abilities, because there’s no real way to objectify what it means if someone has a headache. Here at Gig Harbor, we have all athletes take a computerized pre-test before the start of the school year to establish a baseline for their cognitive ability. This gives us data, not only to evaluate if a player has had a concussion, but also to back up what we tell coaches and athletes after a concussion.
One of our soccer players recently sustained three head injuries and both the athlete and her parents wanted her to play, even though her doctor told her she couldn’t head the ball. When I tested her on the computer, two of the seven tests were too far from her original baseline for her to safely play. It was easy to show that to the athlete and tell her why she couldn’t play.
How did you get involved with the U.S. men’s soccer team?
In 1989, I was an athletic trainer for the Tacoma Stars, a professional indoor soccer team, and one of the players also competed for the national team. He gave my name to people at a national team camp and they called me. So I went to Bradenton, Fla., with an under-17 team and served as its athletic trainer for a few weeks, during which time I was evaluated by the team and staff. I was asked to come back year after year and in 1998, one of the national team athletic trainers stepped down, which allowed me to take that spot.
What kind of work do you do at Northwest Sports Physical Therapy?
At the clinic, we do outpatient rehabilitation of surgeries. I work as an aide in the clinical setting, technically as a clinical manager, which I like a lot because it’s a way to connect with patients and share my expertise. We see a lot of different types of people at the clinic, from professional and college athletes to geriatrics.
I think our patients all appreciate that we treat them the same no matter their age or activity level. My goal when working there is to get everyone back to their normal life, whether that’s playing sports, working, or just getting grandma back to being grandma.
Why did you become a certified examiner for the clinical boards exam?
I wanted to give something back to my profession because it’s given so much to me. I don’t have a lot of free time to give anything else, but I thought I could take a few weekends out of my year and help athletic trainers who are trying to learn and get licensed. Over the years, I’ve done this at both the high school level and the state level, and it’s been a good experience.
How do you balance all of your responsibilities?
It’s become my way of life. I don’t want to say I live to work, but this is who I am. And I can’t complain because I’ve created something very interesting. It is tough for me to find a good work/life balance because the time constraints really get a hold of me, but all athletic trainers have to figure out what works for them in their own way. I’ve had my family come to games as spectators just to see me work and see what I do when I’m not at home. I think it has helped them understand my work ethic and see that being involved in sports is a huge part of my life that I love and that is important to me.
What do you find rewarding about your job?
It’s seeing grandma throw out her walker and walk on her own, or seeing an athlete get closer to 100 percent so he can play in the World Cup, or seeing a high schooler overcome an injury to make it to a state championship game. Those things are what drive me. It’s also rewarding knowing people are willing to help you. I don’t know everything, but it’s a blessing to know people all over the world who can help me if I need it.
What’s next in your career?
I’m at a crossroads when it comes to whether I will continue working with the national soccer team. On the one hand, I’m past the point where it’s going to help boost my career and resume, but on the other hand, it’s a part of my life that I really enjoy and if I step back, I know I won’t get the chance to return to the team. Either way, I feel blessed having been able to go to three World Cups. It may be time for someone else to boost their career.
Clarification: In the printed version of this article, we included a response from David Andrews that he would like to clarify.
T&C: How have you adapted to the increased workload at Gig Harbor?
Andrews: In my response to this question I stated, “I must teach students how to do things like taping and evaluating injuries–and then trust those evaluations.” Confusion was formed when people misinterpreted the meaning of evaluation of which it has several layers of meaning. In the Student Program at Gig Harbor High School, and throughout the state of Washington, students do not evaluate injury but they do observe Licensed Athletic Trainers’ evaluations. The students are attending games with the Licensed Athletic Trainer but their role is of observing situations that are present and the supervising LAT is dealing with. They become another set of eyes watching situations that may occur and can bring those situations to the attention of the licensed health care provider. A certified first aider can evaluate minor injuries like a cut and determine the appropriate level of care. Supervision is always present and only Licensed Professionals evaluate injuries that occur.
Correction: The printed edition incorrectly stated Andrews’s title in working with the World Cup soccer teams and the name of the clinic where he is employed. These details have been corrected in this online edition.