Jan 29, 2015
High School Story

A couple of weeks ago, T&C blogged about a study conducted by the Chronicle of Higher Education that surveyed NCAA Division I head athletic trainers, head football athletic trainers, and other sports medicine professionals, reporting that nearly half of the 100 or so responders indicated they have felt pressure from football coaches to return concussed players to action before they were medically ready. Does the same hold true at the high school level?

In response to our blog, we received a letter from a current high school athletic director who is also a certified athletic trainer. In it, he shared the story of losing a previous athletic training job at another high school because he made medical decisions that were not embraced by the school’s head football coach.

By Steve Friebus, MEd, ATC, LAT

I am a certified athletic trainer who is also currently a high school athletic director. Years ago, I basically lost my job at another high school because of the reasons mentioned in the Chronicle of Higher Education study. At that school, the head football coach was also an assistant athletic director and was my immediate supervisor. I knew there was a conflict of interest when he expected me to cater to his sport regardless of whether it was in or out of season over other sports. There were times when he felt that athletes were faking injuries, including concussions, even though I had objective data from ImPact tests, SAC, and BESS tests that showed otherwise.

I could have a doctor’s note withholding an athlete from play and he would try to get me to clear the athlete or find a doctor who would. He would tell athletes not to tell me about an injury so they could continue to play. I would have athletes and their parents tell me how the athlete was pressured to play or risk being ostracized by coaches and teammates. At practices, injured athletes were forced to wear a colored target jersey on the sideline so all could see they were “injured” as if we didn’t know who they were.

In one instance, a player in a foot cast for a stress fracture who was non-weight bearing had to stand the entire two-and-a-half hour practice on the other foot because he had to be out there as part of the team and players are not allowed to sit during practice. Another who had a concussion was not allowed to stay indoors, but was supposed to be doing “mental reps” at practice in the bright sun and 105 degree heat. Not until the doctor wrote a note that said he had to stay indoors during practice did the coach relent. This coach went to the head AD and said he wanted me gone.

Meanwhile, the head athletic director didn’t want a confrontation and the superintendent didn’t want to get in the middle of our situation, so the district decided to “go in another direction” with the sports medicine program and I was let go.

If you look around the high school athletics landscape, many athletic directors are ex-coaches who have no medical training other than a 25-hour Care & Prevention course or a CPR certification. Most have no idea how to run a medical program and treat athletic trainers as subordinates to the coaches and feel the athletic trainer should answer to the coach or athletic director. Because of this, it should be standard protocol that decisions made by an athletic directors should can be reviewed by the team physician, not a coach or athletic director.

As a college student studying athletic trainer, I remember discussing what we would do in this type of pressure situation and it is easy to say what we would do, but when it happens, it is a whole different ball game. I lost my athletic training job because I would not sacrifice my ethics or the safety of an athlete to save my job.

As an athletic director, just as when I was an athletic trainer, I know I would rather lose a game rather than have an athlete injured and I know I am not alone in this thinking. Still, there are others who do not share this school of thought and we need to put measures in place to make sure their decisions threaten athlete safety.

Steve Friebus, MEd, ATC, LAT, is Director of Athletics at Rogers College High School in Tulsa, Okla.

I have a similar story to the one shared above. I was at a high school as part of an outreach program tied to a PT clinic I worked at at the time. Similar story: head FB coach was also the AD, and he expected me to only work with FB and boys’ basketball, putting those athletes above all others at the school. He also tried to get me to clear FB players who were still experiencing concussion symptoms (and had been cleared by an MD!), as well as pressuring me to clear other injured players for full participation when they were far from being ready. Another FB athlete sustained a full rupture of the MCL. He was told by initial MD — a pediatrician — he was fine to play with no time off, but when I insisted he was not fine, and was able to get him in to see an actual Ortho MD, and my evaluation was confirmed. I was told by the FB coach and an assistant I was “just really pessimistic.”

When I refused to “just tape him and get him back in the game” when I suspected the star running back had fractured his ankle, the following week the head FB coach/AD complained to my employer that I refused to let athletes play when they had been cleared by MDs, that I refused to help visiting team athletes (in reference to an incident when I had an athlete having chest pain and difficulty breathing after being hit in the chest with a helmet, and at the same time I was administering to him, a player on the other team hurt his knee, and got up and walked off under his own power), and that I was argumentative. He also took exception to my telling female athletes at the school that I was also there for them, that they were allowed to use the ATR and come to me with injuries, etc.

Rather than consider my side of the story, my former employer was more concerned about his reputation, rather than the welfare of the athletes. I was pulled from the high school two days after football season ended. In my place, they put an AT who was a complete pushover who would not stand up for himself.

I’ve heard recently that this particular high school is back to denying AT care for female athletes, which is another issue entirely.

I wasn’t surprised with the findings of the NCAA D1 survey at all. I know many ATs who have been removed from their positions because of differences of opinion with coaches. I’m not surprised to hear this happened to someone else at the high school level. I think it happens more than most people know. Unfortunately, failure to compromise one’s ethics in order to protect student athletes IS getting ATs fired or reassigned, and I think people would be astounded at how this is the norm rather than the exception.

Rachel A. Blakeman, MA, ATC

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