Injuries including sprains, strains, fractures and even concussions are all too common in the world of athletics, regardless of the athlete’s age. The Center for Disease Control reports that high school sports account for more than two million injuries, 500,000 doctor’s visits and 30,000 hospitalizations every year and concussion rates have doubled in the last 10 years.

It is often the decisions made in the moments immediately following an injury that can have the greatest impact on the athlete’s recovery and even the severity of the injury. What type of injury is it, how severe and whether can the athlete be safely moved off the field or can the athlete return to play are questions that must be answered immediately in order to keep the athlete safe and minimize the risk of further injury.

But, who is making these decisions? With the ever-increasing concern for the health and safety of our young athletes, it has never been more important for parents to understand the education and training of the people working with their athletes and making medical decisions when an injury occurs.

Recreational sport coaches are often volunteer parents or former athletes who simply have a love for the sport they coach. These coaches generally are not required to have any type of medical training except where required by their local leagues. While these coaches have the least required medical training, the athletes they coach (age 5-14) make up 40 percent of all sports-related injuries treated in hospitals.

Coaching jobs in public school are often paid positions but most of these coaches also have jobs inside or outside the education system. All middle school and high school coaches in Maine are required to maintain certification in first aid and CPR as well as undergo a training program through the Maine Principals’ Association, which includes a 15-minute educational video and quiz about the recognition and treatment of sports related concussions.

While these requirements are a good safety measure, they in no way fully prepare a coach to handle medical emergencies, make medical decisions regarding the care of an athlete, or determine if the athlete is safe to return to play, all while being responsible for 20 or more other athletes. However, this is often what these coaches are asked and expected to do on a daily basis at some schools.

If you watch any NCAA or professional sporting event including MLB, NBA, AHL or NFL, when a player sustains an injury, the person responsible for providing care for that athlete on and off the field is usually an athletic trainer. These highly educated healthcare professionals are specially trained in the prevention, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions, including concussions.

Athletic trainers hold a minimum of a bachelor’s degree while the majority have a master’s degree or higher. They are required to pass a national certification exam as well as undergo 50 hours of continued education every two years.

In Maine, it is illegal to call yourself an athletic trainer without meeting these requirements and all athletic trainers must be licensed by the State Office of Professional and Occupational Regulation in order to practice for any length of time within the state. But you don’t have to be a professional or even college athlete to receive these professional healthcare services for your athlete.

While there are no requirements in the state, more than 87 Maine high schools utilize an athletic trainer as part of their athletic programs to help reduce injuries and ensure that athletic injuries are treated properly. They may be employed by the school system or their services may be contracted through a local hospital, physician’s office or rehabilitation center.

They are often visible on the sidelines during sporting events and usually hold clinical hours during or after school to assess injuries, provide injury rehabilitation and counsel athletes and active individuals on a variety of healthcare concerns from injury prevention to sports nutrition. Athletic trainers can help make referrals to physicians and specialists as needed and improve communication between athletes, coaches, physicians and parents. Because athletic training services are contracted by the school system, all of their services are done at no cost to the athletes or their parents.

Statistics show high schools with an athletic trainer have concussion rates up to eight times higher than those without. Why? Athletic trainers are trained to recognize the signs and symptoms of a concussion and are available on site to assess these injuries quickly and accurately.

These statistics imply that high schools that do not utilize an athletic trainer may have a higher rate of athletes participating with undiagnosed concussions. Current research shows that participating in athletics while still symptomatic after a head injury places an athlete at a significantly higher risk for catastrophic and permanent injury.

It is also important for parents to know that 62 percent of all sports-related injuries, including concussions, occur during practices when the least amount of medical assistance is typically available. An athletic trainer working full time for a school system is typically available after school and during practice times to provide immediate assessment and treatment of injuries.

When not readily available, athletic trainers can offer guidance to coaches and parents to properly care for their athletes. Athletic Trainers also may conduct educational and training sessions for coaches in sports as well as first aid and CPR to help keep them up to date and practice their ability to respond and assist in the event of an emergency.

Athletic trainers can be a valuable resource for area coaches, athletes and parents. There are 256 athletic trainers licensed in Maine working in a variety of settings from public and private schools to colleges, professional teams and even local industries. If you or your child is involved in athletics, regardless of level, it is important to know who will be available during games and practices to make medical decisions and what that person’s qualifications are. When in doubt, ask.

For more information you can visit the Maine Athletic Trainers Association at or the National Athletic Trainer’s Association at

March is National Athletic Training Month. During this time it is important for you to ask, “Who is taking care of your athletes?” If it is an athletic trainer, tell them and the school’s administration, “thank you.”

Richard B. Garini, ATC, is an athletic trainer with MaineGeneral Sports Medicine and chairman of the Governmental Affairs Committee for the Maine Athletic Trainers Association.