Not Just a Tape Dispenser : Trainers Help With Conditioning and Recovery, but Not All Schools Can Afford Them

Santa Margarita quarterback Carson Palmer knows the value of a good athletic trainer.

Before the football season started, Palmer was sidelined with a stress fracture in his foot.

“I was just jogging in practice and it was bugging me,” he said. “I thought it was my ankle.”

Initially, Palmer said, he was expected to miss four to six weeks of his senior season. But trainer Ray Gonzalez, who diagnosed the injury and suggested Palmer get X-rays, helped him speed his recovery.

“Ray was working with me every day,” Palmer said. “I was doing weights, riding a bike. Slowly, I started running and getting back into it. I wasn’t supposed to be back for four to six weeks, and I was back in three. Ray had a lot of exercises for me to get back into shape to play again.”

Palmer, who came back the second week of the season and eventually led the Eagles to the Southern Section Division V title, made the most of the help available. But not all high schools are as prepared with a certified trainer on site when an athlete is hurt.

“There’s nothing more valuable for an athletic program than a good, certified trainer,” said Robert Rishel, boys’ athletic director at Magnolia High School. “Otherwise, people are trained to do nothing more than tape. We need people who are qualified in prevention and rehabilitation of injuries.”

Because of budget cuts, school districts have been forced to trim certain full-time positions from their budgets. In many districts, athletic trainers and school nurses work only part-time.

Some nurses work two or three days a week. At some schools, certified athletic trainers are not present at some freshman or junior varsity events.

Take a typical day at a high school. Junior varsity and varsity boys’ and girls’ basketball teams are practicing, or playing games. Wrestlers are practicing indoors, while the boys’ and girls’ soccer teams are practicing or playing games outdoors. The girls’ water polo team might be practicing. Including freshman teams, there could be more than two hundred athletes participating at the same time of day.

“We have one trainer who’s here at varying hours, trying to fit that into his schedule,” Marina Athletic Director Larry Doyle said. “We also have a volunteer [trainer] from [a physical therapy clinic in Fountain Valley].”

Magnolia doesn’t have a trainer. “We have coaches who tape,” Rishel said. “We’re in a vulnerable position right now . . . It’s a very regrettable situation. But we can’t find one.”

Many athletic directors cite the passage of Proposition 13 in 1978 as the beginning of crucial budget cuts that had a cascade effect. Some courses were cut. Money allotted for on-site medical personnel, such as school nurses and athletic trainers, dwindled.

In the Huntington Beach District, about $35,000 is set aside for trainers for the district’s six high schools. But Doyle points out that the trainers at Ocean View and Westminster high schools have held those jobs for a long time, and therefore will make more money than less-experienced trainers at other schools in the district.

At Magnolia, there’s about $5,100 per year set aside to pay trainers.

“People cannot live on $5,000 a year,” said Rishel, a certified athletic trainer who was on the training staff of the 1984 Olympics. “The ideal situation is what I did. I was a teacher. I had fifth-period conference. That was the time to get the training room ready.

“Sixth period I did taping, assessing injuries. That was the ideal situation. I did that for 17 years at Magnolia. I was getting paid something like $2,000 a year [in addition to his teacher’s salary].”

Most high school trainers spend the early part of their day at physical therapy clinics. In the early afternoons, they head to their high school campuses to tape athletes preparing for practice. Sean Higgs, a trainer at Fountain Valley High School, is one of those trainers.

Higgs spends mornings at a physical therapy clinic in Newport Beach. Then he heads to campus, arriving about 20 minutes before school lets out, to prepare the training room.

Along with taping athletes and evaluating injuries, he does some rehabilitation (ice, heat, massage) and has also developed strength programs for various teams.

“We’ve created funding for trainers,” Higgs said. “If you want to play sports [at Fountain Valley], you need a card that proves you’re insured, and pay a $20 [activity] fee.

But some athletic directors hesitate to impose steep activities fees, which might be prohibitive is less-affluent districts.

“[The fee] is not an ideal solution to the problem, but now everyone knows I’m here. Second, it creates money for the [trainer] position. I’ve only had a few parents complain [about the fee], but when I explain to them what we do, show them the [injury] figures, then it’s OK.”

Higgs, also a licensed physical therapist, became interested in a career as athletic trainer in high school.

“I was injured a lot,” he said. “I was always going to go into physical therapy. I played football, wrestled. Plus being in various car wrecks was enough to get me interested.”

Higgs sings the praises of Fountain Valley’s system. Working with him is an intern from Long Beach State, and 10 student helpers.

“The quality of care here is excellent,” he said. “A doctor group comes in and donates time to do physicals, and they bring in five or six nurses.”

When an athlete goes down in practice or competition, the first person on the court or field is usually the trainer. They assess an injury, then determine whether paramedics need to be summoned.

“In the fall of 1992, we had a severe head injury in a JV football game,” said Gonzalez, the full-time trainer at Santa Margarita. “We had a kid suffer a severe concussion, which led to him being transported to a trauma center in Mission Viejo. I was on the sideline when he collapsed. It’s a terrible thing to see. Paramedics were there within four minutes.”

Even when the injury is not as serious, the trainer is on the line.

“We’re in the middle of the tornado,” Gonzalez said, “that being the coaches, parents and athletes. We try to get everyone on the same page. We’re trying to get the athlete back into competition the early as possible.”

And the more competitive the athlete, the more likely they are to push themselves--even lie about the pain--which could exacerbate the injury.

“Then you’re the hero and the goat at the same time,” Gonzalez said.

But when an injury occurs, the value of a trainer is obvious.

Brea Olinda basketball player Chelsea Trotter tore her anterior cruciate ligament during the first 90 seconds of her high school career as a freshman.

“I was driving to the basket at the beginning of the [intrasquad] scrimmage,” she said. “I took a big step with my left leg and felt it snap. I didn’t think it was a big deal, because I got up and walked off the floor.

“It hurt, but I think it was more emotional than physical,” the 6-foot-2 center said. “All I could think was, “Oh my gosh, my knee. Anything but my knee.’ ”

But trainer Debbie Thompson was cautious. She recommended a doctor, and Trotter had surgery last December. Trotter was on crutches for more than a week, and Thompson designed a rehabilitation program.

“She gave me a lot of emotional support,” Trotter said. “[During rehab,] she’d ice it and stimulate my knee. Now it feels great.”

Trotter returned to the court for the Ladycat Classic in mid-December.

There are more than 16,980 trainers certified by the National Athletic Trainers’ Assn. in the United States, according to the Dallas-based NATA. Of those, 2,310 work full-time in high schools in the U.S.; 2,083 work part-time.

Trainers have, at a minimum, a bachelor’s degree, usually in health, physical education or exercise science. Nearly 100 universities and colleges offer NATA-approved curricula.

Certification tests, administered several times a year in California, are tough: one part is multiple choice. In the practical section, a candidate is given a situation, with a trainer playing the athlete and a panel of trainers observing. One part is a written simulation.

There are no Southern Section rules that mandate a doctor or trainer be present at all school sporting events. Most leagues, however, have a constitution which usually mandates a doctor--but not necessarily an ambulance--be present at football games.

Although few high schools in Orange County have full-time trainers, most coaches have certification in first aid.

Athletic directors are acutely aware of the dilemma. It’s difficult to ask a professional who has passed premed classes such as kinesiology, anatomy and physiology, along with a grueling certification test, to take a part-time job that pays less than $5,000 per school year.

One solution might be higher athletic fees, or a co-pay whenever an athlete needs to visit the trainer for an injury.

Those would provide some funds, but it might prevent students in less affluent areas from getting treatment, which could worsen the injury.

Magnolia’s Rishel comes at it from another angle.

“The next person we hire who has the skills for the position--like if we need a science teacher--and someone who comes in here who can teach science and is a trainer--they have to be given a priority,” Rishel said. “You have to look at what’s good for the whole school.”

Higgs said college students who are planning to become trainers are being encouraged to get their teaching certificate, so this might open the door to a high school job.

“Our superintendent has made it a priority to get a trainer in every high school,” Rishel said. “I think next year we’ll have one. As AD, that’s No. 1 on my list of priorities. We have to have it. I’m going to the mat for this.”

Recently, the Hawaii state legislature passed a bill providing that all high schools in the state hire a full-time trainer, certified by the NATA.

“But Hawaii is a smaller state than we are,” said Tim Finnecy, Governmental Affairs Chairman for District 8, which covers California, Hawaii and Nevada. “Ideally, we would love to mandate a certified trainer in every California high school. But if you do something like that, you’re probably looking at $30,000-$35,000 in salary, plus benefits. So the financial impact is huge. With high schools getting rid of school nurses and sharing librarians and such, it’s not going to happen.”

According to the NATA, 14.3% of California’s high schools--there are more than 1,140--employ a full-time certified athletic trainer; 46.9% have a staff member provide athletic health-care services.

Mike West, the full-time athletic trainer at Chino Hills Ayala High School, has met with state Sen. Ruben Ayala (for whom the high school is named). Ayala (D-Chino Hills) plans to introduce a bill to mandate Department of Education funding for a study of injuries in state high schools.

But the wheels of government turn slowly. Advocates expect the bill to take a full year for passage, and another two to collect data.

The long-term goal is “to get the risk management person at each school district to recognize that [a full-time trainer] is an employee the school district cannot do without,” said Finnecy, head trainer at American River College. Of about 45 high schools in the Sacramento area, he said only eight have trainers.

Many wonder why it has taken this long to get the ball rolling.

“The California Athletic Trainers Assn.--they’re working at the government level to have all high schools require this,” Higgs said. “And it should be an easy sell, because it improves health care for the athletes. All colleges have it. All JCs have it. The way I look at it, if any high school offers sports, they’ve got to have at least one person here to take care of it.”