Playing With Fire When the Heat Is On

The climate was mild; the test, a relatively tame agility drill, the kind thousands of high school football players complete every day during summer practice.

Then, suddenly, Jason Chamberlin sprawled on the Glendale High field, unresponsive. And there was nobody with medical training around to help.

The football team’s certified athletic trainer, paid through a program funded by a local hospital to attend practices 10 hours a week, had skipped the session in favor of covering other workouts.

All school officials could do in her absence was check Chamberlin’s blood pressure, put a blanket over him and call 911. By the time the sophomore got to a hospital, his body temperature was 107 degrees. He had heatstroke.

Two weeks later, Chamberlin was in class for the first day of school. His prognosis for a full recovery is good, and he hopes to return soon to his place on Glendale’s offensive line. But his ordeal underscores a danger that continues to plague high school athletics: the lack of consistent medical supervision and care.

In a recent survey of officials from 905 California high schools, only 62% said they had trainers on campus--and only 35% of those trainers were certified.

“The people who might have the wherewithal to fund certified athletic trainers at the high school level don’t realize the positive impact they have in terms of catastrophic injuries and the rate of injuries,” said Dr. Keith Feder, the Manhattan Beach orthopedic surgeon who conducted the survey.

Feder, who is active in high school sports, said multiple independent studies have found that a full-time, certified trainer can reduce injuries by 30% to 40%.

As things are, the health of high school athletes is “being compromised every day because people are not put in a position to protect them,” said Julie Max, Cal State Fullerton’s head trainer and president of the National Athletic Trainers Assn.

Because the responsibility for medical care rests with individual schools or districts rather than a regional or state entity, the quality of coverage varies widely. Many school administrators say they would like to implement trainer programs but are hampered by a harsh economic climate.

“It’s an issue we have talked about at the district level for a number of years,” said Barbara Fiege, director of athletics for the Los Angeles Unified School District. “The huge obstacle is funding.”

Feder believes that in the past year there has been little to no increase in training supervision at Southern California schools despite the deaths of four local high school athletes last fall. He has no specific data supporting his assertion, but bases it on the high number of phone calls from school officials to his office requesting assistance from his volunteer community program, Team to Win.

The program, based at Centinela Hospital, provides certified trainers who attend practices and football games at 24 high schools and offers follow-up care to about 12,000 athletes. Most of the trainers work 12-15 hours a week--two practices and a game--during the football season. Feder estimates the program, funded by donations and subsidized by Centinela, costs about $1 million a year.

Feder said a shortage of funds isn’t the only reason more schools aren’t using certified trainers. Other factors, he said, are a scarcity of qualified practitioners and an unwillingness among health care professionals to work for anything less than the going rate.

“In our program, the physicians have to take a reduced rate of remuneration for their services or do it on a volunteer basis,” Feder said. “We know as physicians that the funding is not out there to pay at the level at which we’re accustomed for these high school kids.”

If there is a model training program in the Southland, it’s offered by the Anaheim Union High School District, which has a paid certified athletic trainer for each of its eight campuses that offers a full complement of sports.

Anaheim trainers are well paid because they double as teachers. The district offers its trainers a yearly stipend of $6,237--in addition to a teaching salary that starts as high as $49,553 for those who have attained a master’s degree and have completed 60 hours of additional coursework.

“They can’t go anywhere else and make that wage,” said Tom Danley, the district’s athletic director. “That has turned some heads.”

When the program started five years ago, district principals were given three years to hire teachers who were also certified athletic trainers. These were not new positions; the trainers filled vacancies created by attrition.

While acknowledging that it has been difficult to always find prospects who can fill the dual role, Danley said the district has formed a pipeline with universities that offer athletic training programs. Cal State Fullerton is among them.

“We try to meet the needs of the high schools by providing certified athletics trainers and encouraging them to get teaching credentials as soon as they [graduate],” said Max, Fullerton’s trainer.

The arrangement is one other medical professionals would like their local districts to adopt. Los Alamitos physical therapist Andrew Einhorn said he has been trying to coax the Garden Grove Unified School District to follow suit--to no avail.

“This is not something we’ve made up,” said Einhorn, who has gone on television and radio shows to promote the concept. “This is happening already.”

Alan Trudell, spokesman for the Garden Grove district, called Einhorn’s proposal “rather unrealistic, particularly for our district. When we hire teachers, we look for the best teachers. His proposal is looking for trainers first and looking for the teacher [as a secondary requirement].”

Trudell said principals in his district have discretion to adjust their athletic budgets, which provide funding for up to 45 coaching positions per school, to pay for athletic trainers if they so desire.

But Einhorn, who has volunteered to assist Garden Grove Pacifica High’s team doctor during football games for 18 seasons, said what is needed is a mandate. He has seen the potentially devastating consequences of not having a trainer on a sideline.

During a Pacifica football game several years ago, a player from the opposing team dislocated his shoulder. Because the team did not have any medical personnel with it, Einhorn said, it was up to the Pacifica doctor to reduce the dislocation. Einhorn said the doctor advised the player that he “was done for the night” and needed to seek follow-up care.

Einhorn later learned that the player reentered the game.

“That was an absolute breach of medical care,” Einhorn said. “It’s a frightening thing.”

Kerrie Smith, Glendale High’s football trainer, doesn’t know if she would have made a substantial difference had she been on the sideline when Chamberlin collapsed. But she is confident of her impact had his condition deteriorated.

“I could have cooled him down and made sure he was breathing. I could have maintained his vital signs,” she said. “From what I was told, no one really knew what to do. They were like, ‘Call 911.’ ”