It’s 2:30 p.m. on a Tuesday in late winter as Claire Golden prepares for the afternoon rush in the training room, a hub of activity in the fieldhouse on the campus of Central High School.
In the span of about 20 minutes, she talks with a mom who popped in to discuss her son’s treatment for a concussion, tells a soccer player recovering from a knee injury — a strained ligament, not torn, thank goodness — to do a light warmup but sit out that day’s game because she hasn’t been practicing, tapes the ankles of another soccer player and begins rehabilitation treatment for a sprinter hobbled by shin splints.
Golden arrived at school before 7 a.m. and won’t leave until close to 10 p.m. because she’s on hand for any injuries at the evening’s soccer and basketball games.
Welcome to the hectic world of high school athletic trainers, some of the busiest folks on campus. Each high school employs two trainers who work with all the athletes, monitor games on-site and oversee middle-school injuries, although those games are covered by trainers under contract. Oh, yes, they also teach several classes in between athletics periods.
“We do injury prevention, injury rehab, injury evaluation and sports psychology,” Golden says. “We’re nutritionists, second mothers and fathers, a sounding board for kids, parents, coaches ... It’s a lot.”
At Keller High School, trainer Evan Poer says he and colleague Ethan Campbell are “like traffic cops” when it comes to the health of the 1,200 athletes they oversee. They keep careful records of ailments and treatments that are monitored by physicians, communicate with coaches, teachers, students and parents, along with rehabilitating injuries.
Working more than 60 hours a week is not unusual during their busy times, says Becky Spurlock, Keller ISD assistant athletic director and a certified trainer herself.
On average, 70 to 80 student athletes come in for some type of treatment every day across the district, Spurlock says. Trainers cover practices throughout the year: off-season, in-season, in school and after school, or 5,000 practices for the year.
Late January and into February are intense months for trainers as winter sports overlap with spring sports. Basketball, soccer, wrestling and swimming are winding down while tennis, track and field, softball and baseball are gearing up.
The other bustling time of year is football season when the shear volume of athletes, equipment and injuries means every practice takes an hour just to set up. And it’s all hands on deck.
‘Our Eyes and Ears’
Student assistant trainers play valuable roles in setting up for practices and games, ensuring athletes are well-hydrated and watching for injuries.
Poer says, “They are our eyes and ears. Kids will tell them things they won’t tell an adult, and then they can diplomatically refer them to us. They can be in more places than we can.”
Central and Keller high schools each have 16 student assistant trainers. They must apply for the position and be taking or have taken Sports Medicine 1, a career training class. Principles of Health Science is a prerequisite for the course. About 80 students are in Sports Medicine classes at each of the two schools.
The school’s athletic trainers teach Sports Medicine 1 and 2. For those who continue beyond that level, they offer a practicum where students can shadow a doctor involved in sports medicine.
For KHS senior Taylor Weber, who wants to become an orthopedic surgeon, getting to observe a total knee replacement was an added bonus to all the rehabilitation she sees as a student assistant trainer.
Assistants get to do some taping of wrists and ankles, treatment of abrasions, dealing with blood on uniforms during games and handing out water, but their biggest job is keeping careful watch. If they see a serious injury, they notify the trainer on duty.
Shelby Henderson, another KHS senior, wanted to become an assistant trainer because she is trying to decide between a career as an athletic trainer or a veterinarian.
“I play softball, and I like being able to work with other athletes and help them along,” Henderson says.
For Central junior Kensie Johnson being an assistant trainer has solidified her plans to pursue some kind of career in medicine.
Johnson says, “I get to interact with a lot of people and see a lot of injuries; some are really cool. It’s just fun getting to help.”
All the student assistants help during football season because of the massive demands of the sport. They then usually have another sport where they keep track of the varsity team and travel to away games. While the home team’s trainers take care of any significant injuries, student assistants are there for support and to report any issues that may require future treatment.
Henderson travels with the Keller Indians soccer team while Johnson follows Central Chargers basketball.
For Henderson, who adds AP classes, other clubs and activities on top of being an athlete and an assistant trainer, one of the best lessons is learning how to be organized.
“I think it gets you ready for college,” says Johnson, who plans to play softball in college next year.
The athletic trainers know the importance of time management.
Golden says, “The biggest challenge is juggling everything: work, family life, personal life.”
Her husband, Kevin Golden, is the head football coach at Timber Creek High School, so they both have commitments almost every night of the week.
Their 9-year-old daughter, Rory, spends a lot of time in the Central fieldhouse. “She runs around like she owns the place,” Golden says.
Golden works with fellow trainer Jonathan Shipley to divide up duties so they each can get nights off. When she oversees the Tuesday evening games, she can take Rory to Girl Scouts while Shipley monitors Friday games.
Keller High’s Poer has a similar answer to the biggest challenge for high school trainers: “volume and hours.”
While a physical therapist might see 20 patients over the course of a day, a trainer could see 15 to 20 in an hour.
“It’s basically triage and follow-up,” Poer says. “We don’t have anyone to handle phones or the schedule. We do everything. It’s pretty intense.”
For those with a chronic injury or one needing surgery, Golden says that trainers work regularly with physical therapists in the area to ensure that students are doing the rehabilitation required of them.
One of the most rewarding parts of the job is seeing athletes return stronger to the field or court. And the trainer is there to guide, prod and cheer them on.
Golden says, “I tell my kids, ‘Keep your head up, keep your spirits up and do everything we tell you and your parents tell you.’ ”
Trainers’ most important task: concussion management
At the four Keller high schools, trainers reported a total of 150 to 160 concussions for each of the last two school years.
Out of all the injuries trainers see on a regular basis, concussions are the most serious.
Concussions can result in chronic traumatic encephalopathy, or CTE: a progressive degenerative disease of the brain that can cause memory loss, dementia, aggression, confusion, depression and suicidal thoughts. Second Impact Syndrome is also a concern, where a second concussion occurs before the first is completely healed. Though rare, when it happens it can cause death or severe brain damage.
As research emerged on the long-term health risks of brain injuries, the Texas Legislature enacted Natasha’s Law in 2012. It requires that public schools have a concussion management team to assess an athlete’s readiness to return to play. The team must include a physician and the school’s athletic trainer.
Trainers and coaches are required to go through training to help them identify concussions. If a coach, trainer, physician or parent suspects an athlete has even one symptom, the athlete is pulled from participation for the day and a medical exam must be performed before he can return to play.
A concussion diagnosis triggers a lengthy list of protocols.
Immediately after the injury, athletes are encouraged to sleep as much as possible (contrary to the old idea of keeping a person awake) to help the brain repair itself. Staying away from computer screens, cell phone screens, television, too much noise or too much light are all part of early treatment.
Keller High School trainer Evan Poer says that trainers work with teachers to reduce homework, reading assignments and testing demands while an athlete is still experiencing symptoms.
Once the student is symptom free, then he goes through a five-step process to gradually increase activity in a contact sport like football or soccer or a three-step process in noncontact sports. Each step takes at least one day, sometimes longer. If the athlete remains at zero symptoms, he can go to the next step 24 hours later.
Keller officials added a concussion evaluation system called ImPACT (Immediate Post-concussion Assessment and Cognitive Testing) and the requirement that athletes see an ImPACT-certified physician before returning to play.
All athletes in contact sports take a 30-minute baseline computer test at the beginning of the season. They are measured for accuracy, speed, memorization and reaction time. After treatment for a concussion, athletes take the test again to see if they are impaired and if more time off is needed.
If the injured athlete is not in a contact sport, test results are compared to a large database of athletes the same age, gender and sport.
Poer says some mild concussions may take months for full recovery while one that appears serious at first may take only a week. If the protocols err, they err on the side of caution.
“If we turn a kid back in before he is healed, we endanger his life,” Poer says.