How to Ask for a Raise as an AT

By Amanda Webster, ATC

As healthcare professionals we tend to put the needs of others ahead of our own. This can lead to poor performance, dissatisfaction and eventually lead to burnout or changing careers.  In order to set up for a long happy career we must mind our needs, and a big part of that is compensation.  Before gearing up for your next preseason, take time to consider your contract.  If you’ve referenced the 2011 salary survey, you already know the national average at the time of this survey was $51,483.  If your pay stubs put you nowhere near that, it may be time to ask for a raise.

How much should I ask for?
Check out the NATA Salary Survey. Compare your setting, education, number of years certified and region to the trend from 2005, 2008 and 2011. How do you stack up?

AT Salary by District

Prove your worth
Athletic directors and administrators don’t know the hours you put in after they go home.  Weekend tournaments, weeknight basketball games, annual physicals: they all add up. Make a spreadsheet to track your hours that you can share with your supervisor (along with the salary survey) when you decide the time is right to ask for a raise.  They would probably be shocked to see how much time you commit to your work and they will want to compensate you appropriately.

Plan B
Decide how much you’re willing to negotiate.  If your employer isn’t willing or able to give you a raise, you can still increase your worth and keep your job by limiting your hours.  Look at the numbers.  If you’re only making $45,000 after taxes, your take home is about $707 a week; if you work 70 hours a week that equates to only $10/hour. Yikes!  At the same salary, you could enjoy your evenings away from work and still put in a standard 40 hours with an hourly wage closer to $18/hour.  To do this, look at your schedule at the beginning of every week and decide which events take precedence based on catastrophic risk.  Also decide which games or practices will go without coverage or will require per diem coverage. Put it in writing to your supervisor.  If they want more coverage, they will have to pay more, either to you or for per diem coverage. It’s not easy, but it is the only way to ensure we’re not shortchanging ourselves or devaluing our profession.

As always, practice professionalism. Show up early, mind your appearance and speak in a professional manner.  If your employer is happy to have you, they will do what they can to keep you happy.

9 Ways to Protect Student Athletes When It’s Hot

High temperatureBy Mike Hopper, MS, ATC

At the beginning of June, we posted an article about how one high school athletic conference is taking on the heat issue. Read the article by Aaron Kremmel here.  But what other steps must be taken? As we begin to start thinking about fall sports, let’s take a look at what we should be doing to protect our student athletes.

The Korey Stringer Institute is a leader in heat illness prevention. They have many recommendations on their website and they have worked with many different states and leagues to pass on those recommendations and guidelines. I was fortunate during my graduate coursework at the University of South Florida to learn under Dr. Lopez, who was a graduate of UConn. This is one topic we discussed, and our conversations honestly really changed my outlook on the topic!

Here are some key points that I think we must all consider when it comes to practicing and playing in the heat and humidity!

1)     Have a limit on when it’s time to quit. When is too hot?

2)     Be prepared to modify and possibly even cancel practices.

3)     Provide unlimited amounts of water and consider electrolyte drinks such as Gatorade or PowerAde®.

4)     Encourage frequent water breaks and rest periods. Allow the athletes to get into the shade and possibly remove equipment if needed.

5)     Know the signs and symptoms of heat exhaustion and heat stroke!

6)     Have an Emergency Action Plan in place.

7)     Use only valid methods of determining core body temperatures.

8)     Have a tub prepared with cool water and ice.

9)     Cool FIRST, transport second!

Take the steps necessary to protect your student athletes. Heat illnesses are preventable, and we must be diligent in doing just that.

The NATA will soon have out a new position statement on heat illness. You can read the executive summary from the NATA here.

New NCAA Guidelines Aim to Improve Student-Athlete Safety

Note: This blog has been cross-posted from the NCAA Sport Science Institute’s website with permission. The original alert appears here.

For the past six months, the NCAA and College Athletic Trainers’ Society have been working with prominent medical organizations, college football coaches, administrators and conference commissioners to develop new guidelines to improve safety for college student-athletes.

Today, those groups released three inter-association guidelines that address independent medical care for college student-athletes, diagnosis and management of sport-related concussion, and year-round football practice contact.

Highlights from the Inter-Association Guidelines

Year-round football practice contact

• Preseason: For days when schools schedule a two-a-day practice, live contact practices are only allowed in one practice. A maximum four live contact practices may occur in a given week, and a maximum of 12 total may occur in the preseason. Only three practices (scrimmages) would allow for live contact in greater than 50 percent of the practice schedule.
• Inseason (including postseason and bowl season): There may be no more than two live contact practices per week.
• Spring practice: Of the 15 allowable sessions that may occur during the spring practice season, eight practices may involve live contact; three of these live contact practices may include greater than 50 percent live contact (scrimmages). Live contact practices are limited to two in a given week and may not occur on consecutive days.

Independent medical care for college student-athletes

• Institutional medical line of authority should be established independently of a coach, and in the sole interest of student-athlete health and welfare.
• Institutions should, at a minimum, designate a licensed physician (M.D. or D.O.) to serve as medical director, and that medical director should oversee the medical tasks of all primary athletics healthcare providers.
• The medical director and primary athletics healthcare providers should be empowered with unchallengeable, autonomous authority to determine medical management and return-to-play decisions of student-athletes.

Diagnosis and management of sport-related concussion

• Institutions should make their concussion management plan publicly available, either through printed material, their website or both.
• A student-athlete diagnosed with sport-related concussion should not be allowed to return to play in the current game or practice and should be withheld from athletic activity for the remainder of the day.
• The return-to-play decision is based on a protocol of a gradual increase in physical activity that includes both an incremental increase in physical demands and contact risk supervised by a physician or physician-designee.
• The return to academics should be managed in a gradual program that fits the needs of the individual, within the context of a multi-disciplinary team that includes physicians, Athletic Trainers, coaches, psychologists/counselors, neuropsychologists and administrators, as well as academic (e.g. professors, deans, academic advisers) and office of disability services representatives.

To learn more about the inter-association guidelines and view additional resources, click here.

Kids Get Arthritis Too

Young athlete

Juvenile arthritis affects kids ages 16 and younger

By Kelly Berardini, MHA, ATC

When Ann Huffman looks at old photos of her daughter Leslie and sees her little girl’s swollen wrists and fingers, she thinks, “How could I have missed that?” Leslie began exhibiting signs and symptoms of juvenile arthritis at age 5 but was not diagnosed until after her 11th birthday. A mother’s guilt hurts, but even Leslie’s pediatrician didn’t put the diagnostic puzzle together. This can be attributed to a lack of awareness – among parents and some healthcare professionals – that kids can get arthritis too.

It’s a common misconception that arthritis afflicts only the elderly, but nearly 300,000 American children age 16 or younger have been diagnosed with the disease. July is Juvenile Arthritis Awareness Month- a great time to promote early detection and to connect families with essential resources.

Defining Juvenile Arthritis
Juvenile arthritis (JA)
is an umbrella term for several rheumatic disease manifestations affecting the joints and musculoskeletal system with onset before age 16. Different forms of JA share common signs and symptoms, but complications and treatment approaches vary per type. Only about 10 percent of children have a disease that closely resembles adult rheumatoid arthritis.

Juvenile idiopathic arthritis (JIA) is the most common form and is characterized by swelling of one or more joints for six weeks or longer. Other types of JA include dermatomyositis, lupus, scleroderma, Kawasaki disease, mixed connective tissue disease and spondyloarthritis (SpA).

Early Signs and Symptoms
Kids frequently can be sidelined by an injury or illness, whether a monkey bump from a bike wipe out or the latest green-snot-producing bug shared among classmates. When should an Athletic Trainer be suspicious that pain, stiffness or fevers could be JA? The following S&S warrant speedy referral:
• Joint pain: typically bilateral and worse in the morning. Most common sites are knees, wrists, ankles and jaw.
• Stiffness: limping, holding joints in fixed positions, struggling with normal movements (e.g., holding a spoon). Worse in the morning.
• Joint swelling: unrelated to acute injury. Joint might feel hot.
• Fevers (unrelated to acute infection): frequent temp spikes with malaise and fatigue. Might occur at the same time each day and then disappear.
• Rashes: persistent, faint pink rashes on the knuckles, across the cheeks nose, and/or on the trunk, arms and legs.
• Eye problems: persistent redness, pain or blurred vision. Some forms of JA cause serious ocular complications such uveitis.
• Weight loss with poor appetite and fatigue.

The prognosis for today’s young arthritis patients is much improved. Thanks to newer drugs and smarter use of older medications, kids with JA are leading healthier, more active lives with decreased incidence of joint damage.  Treatment options include NSAIDs, intra-articular corticosteroid injections, disease-modifying antirheumatic drugs (DMARDs, e.g., methotrexate) and biologic drugs (e.g., Enbrel). Exercise therapy and regular physical activity can also decrease disease parameters and improve quality of life. The ultimate goal is remission – inactive disease.

Juvenile Arthritis and Sports
Children with JIA can safely participate in athletics when parents, physicians and Athletic Trainers monitor them carefully and follow evidence-based recommendations. In fact, inactivity can worsen disease symptoms and accelerate muscle atrophy and bone loss, so patients should be encouraged to participate within their tolerance and capacity.

Kids whose disease is well controlled and who are screened for C1-C2 instability can participate in contact sports. Activity should be limited during active disease flares with gradual return to play following.

1) DMARDs can cause significant side effects, including increased risk for infections. What procedures would you employ to help protect a JA patient from infections?
2) Spondyloarthritis accounts for up to 20% of JA cases. Review the clinical features of SpA, along with beneficial and contraindicated exercises for these patients.
3) Children with JA can benefit greatly from individualized exercise training within a group setting. How might you incorporate this model into your practice?

Arthritis Foundation
Kids Get Arthritis Too
American College of Rheumatology
Evaluation of the presentation of systemic onset juvenile rheumatoid arthritis: data from the Pennsylvania Systemic Onset Juvenile Arthritis Registry (PASOJAR).
Biologics for the treatment of juvenile idiopathic arthritis: a systematic review and critical analysis of the evidence.
Systematic review of disease-modifying antirheumatic drugs for juvenile idiopathic arthritis.
The role of exercise therapy in the management of juvenile idiopathic arthritis.
Economic impact of juvenile idiopathic arthritis.
The clinical effectiveness of intra-articular corticosteroids for arthritis of the lower limb in juvenile idiopathic arthritis: a systematic review
The future of treatment for juvenile idiopathic arthritis
Does sport negatively influence joint scores in patients with juvenile rheumatoid arthritis. An 8-year prospective study.
Physical conditioning in children with arthritis: Assessment and guidelines for exercise prescription.
Pilot study of fitness training and exercise testing in polyarticular childhood arthritis.

Alaska Passes AT Licensure Law

Alaska licensure bill signing

Alaska Governor Sean Parnell and bill supporters at a signing ceremony for the state’s new AT licensure law

Alaska law now recognizes Athletic Trainers as healthcare providers, thanks to the passage of a new licensure bill. HB 160, signed by Governor Sean Parnell on June 18, requires Athletic Trainers (ATs) to be licensed in order to practice.

The new regulation is a victory not just for the athletic training profession but especially for the public. According to Lynne Young, M.Ed, ATC, an Alaska AT who advocated for the new regulation, this bill is an important step to protect young athletes and other community members.

“It ensures that those individuals on the sidelines taking care of our kids and community have met the requirements, education and necessary training to successfully perform their duties,” Young said. “The public would be sure that the person calling themselves an Athletic Trainer met the requirements to do so.”

Alaska is the 49th state to regulate Athletic Trainers, leaving only California without regulation. State licensure establishes ATs as recognized healthcare professionals who provide outreach, education and care, Young said.

“This will aid in the distribution of important timely information on prevention, management, and treatment of various activity related injuries and illnesses,” she said.

To qualify for licensure, an AT must be BOC certified, apply to the state regulatory agency, pay applicable fees and meet the agency’s requirements. Application details are not yet available.

Dan Libera Award Recipients and Drawing Winners Announced

The BOC exhibited at NATA’s 65th Clinical Symposia & AT Expo in Indianapolis, IN, June 25-28. The BOC staff and board members were on hand to answer questions and connect with convention attendees at the BOC booth. Once again, we congratulate NATA for a great convention with attendance over 10,000.

On June 27th, the BOC Board of Directors and staff hosted a reception to honor BOC volunteers and to present the Dan Libera Service Awards. The BOC Dan Libera Service Award was established in 1995 to recognize individuals who have shown dedication to the mission of the BOC. Longstanding contributions to the BOC’s programs are the primary criteria for the award. Congratulations to this year’s award recipients!

2014 Dan Libera Award Winners

AJ Duffy, III

Valerie Herzog

Christine Odell

Kim Peer

Mark White

The BOC also congratulates Lynette Carlson, who was awarded the Lindsy McLean Scholarship sponsored by the BOC. This scholarship honors Lindsy, who was the first Chair of the Certification Committee.

This year, BOC staff members led an hourly trivia contest at the booth. Winners received $25 gift cards. Congratulations to the following trivia winners!

Trivia Winners

Fawn Michel

Dawn Hammerschmidt

Amanda Sampsel

Theodore Hirschfeld

Lucas Dargo

Mackenzie McLaughlin

Ashly McDaniel

Tieka Phiniezy

Brandon Johnson

Shabnam Dezfouli

Emily Dunn

Thank you to everyone who stopped by the BOC booth, and congratulations to the winners from our prize drawings!

Free Certification Plaque

Free Certificate

Free Self Assessment Exam

Lynne Young

Megan Davis

Heidi Lavorato

Jacqueline Phillips

D. Kalei Namohala

Brandon Grecinger

Andrew Calore

Ashley Kessler


Free Home Study Course

Mary Joos

Ron Wollenhaupt

Daniel Ryan

Amanda Baldwin

Lindsay Moccia

John Doherty

Lindsey Loughran

Bart Welte

Andrea Kovalsky

Alison Kotek

Ashley Thrasher

Shawn Giebner

Erin Garms

Jasmine Honey

Jessica Schumacher

Ospaldo Lopez

Encourage Free Play and Improve Youth Athleticism

Free playBy Tim Koba

Eric Cressey wrote a great post on athleticism in young athletes, or the general lack of it. He has a great point on the deterioration of the raw athleticism of younger athletes that can be attributed to lack of physical education classes in high school, lack of free play and early sport specialization.

As professionals we can evaluate and analyze injuries, risk factors and treatment options, but we also need to educate our coaches, parents and athletes about the benefits of unstructured activities and physical fitness.

The proliferation of yearlong sports clubs and sport specific training programs may be helping to improve some sport skills, but it is at the cost of complete development, body control and general movement skills.

Working hard to educate our athletes and change the current patterns will hopefully bring back the times of fun play with friends outside of a structured sporting event. Kids need to have fun running, jumping, playing and discovering the joy of movement on their own while experiencing new things. While we may not be able to change everything all at once, we can offer guidance on returning to play for the sake of fun. We can also offer programs that reinforce discovery of movements in a fun setting that focuses on running, jumping, climbing and throwing in a less structured, but still controlled environment.

Have you seen successful programs that encourage more free play? What was the coach doing to develop overall athleticism and encourage free play?

Ethics In Action: Going the Extra Mile – At What Cost?

By Kimberly S. Peer, EdD, ATC, FNATA

Athletic Trainers (ATs) are challenged by contractual constraints in some settings.  Although they would like to provide care to all athletes in all sports, clearly coverage is prioritized to meet the needs of the contract rather than the needs of the athletes necessarily.  As a profession, we are striving to improve work-life balance and salaries.  We have initiatives in place to emphasize the need for ATs in high schools across the country.  Yet in most school districts, funds are limited and contracted services for athletic training is the best they can do.  Consider this current state in the profession against the case below.

As an AT at a local high school, you are asked to create a strength training plan for the football team.  You are hired part-time (1,000 hours/year) and you are responsible primarily for football, soccer, basketball, baseball and softball.  When the basketball coach asks you to help him set up a strength training plan for his athletes in the winter, you disclose that you “don’t have time left in your contract to do this for his team” without using up spring hours that you are assigned.   Is this ethical?

1. Should you, as an AT, provide equitable services (for the sake of fairness and justice) to all athletes?

2. Is it better for the profession to simply not contract for limited services to emphasize the need for full-time athletic training coverage?

3. Does part-time coverage really provide equitable access to all athletes?

4. How do you in this case try to balance the willingness to help the athletes and coaches without compromising your own time?  How do you do this without perpetuating the old adage of “giving our services away for free”?

Dr. Peer is an Associate Professor at Kent State University. She holds a Doctorate in Higher Education Administration with a Cognate in Health Care Management. Kimberly was recently appointed as the editor-in-chief for the Athletic Training Education Journal and serves on the Commission on Accreditation of Athletic Training Education Ethics Committee as well as the NATA Committee on Professional Ethics. Her national contributions include service to the BOC, NATA, JAT and REF in multiple capacities. Her statewide service includes the Governor’s appointment to the Ohio licensure board and over 12 years of service to the OATA.

Self-Evaluation Time: Are You a Safety Role Model?

Warning sign

By Beth Wolfe

Athletic Trainers are stewards of safety in many facets.  From protecting our patients from potential harm to educating and providing care to the community, safety promotion is deeply rooted within our scope of practice.  National Safety Month is upon us and it is time to do a quick self-evaluation: are you a safety role model?  As an AT, are you embodying and exemplifying the practices that you preach/teach or are you the exemption to the rule?

The topics for this year’s National Safety Month are: prevention of prescription drug abuse, stopping slips/trips/falls, being aware of your surroundings, putting an end to distracted driving and promoting summer safety.  These topics do relate to the daily tasks and job settings of Athletic Trainers. Here is another quick self-evaluation:

- Are all medications kept behind at least two locked doors?  Is a patient exhibiting behaviors that might suggest prescription drug abuse or misuse?

- Is your athletic training facility compliant with the BOC Facility Principles to help prevent patients from slipping, tripping and falling?

- Be a sponge to your environment and take notice of any suspicious persons, someone who may be in distress or if inclement weather may be approaching.  Are you a tunnel vision AT in need of being more observant?

- ATs are attached to cell phones, walkie-talkies and other forms of technology that ARE distractions while driving ANY vehicle.  Are you multitasking behind the wheel (ATV, Gator, Golf cart, van, etc.)?  What are your state laws about distracted driving or using an electronic device while operating a motor vehicle?

Pre-season will be here before you know it. Are you prepared to put on your sunscreen every day, wear your sunglasses and hat, and stay just as hydrated and fed as your patients?

Behavior change and safety compliance from your patients can be difficult to achieve; at times it can be a constant uphill battle.  However, hypocrisy and setting double standards are destructive in promoting change.  Our patients are very observant, and in some cases idolize their Athletic Trainer. Are your actions, behaviors and habits worth replicating?

Arving Devalia, an Amazon best-selling author, says that you must “help yourself before helping the world.”  For a healthcare provider, this quote is a friendly reminder that it is OK to be a little selfish with your time or daily priorities to ensure you are setting a good example, protecting yourself and, most importantly, placing yourself in a better position to help others.

Where will you start?  What safety habits do you need to break or change?  Not sure?  Here is a blog by Nozomi Morgan that gives some small, practical ways to motivate and guide your National Safety Month endeavors.

CWS: Meet a Texas Tech AT

Texas Tech - Andy Reyes and Bryan Simpson

Graduate Assistant Andy Reyes, left, and Athletic Trainer Bryan Simpson of Texas Tech provided care for their team during the College World Series.

During the College World Series, we are talking with the Athletic Trainers (ATs) who traveled the Road to Omaha to keep their baseball teams healthy during the Series. In this edition, we talked with Bryan Simpson, MAT, ATC, LAT, of Texas Tech University.

Describe the athletic training team that is at the CWS.
Our sports medicine staff for the College World Series includes one of my graduate assistants, Andy Reyes, our team physician, Michael Phy, D.O., and myself, Bryan Simpson.

Throughout the year, I was assisted by another graduate assistant, Iain Mistrot, who is currently working with the San Francisco 49ers, and undergraduate student assistant Lyle Danley, who went to begin graduate school at Texas A&M.

Once you found out your team was in, how did you start preparing for the CWS?
We did everything the way we’ve been doing it all year. We stuck with the same routines. You can’t change anything at this point.

What will your days be like during the College World Series?
Hectic. We do our best to take care of each athlete. Thankfully, we do have some off days, but at this point in the season, the athletes are tired and some need more attention than in past weeks.

What are the challenges of an AT during this event?
For me, it’s new. We’ve never been here before and we plan to be here a while. We will have to figure out where to go for special needs. Curtis Self and his staff have been integral in pointing me in the right direction.

What do you enjoy most about being an AT?
Helping serve athletes and being able to be a part of a team. I really enjoy the competitive nature of baseball at this level. It pushes me to become a better Athletic Trainer, so I can better serve my athletes.