Practicing Responsibly: Understanding Athletic Training Regulation and State Practice Acts

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Posted June 7, 2016

Nicole T. Wasylyk, MSEd, LAT, ATC

Nicole T. Wasylyk, MSEd, LAT, ATC

Athletic training regulation varies across the United States from no regulation to registration, certification and licensure. Understanding the laws that regulate athletic training services within your area is key to responsible practice.

So what’s the difference between certification, registration and licensure?

The least restrictive form of government regulation is registration; these states require individuals to submit information prior to practicing as an Athletic Trainer (AT). Registration usually requires name and qualifications, but this can vary based on the state. Next is certification; certification protects the titled use of the term Athletic Trainer and is granted to those who meet predetermined standards. In a state where certification is the only requirement, an uncertified individual may perform the duties of an AT but they may not use the title Athletic Trainer. Finally there is licensure, which is the most restrictive form of government regulation. In a state that requires licensure it is illegal to practice athletic training without first obtaining a license.

With ATs employed in clinics, hospitals, collegiate and interscholastic roles, it’s important to understand the language of laws and practice acts. Some states contain restrictive wording that may, unfortunately, limit an AT’s ability to perform services for certain populations. Alaska, for example, states ATs may provide services to athletes; their definition of an athlete “means an individual who participates in an athletic or sport-related exercise or activity, including interscholastic, intercollegiate, intramural, semiprofessional, and professional sports activities.”1 Although not completely restrictive, the act does reveal concerns about use of language and how it can limit an AT’s ability to practice in certain settings.

An example of non-restrictive language includes that from the state of Wisconsin. ATs in this state may evaluate and treat individuals who participate in physical activity with the definition of physical activity being “vigorous participation in exercise, sports, games, and recreation, wellness, fitness, or employment activities.”2 This definition is inclusive of a myriad of patient populations, allowing ATs to practice in any number of settings.

ATs are growing into more dynamic and diverse roles; we provide services to individuals indiscriminate of athletic ability. Rethinking the way our practice acts are written may be critical in the coming years as we progress as a profession so as not to restrict our services to athletes and athletic populations. Some practice acts may not yet be reflective of our new roles or may contain legislation that is over a decade old with minimal amendments since inception.

If you’ve ever seen the Schoolhouse Rock “How a Bill Becomes a Law,” you’ll understand how it takes time and significant effort and support to pass legislation. Similar effort is needed when amending these laws. The National Athletic Trainers’ Association (NATA) and Board of Certification (BOC) have made strong efforts to improve the practice of athletic training, both through support of state licensure and bills related to athletic training practice. Current legislative efforts include the Sports Medicine Licensure Clarity Act (H.R.921 / S. 689), which seeks to provide legal protection for ATs or sports medicine professionals who travel to another state with an athletic team solely to provide care for their team. Currently, medical liability insurance does not cover an AT when they travel with their respective team to states where they are not licensed to practice.3

Be sure to access your state practice act and read through it in its entirety. Even though licensure is required for the vast majority of states, not all practice acts are created equal. Scope of practice is not entirely determined by a practice act, but it is crucial to know exclusions to practicing that may be described within the document. Access your state practice act through the NATA or BOC websites.

References and Resources:




State Regulation

NATA Scope of Practice Webinar

Sports Medicine Licensure Clarity Act

About the Author

Nicole Wasylyk works as an Athletic Trainer in a physician practice at Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, New Hampshire. Prior to DHMC she resided in Madison, Wisconsin and was an Athletic Trainer in a physician practice at Meriter-Unity Point Health. Wasylyk obtained her Bachelor of Science in Athletic Training from Boston University and Masters of Science in Education from Old Dominion University. She has completed a residency program for healthcare providers who extend the services of a physician at UW Health. Wasylyk also obtained her orthopedic technician certification. Her professional interests include injury surveillance and prevention, standardization of best practices and patient reported outcomes collection.

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