Youth Football!

We are back! This blog was actually written about a month ago, but I was waiting for our new website to go live before publishing this. It took a lot longer than expected and in the meantime, I had a baby! We are all doing well and I promise to write more about this soon and the transition, but without further ado..... Youth Football!

Athletic Training:

Youth football can be either extremely easy or pretty stressful. With more and more parents and coaches aware of our roles, expectations are getting higher… but there are still the times that it feels like we are back in the dark ages with coaches and parents questioning why we are there. During September, we learned about 4 different concerns from clients and ATs. I think this is good stuff to think about! I’m going to do some summarizing of the concerns here, then tell you a little about the environment at youth football games and give ATs a few suggestions to help you avoid conflicts (and lawsuits). I hope we can get a little discussion going here or perhaps some of you will share some of your experiences and some advice!

#1. Client Concern: Athletic trainer missed a big injury call on the visiting team’s bench and player sustained a fracture requiring surgery.

What actually happened: In the middle of the initial assessment, another patient sustained a concussion requiring the AT to leave and run onto the field. The AT first gave the patient ice and then told the parent that they’d be back to re-assess the injury as soon as possible. When the AT got back to the sideline, the mother had left with the player for the ER. The AT did not have the chance to get information for an injury report.

#2. Client Concerns: Athletic trainer did not come to visiting sideline when players were hurt. Coach had to walk a player to the other sideline to get help.

What actually happened: All of that… However, these patients got off the field on their own and within a timely manner that did not warrant an AT to come out. No one called the AT to the other sideline and therefore the AT had no way of knowing that help was needed.

#3 Client Concerns: The athletic trainer did not pay enough attention to her son’s contusion.

What actually happened: The AT was busy with a concussion evaluation at the time and triaged as needed.

And on the other end of the spectrum:

#4. AT Concern: Coaches seemed to be unhappy that AT was conservative with the patients. AT heard coach telling kids that if they go see her, they are wimps. Coaches were also questioning her qualifications.

What actually happened: All of that… The reasoning was that earlier in the day, the AT sent a player to the ER to rule out a fracture. 2 hours later, once a fracture was ruled out, the patient returned to the stadium and was running around like nothing ever happened. Coaches thought AT over reacted.

Covering youth football games as a per diem AT can be tricky and taxing! Here’s the set up. Generally the AT is responsible for covering both sidelines for several games in a row, sometimes for 7+ hours. There will be games at all youth levels from the little tiny kids just learning the game to the middle school kids who are bigger than some high school players. You’re hanging on the sideline of the team who hired you, watching the games and sometimes heading back and forth between sidelines and occasionally running out onto the field. The games happen consecutively with about enough time for a quick bathroom break in between games. Sounds pretty standard right?

So, the youngest kids generally don’t sustain more than bumps and bruises, because most are too small to hit hard enough to do any actual damage. But as these kids get older and older, they hit harder and you see patients who have taken their first big hit as well as those who have never had the wind knocked out of them and those who have never really felt any real pain in their life. These situations can be very scary for our patients. Then there are the kids who fake injuries to get out of the game because they are afraid of being hit or just don’t want to be there. Also, like most per diem jobs, we’ve never met these kids and have no clue about their pain tolerances. So those are the kids...

Then there are the coaches. Some of them are unaware of our role on the field and our education and can become upset when we tell them something they don’t want to hear. Most are usually happy we are there so that they don’t have to try to “play doctor” and coach at the same time. AND THEN… there are the parents. The parents are a complete mixed bag, and you never know what you’re going to get until you call them down to the field. Some will do everything you tell them, ask you educated questions and thank you later. Some will make their kids send you thank you notes! (I love these!) Others will blow you off and say that they know their kid and that he’s just fine. They’ll complain about you for adhering to state concussion laws and threaten to sue for taking their kid out of the game. I’ve seen a patient’s older sister tell him after getting hit in the head and being taken out of a 3rd game in 4 weeks that he was embarrassing her and their family.

Now, just to throw another log on the fire, when it comes time to do an evaluation, you’ve got coaches and parents hovering along with the occasional unrelated nurse mom and of course the assistant coach who is also an EMT. Unless you have eyes in the back of your head, you know it’s impossible to assess a patient sitting on the bench AND see the game at the same time. That’s about the time when the player from the other sideline goes down. So there’s your environment. Can you see how some of these situations above may have come about?

Now some of you may be reading this and thinking, “So what, Mara! This is what my job is like every single day!” If that’s you, I’m sorry to hear that. You should quit and come work with us at Precision AT as 75% of our jobs are pretty painless. For the rest of you who’ve I’ve just scared to death… here are a few ways that you can get through this and successfully represent our profession at the same time:

1. If possible, introduce yourself to everyone between every game. EVERYONE! EVERY GAME! That means the refs, both teams’ coaching staffs, and a quick announcement to both teams’ players. This takes 2 seconds! I generally say something like “Hey everyone, I’m Mara the Athletic Trainer! I hope I won’t see any of you anymore today! Have a great game!” I then tell the coaches how to get my attention during the game. Generally I tell them to wave their arms and make a scene so that I can see them from across the field or tell the refs that they need me. I also introduce myself to the people working at the snack bar and tell them where I will be during the game so that they can direct parents or players to me as needed. (This is also a strategy to getting free snacks later!)

2. Be present on the sideline during play. Yes, these are little kids and this is youth sports, but it’s still football. You wouldn’t sit during a high school football game and these guys need the same amount of attention.

3. Do not leave for the visiting team’s sideline without 2 bags of ice in hand. (Have these pre-made!) There is nothing worse than getting all the way over there and having to go back to the home bench for an ice bag. Why 2 bags? Because you better believe that another player is going to need some too. Also, don’t be afraid to run across the field in between plays during the younger kids games … You’ve introduced yourself to the refs and they’ll usually make time for you get across.

4. Be very careful with what you say to parents! “He will be fine” will eventually come back and bite you. Yes, we have great evaluation skills and instincts, but it can NEVER hurt to give parents warning signs of when a doctor’s or ER visit may become necessary even when you think the patient is totally fine. For concussions, the laws in MA are that if a player sustains a concussive force and has even 1 concussion symptom, that player is to be removed for the day. Be kind when you tell this to players and parents and tell them why that rule is there in a way that will not scare them (or their little kids) but in a way that shows you are concerned for the well-being of their child and not just trying to CYA. Following up by phone is almost always appreciated as well!

5. Remember Two Things: 1. Kids break and bend easily and have growth plates! 2. Kids crash fast! Never leave a patient who is feeling faint or looking green or pale. Get adult back up as soon as you see this happening just in case you have to run out onto the field. Don’t wait too long before calling 911. When in doubt, it’s always better to be conservative.

6. Use voice memo on your cell phone to help you document information fast and get names and phone numbers first in case you get called away. Be thorough! Then when you get home… write up the formal reports and follow up!

These helpful hints aren't just for Football. They can actually apply to most sports! I hope you readers will share experiences and advice in the comments section. Youth football organizations are finally starting to transition from EMTs to ATs and I don’t foresee having traveling ATs (or 1 per sideline) becoming the norm anytime too soon, so whatever we can do to help each other will help our profession as well.

Please share your stories! Thanks!

Mara