Chapter 1. My Career as an Athletic Trainer.

As a child I always wanted to be a medical professional when I grew up. Some of my earliest memories are of being fascinated by biology and medicine. I wanted to be Einstein or a physician. I took my first first-aid course at the age of 13 in a class full of adults and was their equal in the book work and practical work. I was an expert on bandaging and splinting. My mother tells me that when I was 11 my Christmas wish list contained two things; Legos™ and medical books. I was trained as an emergency medical technician by the time I was 18, and fantasized about being a paramedic, athletic trainer, researcher or physician. While I bounced around between career choices, I had a general sense of where I was going.
I wanted to get an advanced degree to increase my chances of “helping people” someday. I had decided upon that general direction but was not too sure what discipline to choose. So during my first four years of college I needed to start making choices and decisions as to what type of graduate degree to pursue. That is true for all college students; there are many choices regarding graduate school that need to be made as an undergraduate. So in effect everyone’s graduate education starts as an undergraduate.
I kind of fell into the world of athletic training when I went to college. The university knew I was an experienced ambulance person and they needed that skill set in the training room.
Athletic training is a para-profession that combines sports medicine, exercise, fitness and athletic competition. Athletic trainers are highly trained paraprofessionals who must manage injuries and help athletes improve their performance. Thus a breadth and depth of theoretical and applied knowledge is needed to be effective. I had worked on ambulances to help pay my way through college, was interested in medicine and science, and had an interest in helping people, so becoming an athletic trainer seemed like a logical extension of these interests. It seemed that a great way to help people would be to work with people who wanted to be helped, wanted to improve themselves, and were looking for help from people like me. Working with athletes to help them stay healthy, recover after injury, and to improve their performance seemed ideal. The athletes appreciated the help and the athletic trainers I worked with were smart people who also wanted to “help people.”
I easily got a job as a student athletic trainer and took some classes in athletic training as a complement to my Chemistry major and Biology minor. A student athletic trainer assisted the university’s full-time athletic trainer and got a stipend. I already knew a lot about anatomy and physiology, so the training classes were relatively easy. Learning how to tape an ankle was pretty easy for me, too, because it was so much like bandaging. When I worked on the ambulance I could bandage anything and do it fast to stop the most serious bleeding, so now I was taping an ankle to keep it from twisting during play. I was indeed helping people. These people just wanted to play a game as opposed to many of the people I tended to on the ambulance, who wanted to drive recklessly, do drugs or engage in bar fights. The career change for me was not away from helping people but towards helping a different kind of person: the competitive athlete.
Athletic trainers got know most of the athletes we worked with very well, and fortunately we rarely if ever had to deal with life-threatening injuries or death. Serious injuries could end a sports career or end a season, but it was mercifully rare to find an athletic trainer having to deal with a cardiac arrest.
Don’t get me wrong, however, athletes can sometimes die of heat stroke or have undiagnosed congenital heart disease that can cause sudden death. Then you would find the athletic trainer doing CPR and every single Certified Athletic Trainer must be trained in CPR and have regular re-certification. I often would be asked to instruct the athletic trainers in CPR because I was one of the few people to have actually done it – a lot. But that was when I was working on the ambulance, which was a life I did not want to go back to. I never wanted to be thumping on someone’s chest again, but was glad to impart knowledge and experience to those who might need to do CPR someday.
The skills needed for an athletic trainer are actually quite similar to those of an ambulance person. You need to be well trained, ready for anything, and calm under pressure. An ambulance person might be under pressure because a couple of family members are watching as you try to help a loved one during some emergency. There is the pressure from the medical emergency itself plus the pressure of the family members watching the events unfold. An athletic trainer, likewise, might be called upon to tend to an injured athlete during a major sporting event in front of thousands of people. Some of my athletic trainer colleagues have been on the field during nationally televised games, which means millions of people watching. So, calmness under pressure is an especially good thing for the athletic trainer.
Within a few weeks of joining the athletic training staff I was put in charge of the woman’s basketball team. I had a student trainer supervisor and the full-time trainer to use as resources when needed. I quickly learned the injuries that female basketball players were likely to get and learned how to help with stretching, warm up, and rehab. For athletic trainers a substantial part of the job is preventative taping for joint support. Taping ankles is what many people think of when the subject of supportive taping is discussed, but an adept athletic trainer can tape many joints to give a little extra support. With a good knowledge of anatomy and tons of experience in bandaging all sorts of limbs, I quickly mastered the art of supportive taping of all the major joints prone to injury in the female basketball player.
The woman’s basketball team was a lot of fun and they were consummate competitors. The women also were very conscious of their performance and their physical characteristics. They constantly wanted to improve their game and themselves. So, if I gave them recommendations to do some stretching exercises or strength training advice, they took it. Often they would do more than required to be better. While this was not always the best thing to do, it showed that they were listening and wanted to be helped. What a joy it was to work with these people, and I got to go to all the games and sit on the team bench, which is the best place from which to see a game.
Every once in a while a serious injury would occur. In my first season as the women’s basketball trainer, the lead point guard, the star of the team at the time, injured her knee during a game. I ran onto the court to tend to her. She described a twisting sensation in her right knee followed by a popping sound or unstable sensation on the inside of the knee. She suddenly felt intense pain and at the same time the knee felt “all loose,” she said. That is a fairly typical description of a tear in the knee ligaments (likely the medial collateral ligament or MCL), the cartilage, or the anterior cruciate ligament (ACL). It could be all three at the same time as well, a combination injury known as ”the terrible triad,” which could be a career-ending injury.
The woman’s name was Casey and she was a criminal justice major. The basketball scholarship she had was her way of getting an education to become a state trooper and eventually a detective. Right now, Casey was not thinking about her scholarship; she was thinking about the pain in her knee and whether she could play the rest of the game. Without doing an exam, I knew that she was not playing again tonight and her future was in doubt. I did a quick evaluation on the court, and much of what I was doing was trying to calm her down and get her to focus on me rather than her quickly swelling knee. With help from the assistant coach, I got her to the end of the bench where the injured players and myself would sit. I put some ice on her knee and told her to rest it a bit for now and we would do more of an exam at half time. As the adrenaline that had kept her pumped on the court started to subside, the tears started to flow. She was upset about the injury and concerned about the ramifications of it all.
At half time she said it didn’t hurt much anymore and she really wanted to try to get back into play. I unwrapped the bandages holding the ice bags in place and examined the knee again. There was a substantial amount of swelling on the inside of her knee. I did not try to evaluate for tenderness, but I did want to see how stable the knee was. To test her knee’s stability I had her get on the training room table and asked her to sit back and relax. I picked up her uninjured leg and to show her what I was going to do, I put one hand under her ankle and held up her leg. With her good leg straight, I gently pushed on the outside of the knee and she just looked at me. I told her that pushing like that should not hurt and that the knee should not move. I went then to her injured leg and gently picked it up by cradling the ankle. She would not let the knee straighten but showed no sign of pain. I asked her if it hurt to straighten it, and she said it just felt better this way. With the knee slightly bent, I again very gently pushed from the outside in, looking for any sign of pain. She did not wince at all. But she did look very surprised because her knee now bent sideways in a way it was not supposed to. I had hardly pushed it at all, and I had the information I needed. She had a serious knee injury and was not going to be playing for a while. There were other tests I could do, but they were not needed now. I told her that she was not playing again and put the ice back on her knee.

To be continued.