Imagine learning your child was found unconscious on a trail during a cross-country meet. Or seeing a high school football player fracture and dislocate his ankle at the same time, almost rotating it 180 degrees in the opposite direction. You’d want the best medical care on the scene — and stat. And treatment followed by the best rehab care to get your student-athlete healthy and back up to speed. In most school districts across the country, certified athletic trainers serve a critical role in providing emergency care for acute illness and sports-related injuries, according to Eric Armstrong, a physical therapist assistant at Ivy Rehab’s clinic in Roxbury, New Jersey. Below we’ll discuss the differences of an athletic trainer vs physical therapist, as well as the important role each plays in sports medicine.
Dual role as an athletic trainer and physical therapy assistant
Armstrong has dual credentials as a licensed and certified athletic trainer and also as a licensed physical therapy assistant. As an athletic trainer, Eric has responded to the above scenarios in real life, but after a decade as an athletic trainer, he now serves a more specialized role as a rehabilitation expert. Along with providing sports physical therapy with Ivy Rehab, he also continues to provide on-site athletic training services to the local community and high schools.
“My training in emergency care of sports injuries and conditions allowed me to determine that she was stable and everything would be fine,” he says of the unconscious cross-country runner who had an undiagnosed heart valve condition. But it was a scary situation that illustrates the serious medical issues athletic trainers must be ready to evaluate and treat.
When care is coordinated, everyone benefits
Athletic trainers, physicians, and physical therapists benefit, along with the student-athlete, by working together to coordinate acute care. Due to the demanding schedule of the job, athletic trainers who coordinate the care of their athletes with a physical therapist have more time to attend practices and get to know their athletes. It’s also an opportunity to build relationships with parents, coaches, and the greater medical community.
Athletic trainers are ready and waiting to respond to emergencies
Athletic trainers provide conditioning and rehab services but are typically hired by professional and college teams and school districts to handle on-the-field injuries and emergencies. Torn ACLs, dislocated shoulders, arm fractures – orthopedic injuries run the gamut.
By definition, athletic trainers “are healthcare professionals who collaborate with physicians to provide preventative services, emergency care, clinical diagnosis, therapeutic intervention, and rehabilitation of injuries and medical conditions,” according to NATA (National Athletic Trainers’ Association).
It’s common to have an athletic trainer on the sidelines, especially at key varsity sports, Armstrong says. He has provided athletic training services and care at every level including the high school, college, and NFL levels.
Some school districts do contract with rehab facilities and physical therapy clinics to provide athletic training services. Usually, the districts are in rural areas that do not have access to a full-time, certified athletic trainer. Ideally, athletic trainers are full-time employees in larger districts. They spend their nights and weekends traveling with teams or making rounds on nights with multiple home sporting events. They’re also called on to treat visiting schools’ athletes at home games. Their schedules are very demanding.
Triage and injury prevention
Athletic trainers are trained to triage injuries and assess what needs to be done. That may be wound care, splinting, or stabilizing an athletic injury until an athlete can get to the emergency room. They often treat muscle strains, sprains, broken bones, and concussions on the scene.
“Really, it’s just making sure the athletes are safe,” Armstrong says. “I’ve had some very serious injuries where the athletes were found unconscious. It’s being on the front lines and providing that care.”
On the injury prevention side, athletic trainers work with athletes on proper nutrition, hydration, strengthening, and stretching. Trainers also provide general education about the warning signs of concussions or more serious orthopedic injuries. ATs also monitor the student-athletes recovery and make sure they aren’t returning too soon or putting themselves at risk for reinjury.
“It’s also making sure they are back to 100 percent prior to returning to their sport so they aren’t at risk for further injury or making their injury worse,” he says.
Physical therapists can assist with more extensive rehab
According to the American Physical Therapy Association, physical therapists (PTs) are highly trained and educated health care professionals who focus on helping patients improve or restore mobility and reduce pain. Often, they can help patients avoid surgery and reduce the need for long-term prescription medications.
It’s less common to have a physical therapist standing on the sidelines because PTs focus on helping a patient on the road to recovery. PTs can attain specialty certifications in orthopedics and sports physical therapy. While athletic trainers are also sports rehab specialists, PTs are recognized by commercial payers as the provider of choice for rehab services. In most states, they will not reimburse athletic trainers for those services. This delineation by the insurance companies usually results in a job site separation.
“They are two separate degrees and licenses, legally a PT can’t represent himself as an athletic trainer and vice versa,” Armstrong says. “The education (for PTs) is less on the emergency management side and doing more strictly on the rehab side.”
ATs and PTs work in tandem
The relationship between the athletic trainer, physician, and physical therapist becomes important as the injured athlete undergoes treatment and rehabilitation. If an athlete sustains an injury that involves surgery, ongoing pain, or sidelines them for more than a few games, it’s time to consider physical therapy. The athlete-centered model of care involves a team of healthcare professionals coordinating acute care to return an athlete to activity and optimal health.
There are several benefits for athletic trainers who recommend athletes visit a physical therapist for rehabilitation, according to an article on MedBridge:
- ATs can spend more time at practice, games, or in the training room working with athletes and coaching staff.
- Physical therapists may be willing to visit the school and address nagging injuries or concerns from athletes.
- Athletic trainers can refer athletes and parents to the physical therapy clinic for a second opinion if parents think their child needs further diagnosis, imaging or treatment.
A unique position as a dual agent
As a physical therapy assistant, Armstrong tries to keep in touch with school athletic trainers as needed. He encourages his patients who are student-athletes to work with their school’s athletic trainer when they don’t have physical therapy, whether it’s just stretching or light strengthening.
And as an athletic trainer, Armstrong always appreciated when PTs would keep him updated on the progress of an injured athlete. Athletic trainers also can be a good resource for parents looking for a referral when a physician orders physical therapy.
“The athletic trainer, physical therapist, and physician all kind of work together as a team,” he says. “I reach out to the athletic trainer and let them know what we’re doing; we approach it as a team environment to get them (student-athlete) back to their optimal performance.”
Advocates on the sidelines
In light of the COVID-19 pandemic, it’s hard to say whether fall sports will be resuming as normal. But, if and when they do, parents, coaches, and athletic trainers will be on the sidelines watching and waiting to spring into action.
If your child has sustained an athletic injury, or your sports team needs a dedicated trainer or specialist, contact your local Ivy Rehab Network clinic. They can connect you with a physical therapist that specializes in sports rehabilitation and performance enhancement skills.
Article by: Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA
Ivy Rehab
Holly is a practicing physical therapist, partner and Director of Clinical Services at Ivy Rehab Network with more than 40 years of experience in sports management with young athletes, and is board certified as a geriatric clinical specialist and certified exercise expert for aging adults. Deuer is certified as an aquatic and oncology rehabilitation specialist and serves as adjunct faculty at Central Michigan University and Grand Valley State University.
