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Authors of extensive research have exposed health care disparities regarding socioeconomic status (SES) and race and ethnicity demographics. Previous researchers have shown significant differences in access to athletic training services (athletic trainer [AT] access) in the secondary school setting based on SES, but with limited samples. To investigate differences in AT access based on race and ethnicity and SES on a national scale. Cross-sectional study. Database study using secondary analysis. Data were collected from the National Center for Education Statistics, Athletic Training Location and Services database, and US Census Bureau. A total of 10 983 public schools. Descriptive data were summarized by measures of central tendency. A 1-way analysis of variance determined differences between school characteristics (median household income, percentage of students eligible for free and reduced lunch, percentage of White students, and percentage of non-White students) based on AT access: full-time (FT-AT), part-time (PT-AT), and no AT (no-AT). A Bonferroni pairwise comparison was used for variables with significant main effects. Across all schools included in the study, 43.8% had no-AT (n = 4812), 23.5% had PT-AT access (n = 2581), and 32.7% had FT-AT access (n = 3590). Significant effects were found between AT access and median household income (P < .001), the percentage of students eligible for free and reduced lunch (P < .001), the percentage of White students (P < .001), and the percentage of non-White students (P < .001). Schools with FT-AT access had a higher SES than PT-AT and no-AT schools. Significant differences existed between AT access groups and the race and ethnicity of schools. Schools with FT-AT access had a significantly lower percentage of non-White students (31.3%) than schools with no-AT (46.0%; P < .001). No significant differences between FT-AT and PT-AT access based on race and ethnicity demographics presented (P ≥ .13). Schools with higher SES had greater AT access, whereas schools with a higher percentage of non-White students were more likely to have no AT access, demonstrating the disparities in health care extends to athletic health care as well. To increase AT access, future initiatives should address the inequities where larger minority populations and counties of lower SES exist.

Social determinants of health are known to affect overall access to youth sports; however, it is not fully understood how multiple social determinants of health may affect access to school-based athletic training services. To determine the relationship between Social Vulnerability Index (SVI) scores on access to high school-based athletic trainers (ATs) in California. Retrospective, cross-sectional study. Online survey. California Interscholastic Federation (CIF) high school respondents of the 2022-2023 Participation Census. Association between SVI scores and access to school-based AT services. In this study, we used data from CIF high school respondents of the 2022-2023 Participation Census. School addresses were used to extract SVI scores from the US Census Bureau. Separate multivariable logistic regressions and generalized linear mixed effects models assessed the relationships between access to school-based athletic training services and SVI scores at the census and county levels. Of the 1598 respondent schools (65% public, 24% private, and 11% charter), 49% reported having an AT, of which 41% were certified. Adjusted analyses revealed that increased vulnerability in household characteristics was associated with lower odds of access to ATs and certified ATs at both county (odds ratio [OR] = 0.89 [95% confidence interval (CI) = 0.80, 0.99]; P = .04) and census tract levels (OR = 0.93 [95% CI = 0.89, 0.97]; P = .002). Increased vulnerability in socioeconomic status was associated with lower odds of having a certified AT at the census tract level (OR = 0.94 [95% CI = 0.89, 0.98]; P = .006) but not the county level (P = .16). Increased vulnerability in household characteristics is associated with decreased odds of access to high school-based athletic training services.

To present recommendations for the prevention and screening, recognition, and treatment of the most common conditions resulting in sudden death in organized sports. Cardiac conditions, head injuries, neck injuries, exertional heat stroke, exertional sickling, asthma, and other factors (eg, lightning, diabetes) are the most common causes of death in athletes. These guidelines are intended to provide relevant information on preventing sudden death in sports and to give specific recommendations for certified athletic trainers and others participating in athletic health care.

Immediate athletic trainer (AT) availability for acute injuries is essential as worse long-term outcomes are associated with delays in receiving medical care. Several factors have been found to influence AT availability between secondary schools, but few studies have evaluated how medical coverage varies between athlete groups. The purpose of this project was to identify factors that impact the time to AT evaluation following acute sport-related injury in a secondary school setting. Cross-sectional study. Retrospective analysis of deidentified patient records via the Athletic Training Practice-Based Research Network. High school athletes diagnosed with an acute sport-related injury during in-season play from 2010 to 2023. Time to AT evaluation was measured as the number of days between injury onset, reported by the patient, and AT evaluation. This report consists of 17 354 patient cases representing 20 different sports. Overall, 46.9% (n = 8138) of patients who sustained an injury during in-season play were evaluated by an AT the same day (range, 0-14 days). Significant group differences were reported for sex (P < .001), setting (P < .001), and sport level (P < .01), with female athletes and in-game injuries associated with longer times to AT evaluation. Freshmen were evaluated sooner than junior varsity (P < .01) and varsity (P < .001) athletes. No difference was observed between junior varsity and varsity athletes (P = .34). Almost half of patients received medical care within 24 hours following an acute injury during in-season play, highlighting how qualified health care is accessible for many student-athletes through ATs in the secondary school setting. Differences in time to AT evaluation may be attributable to sex discrepancies in immediate medical coverage between sports and injury reporting patterns among athletes.

In many US high schools, the athletic trainer (AT) has the responsibility to identify and manage athletes with concussions. Although the availability of ATs varies a great deal among schools, how the level of AT availability in high schools affects the reported incidence and management of sport-related concussions (SRCs) is unknown. To determine how the presence of an AT affects the reporting and management of SRCs. Prospective cohort study. A total of 2459 (female = 37.5%, age = 16.1 ± 1.2 years) athletes from 31 Wisconsin high schools were categorized as having low availability (LoAT), mid availability (MidAT), or high availability (HiAT) of ATs. Athletic trainers recorded the incidence, days lost from sport, and postconcussion management through return to sport. The incidence of SRC reporting among categories was examined using a multivariate Cox proportional hazards model. Fisher exact tests were used to determine if postconcussion management differed based on AT availability. The incidence of reported SRCs was lower for the LoAT schools (2.4%) compared with the MidAT (5.6%, hazard ratio = 2.59, P = .043) and HiAT (7.0%, hazard ratio = 3.33, P = .002) schools. The median time before the first AT interaction was longer for LoAT schools (24.0 hours) than for MidAT (0.5 hours, post hoc P = .012) and HiAT (0.2 hours, post hoc P = .023) schools. The number of post-SRC interactions was different in all groups (LoAT = 2 interactions, MidAT = 3, and HiAT = 4; all post hoc P values < .05). Days lost were greater for MidAT and HiAT (both 14 days lost) schools compared with LoAT schools (11.5 days lost, post hoc P = .231 and P = .029, respectively). Athletes at LoAT schools were less likely to undergo a return-to-play protocol (9/18 SRCs, 50.0%) than athletes at MidAT (44/47 SRCs, 93.6%; post hoc P = .001) or HiAT (64/64 SRCs, 100%; post hoc P < .001) schools. The level of AT availability positively influenced the reported incidence of SRCs as well as postconcussion management activities in this sample of high schools.

To synthesize the best available evidence regarding the perceptions and current clinical practices of athletic trainers (ATs) in integrating psychological skills into patient management. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL; via EBSCOhost), PsycInfo (via EBSCOhost), SPORTDiscus (via EBSCOhost), and Scopus (via Elsevier). Studies had to investigate the current clinical practices and perceptions of certified ATs in integrating psychologically informed practice for patient management. Studies that had level 4 evidence or higher were included. Studies were excluded if they were published before 1999, the primary language was not English, they involved athletic training students or other rehabilitation specialists, or they explored the athlete's and/or patient's perception of psychosocial techniques or strategies. This systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement in Exercise, Rehabilitation, Sport Medicine and Sports Science guidance. A total of 1857 articles were reviewed, and 8 met inclusion criteria. Two studies had level 2a evidence, 4 studies had level 4a evidence, and 2 studies had level 4b evidence. Six studies were rated as good quality, and 2 studies were rated as lesser quality. The included studies demonstrated a high-quality body of evidence with consistent results, which strengthens the review findings. Athletic trainers have the knowledge to identify when athletes are psychologically affected by injury and can identify common psychological responses. Although ATs acknowledge the value of implementing psychosocial strategies, a lack of confidence in implementing basic or advanced techniques, feeling underprepared by their educational program, and a lack of clinical training appear to affect the use of psychosocial techniques in clinical practice and the rate of mental health recognition and referral among ATs.

Adductor-related groin pain is a common problem in sports. Evidence-based management of athletes with adductor strains, adductor ruptures, and long-standing adductor-related groin pain can be approached in a simple yet effective and individualized manner. In most cases, managing adductor-related pain in athletes should be based on specific exercises and loading strategies. In this article, I provide an overview of the different types of adductor injuries, from acute to overuse, including their underlying pathology, functional anatomy, diagnosis, prognosis, mechanisms, and risk factors. This information leads to optimal assessment and management of acute to long-standing adductor-related problems and includes primary, secondary, and tertiary prevention strategies that focus on exercise and load-based strategies. In addition, information on different options and contexts for exercise selection and execution for athletes, athletic trainers, and sports physical therapists in adductor injury rehabilitation is provided.

Athletic trainers (ATs) provide regular encounters with a healthcare provider for many Title 1 student–athletes with healthcare access and quality barriers. Thus, they are uniquely positioned to serve as a student–athletes’ first point of contact for general medical concerns. This study aimed to describe ATs’ experiences providing primary care for Title 1 student–athletes. This qualitative design employing an interpretative phenomenological analysis (IPA) approach used in-depth, virtual focus groups to examine the experiences of ATs practicing at Title 1 secondary schools. The findings reveal that ATs were called upon to evaluate, treat, and, when necessary, refer student–athletes with general medical conditions. However, Title 1 ATs encountered numerous complex social determinants of health (SDoH) preventing efficient and effective referral to specialty healthcare providers. Thus, ATs ultimately felt their most important roles in the primary care of low socioeconomic adolescents were as caregivers who mitigated avoidable healthcare barriers in addition to coordinators of integrated care that assisted student–athletes and their families with navigating the healthcare system. Title I ATs need to be aware of the SDoH affecting their student–athletes and the ability of those SDoH to affect health outcomes as well as overall student–athlete health and well-being.