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Athletic training
Athletic training
Athletic training
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Athletic training
Occupation
SynonymsAthletic therapy
Occupation type
Profession
Activity sectors
Health care
Description
CompetenciesSports medicine, Primary care, Emergency service, Exercise prescription
Education required
Master of Science Bachelor of Science
Fields of
employment
Sport, Clinic, Performing arts, Occupational medicine, Public security
Related jobs
 Sports medicine physician, Physiatrist, Physician assistant, Physical therapist, Emergency medical technician

Athletic training is an allied health care profession recognized by the American Medical Association (AMA)[1] that "encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of emergent, acute, or chronic injuries and medical conditions."[2] There are five areas of athletic training listed in the seventh edition (2015) of the Athletic Training Practice Analysis: injury and illness prevention and wellness promotion; examination, assessment, diagnosis; immediate and emergency care; therapeutic intervention; and healthcare administration and professional responsibility.[3]

Athletic trainers (ATs) generally work in places like health clinics, secondary schools, colleges and universities, professional sports programs, and other athletic health care settings,[4] usually operating "under the direction of, or in collaboration with a physician."[1]

Overview

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According to the National Athletic Trainers' Association, there are more than 58,000 athletic trainers around the world.[5] The U.S. Department of Labor Statistics projects that employment of the athletic trainers is estimated to grow by 19% between 2018 and 2028.[6]

Working environments

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Athletic trainer attending to a Portland Thorns player

The traditional setting for athletic trainers is embedded within a sports team.[7][8][9] In the United States, over 40% of athletic trainers work at an educational institution, including universities, secondary schools, and middle schools, providing health care to student athletes.[10][11] Athletic trainers in this setting are commonly present at practices and competitions to be able to serve as first responders and deliver care as needed.[9] Providing care at practices and competitions commonly leads to long working hours, including nights and weekends.[7]

Also, in the United States, approximately 18% of athletic trainers work in a clinic setting.[10][11] This includes sports medicine clinics, outpatient ambulatory rehabilitation clinics, emergency departments, physician clinics, and assisting in surgery, among others.[9][12] Job duties and responsibilities vary in this setting.

In recent decades, athletic trainers have been expanding into additional settings such as the performing arts, occupational medicine, and public security.[9][10][11][12][13]

Roles and responsibilities

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Scope

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Athletic trainers work under the direction of a physician to deliver sports medicine services.[10][14] They are commonly primary care providers for the populations that they serve, managing their day-to-day health care and care coordination needs.[14] As sports medicine professionals, athletic trainers are broadly concerned with the prevention and treatment of sports injures.

Athletic trainers receive formal training in:[15]

Referring

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In certain instances, patients and clients may require treatment or consultation that falls beyond the scope of an athletic trainer's expertise. In such cases, the athletic trainer's responsibility is to make appropriate referrals to other healthcare professionals. Various supporting health services may be utilized, including school health services, nurses, physicians, dentists, podiatrists, physician's assistants, physical therapists, strength and conditioning specialists, biomechanists, exercise physiologists, nutritionists, psychologists, massage therapists, occupational therapists, emergency medical technicians, paramedics, chiropractors, orthopedists, prosthesis experts, equipment personnel, referees, or social workers.[4]

NATA code of ethics

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"The National Athletic Trainers' Association Code of Ethics states the principles of ethical behavior that should be followed in the practice of athletic training. It is intended to establish and maintain high standards and professionalism for the athletic training profession."[16]

Education

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Undergraduate general studies

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The content of the courses will vary based upon the institute and professor, but there are some general subject matters that any AT should know including human and exercise physiology, kinesiology, anatomy, and nutrition. These subjects are commonly studied to increase knowledge regarding athletic training.

Physiology "is the scientific study of functions and mechanisms in a living system".[17] More in-depth studies of physiology is between human and exercise physiology. Human Physiology is more anatomical structures, exercise physiology is physical exercise conditions and treatments. Kinesiology "identifies stress in our muscles and uses relaxation techniques to release tension and improve our mood, health, and overall well-being" Used in athletic training, focuses more on muscle anatomy and sport focused rehabilitation.[18] Human anatomy studies the structures on the body including muscular systems, organs, respiratory, bone anatomy, veins, and arteries. This also includes physical examinations of the extremities. Which will include injury recognition, treatment, taping, bracing, and care. After the examination an AT might have to perform acute care of injury. This is implemented when dealing with trauma and illnesses sustained during sport participation. This includes field evaluation of medical emergencies, such as cessation of breathing or circulation, shock, concussion, and spinal injury. After performing care, somewhere down the road athletic trainers may have to provide rehabilitation strategies to go through with the athlete. ATs need to know about basic nutritional principles and concepts that lead to an athlete's personal health, relationship with food and overall optimal health. How a student eats is influential on their recovery time and overall athletic performance.[19][20]

Accreditation

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The Commission on Accreditation of Athletic Training Education (CAATE), under the Council for Higher Education, is the accrediting body for athletic training education programs in the United States.[21] Only individuals who successfully complete an accredited program are eligible to sit for the certification exam to become an athletic trainer.[22] CAATE lists all the accredited programs in the United States on their website.[21] It provides the college's name, contact information, and a link to the institution's website.

Entry-level master's programs

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An entry-level master's program is a two-year program that covers the material required for an athletic training degree. Standard prerequisite classes are human anatomy, human physiology, kinesiology, biomechanics, exercise physiology, nutrition, personal health, and a certain number of observation hours completed under a certified athletic trainer (ATC).[21]

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There are 15 schools in the US with an accredited athletic training master's program for those with a bachelor's in athletic training who want to pursue further education.[23] These programs are typically two years in length. While enrolled in one of these programs, the athletic trainer may gain clinical experience and receive a stipend through a graduate assistant internship.

Graduate assistant internships

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Typical responsibilities for graduate assistant interns include administering daily medical care to selected intercollegiate athletic teams, evaluating and documenting athletic injuries, completing administrative duties, serving as an approved clinical instructor or clinical instructor in a CAATE-accredited ATEP, and assisting the head athletic trainer. Other internships may include working at a high school or clinic, teaching, or researching. Graduate assistant positions are generally around 10-month appointments that may be renewable after the first year and sometimes include additional summer work.[24]

Accredited programs

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CAATE evaluates athletic training programs to ensure that they follow the standards for entry-level athletic training programs. Evaluations may take place every three to seven years. Completing the CAATE accredited education program is a part of the criteria that determines a candidate's eligibility for the Board of Certification (BOC) examination.[25][26]

Organizations

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The National Athletic Trainers Association (NATA) is the professional organization for athletic trainers in the United States. NATA is divided into 10 geographical districts which each appoint their own agendas and board members. Each district consists of about 3-6 states/territories which have a director that serves on the NATA Board of Directors.[27] Every state has its own state athletic training association that acts similar to the district associations with their own board members. The state associations answer to the district associations and NATA.

Before the formation of NATA, athletic trainers occupied a somewhat insecure place in the athletic program.[28] Since then, considerable professional advancement has been made in the field.[4]

As well as the NATA, there is also the World Federation of Athletic Training & Therapy (WFATT) which began in 1998 but was founded in 2000. The WFATT's mission statement includes "Athletic Training & Therapy will be recognized as an essential part of multidisciplinary healthcare teams worldwide". Across 4 continents, 12 countries and in 42 member associations, there's well over 50,000 athletic trainers registered. To start the WFATT, the US and Canada (Canadian Athletic Therapists Association) went and promoted athletic training in various countries through workshops.[29]

References

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Revisions and contributorsEdit on WikipediaRead on Wikipedia

Athletic training

View on Grokipedia
from Grokipedia
Athletic training is an allied profession that encompasses the prevention, examination and , treatment, and rehabilitation of emergent, acute, subacute, and chronic injuries and medical conditions among physically active individuals. Athletic trainers (ATs) are board-certified healthcare professionals who specialize in optimizing and participation, often collaborating with physicians to provide comprehensive care. Recognized as an allied health profession by the (AMA), (HRSA), and U.S. Department of Health and Human Services (HHS), athletic training emphasizes evidence-based practices to enhance patient outcomes and reduce healthcare costs. The profession traces its modern origins to the late 19th century, when institutions like began employing individuals to care for athletes in 1881, evolving into formalized roles by the early 20th century. The National Athletic Trainers' Association (NATA) was established in 1950 to advance the field, marking the beginning of organized professional development and standards. In 1990, the AMA officially recognized athletic training as an allied health profession, solidifying its status and leading to regulation (through licensure or other means) across all 50 U.S. states and the District of Columbia. Education and certification form the cornerstone of the profession, requiring completion of a master's degree from a program accredited by the Commission on Accreditation of Athletic Training Education (CAATE). Graduates must then pass the Board of Certification (BOC) exam to earn the "Athletic Trainer Certified" (ATC) credential, demonstrating competency in five key domains: injury/illness prevention and wellness promotion, examination, diagnosis, and assessment; acute care and emergency management; therapeutic interventions; and healthcare administration and professional responsibility. Certified ATs must maintain their credentials through continuing education, with approximately 56,906 individuals holding BOC certification as of 2023. ATs practice in diverse settings, including secondary schools, colleges and universities, teams, military installations, , clinics, hospitals, and occupational environments, treating patients of all ages from youth athletes to industrial workers. Their services, including evaluations and therapeutic interventions, are billable under relevant CPT codes such as 97169–97172 for evaluations and 97110, 97112 for certain therapeutic procedures, contributing to improved outcomes and cost savings in healthcare delivery.

Definition and Scope

Overview

Athletic training is an allied profession dedicated to the prevention, examination, , treatment, and rehabilitation of emergent, acute, or chronic injuries and medical conditions among physically active individuals, including athletes and those engaged in recreational or occupational . This field is recognized as an allied health profession by major bodies such as the (AMA), (HRSA), and U.S. Department of Health and Human Services (HHS). Certified athletic trainers (ATs) serve as highly qualified healthcare professionals who deliver these services under the direction of or in collaboration with physicians, encompassing emergency care, wellness promotion, and comprehensive support for injury management in dynamic environments. ATs address the needs of diverse populations beyond elite sports, including , , and performing artists, while operating across key domains such as prevention, clinical evaluation, immediate care, treatment, and rehabilitation. ATs are distinct from related fields like and sports coaching due to their specialized emphasis on sports and exercise settings, where they prioritize immediate assessment, on-field response, and prevention strategies tailored to high-risk physical activities. In contrast to , who often focus on long-term rehabilitation for mobility impairments and chronic conditions across varied patient groups, ATs integrate medical-model training to support safe participation in athletic endeavors. Unlike sports coaches, who emphasize technique, strategy, and performance optimization, ATs apply clinical expertise in healthcare delivery rather than instructional fitness guidance. Current professional standards require ATs to hold at minimum a from a Commission on Accreditation of Athletic Training Education (CAATE)-accredited program, a mandate effective for new entrants to the profession starting in 2022, along with national as an Certified (ATC) from the Board of Certification, Inc. (BOC).

Domains of Practice

Athletic training practice is organized into five core domains, as established by the Board of Certification, Inc. (BOC) Practice Analysis, 8th Edition (effective 2023), and aligned with standards from the National Athletic Trainers' Association (NATA) and the Commission on Accreditation of Athletic Training Education (CAATE). These domains outline the essential required for certified athletic trainers to deliver comprehensive care, emphasizing and interprofessional collaboration throughout. The first domain, risk reduction, wellness and , focuses on strategies to minimize risks and promote overall . This includes conducting risk assessments to identify environmental and individual factors that could lead to injuries, developing conditioning programs tailored to enhance and resilience, and educating individuals on , hydration, and safe practices. Athletic trainers also select and fit protective equipment and monitor environmental conditions to prevent heat-related illnesses or other hazards, integrating evidence-based guidelines to inform these preventive measures. Interprofessional collaboration occurs through consultations with physicians and other specialists to address underlying risks. The second domain, assessment, and , involves systematic to identify injuries or illnesses accurately. Athletic trainers perform comprehensive histories, physical examinations, and diagnostic tests to formulate differential diagnoses, often using evidence-based clinical decision-making tools to ensure precision. This domain requires interpreting findings to guide initial care plans and recognizing when referral to physicians or other healthcare providers is necessary, fostering interprofessional for optimal patient outcomes. Critical incident management, the third domain, addresses urgent responses to acute incidents. Key activities include rapid on-site assessments, stabilization of injuries, and implementation of emergency procedures such as (CPR) or (AED) use. Athletic trainers develop and execute emergency action plans, communicate effectively with emergency services, and apply evidence-based protocols to manage critical situations like concussions or spinal injuries, while collaborating with medical teams for seamless transitions to advanced care. The fourth domain, therapeutic intervention, centers on restoring function and preventing re-injury through targeted interventions. This encompasses prescribing therapeutic exercises, manual therapies, and modalities such as or electrical stimulation, all grounded in evidence-based rehabilitation protocols to track progress and adjust plans. Athletic trainers educate patients on self-management techniques and monitor return-to-activity criteria, often working interprofessionally with physical therapists and physicians to coordinate holistic recovery programs. Finally, the fifth domain, healthcare administration and , pertains to administrative and ethical responsibilities that support effective practice. Athletic trainers manage healthcare facilities by ensuring compliance with regulations like HIPAA and OSHA, maintaining accurate records, and developing policies for and . This domain promotes through and advocates for the of both patients and practitioners, incorporating evidence-based strategies for workload management and interprofessional health initiatives.

History and Development

Origins

The origins of athletic training trace back to , where organized physical preparation for competitions became integral to society following the establishment of the in 776 BCE. In Greek city-states, particularly and , athletes trained in public gymnasia under the guidance of paidotribai—specialized trainers responsible for developing strength, endurance, and technique through exercises like running, wrestling, and discus throwing. These trainers emphasized balanced regimens that included diet, , and , drawing on early medical knowledge from figures like Herodicus, a 5th-century BCE physician who advocated exercise as therapy for ailments. Such practices not only prepared competitors for pan-Hellenic festivals but also reflected broader cultural ideals of , or excellence in body and mind. Roman civilization adopted and adapted Greek athletic traditions after conquering much of the Greek world in the BCE, integrating them into training and public spectacles. Roman trainers, often called palaestrae instructors, focused on conditioning soldiers and gladiators with weight training using (handheld weights) and regimen emphasizing nutrition high in and to build resilience. While less formalized than Greek systems, these roles involved treating injuries with ointments and bandages, as described by writers like , a 2nd-century CE physician who served as a trainer for gladiatorial schools and emphasized holistic care combining exercise and . In the 19th century, athletic training began emerging in the United States amid the rise of intercollegiate sports, particularly football and track, at institutions like Harvard University. By the 1880s, colleges employed basic trainers alongside team physicians to manage injuries and conditioning, marking a shift from ad hoc care by coaches or students to more dedicated support; Harvard hired James Robinson in 1881 as its first full-time athletic trainer for the football team, a role that involved taping, basic rehabilitation, and preventive measures during games. This development was influenced by growing athletic programs, with similar informal positions appearing at Yale and the University of Pennsylvania to ensure competitive edges in amateur contests. The pre-professional era of athletic training in early 20th-century American amateur and college sports featured informal, multifaceted roles often filled by coaches or volunteers without standardized training. Key figures like Michael C. Murphy, who served as trainer and coach at the University of Pennsylvania from the 1880s to 1913 and later with U.S. Olympic teams, exemplified this by combining injury management with performance enhancement, using innovative techniques like rubber tubing for resistance exercises. Similarly, Samuel E. Bilik, dubbed the "father of athletic training," published influential texts such as The Trainer's Bible (1916), which codified practices for handling sprains, strains, and conditioning in college settings. These efforts laid groundwork for formalization, as trainers operated amid unregulated amateur sports where roles blended coaching, medical aid, and equipment maintenance without professional oversight.

Evolution in the United States

The professionalization of athletic training in the United States accelerated after , culminating in the formation of the National Athletic Trainers' Association (NATA) in 1950 as the first dedicated professional organization for the field. The inaugural meeting, held at the in , drew approximately 200 athletic trainers who sought to establish uniform standards, promote education, and gain broader recognition for their role in and care. This gathering marked a pivotal shift from informal practices rooted in earlier traditions to a structured , with NATA initially operating through a postal network before establishing its first office in 1977. By fostering collaboration among trainers working primarily in collegiate and high school settings, NATA laid the groundwork for national standards that would define the discipline. Certification emerged as a cornerstone of professional legitimacy in the late , with the Board of Certification (BOC) established in under NATA auspices to develop and administer entry-level exams. The first certification examination was administered in 1970 in , enabling athletic trainers to earn the ATC credential and demonstrating competency in areas such as injury assessment and rehabilitation. This initiative addressed inconsistencies in training and qualifications, with the BOC becoming an independent nonprofit in 1989 while maintaining its role as the sole accrediting body for athletic trainers in the . As of 2023, the BOC had certified 56,906 professionals, reflecting the exam's evolution to align with analyses conducted periodically. Educational standards advanced significantly in the ensuing decades, transitioning from primarily baccalaureate programs to a mandatory entry-level by 2022, as mandated by the Commission on of Athletic Education (CAATE). This shift, endorsed by the NATA in 2015 through its strategic alliance with CAATE, aimed to enhance clinical proficiency and align athletic training with other requiring graduate preparation. CAATE-accredited programs, numbering 359 as of 2024, now emphasize advanced coursework in , interprofessional collaboration, and diverse clinical rotations, ensuring graduates meet rigorous competencies before BOC examination. Existing certified trainers were grandfathered, but the change elevated the profession's academic rigor and employability in healthcare settings. Legislative progress further solidified athletic training's status, with state licensure laws beginning in the 1980s—such as becoming one of the first in 1987—leading to regulation in 49 states and the District of Columbia by 2025. These laws define , require BOC certification for licensure, and mandate , protecting public safety while expanding access to services. Enhanced recognition as allied health providers under federal reforms, including the (ACA) of 2010, facilitated reimbursement for athletic training services in clinical environments and integrated trainers into broader healthcare delivery systems. Paralleling these developments, the profession grew dramatically, with NATA membership rising from approximately 2,500 in 1970 to about 50,000 as of 2024, underscoring increased demand and professionalization.

Roles and Responsibilities

Core Duties

Athletic trainers (ATs) perform a range of hands-on responsibilities centered on direct patient care for athletes and active individuals, encompassing prevention, assessment, treatment, , and documentation. These duties align with the core domains of athletic training practice, including , clinical evaluation, immediate care, treatment and rehabilitation, and organization and administration. In injury assessment, ATs conduct thorough physical examinations to evaluate emergent, acute, or chronic musculoskeletal injuries and medical conditions, often using tools such as goniometers to measure , along with assessments of , swelling, strength, balance, , and functional capacity. These evaluations enable ATs to identify injury severity and guide subsequent care plans, with testing being a standard component utilized by over 90% of practitioners in return-to-activity decisions. Treatment application involves implementing therapeutic modalities and interventions to alleviate pain, reduce , and promote recovery, such as with ice packs to decrease swelling and nerve impulses, therapeutic ultrasound to enhance tissue healing, and taping or bracing techniques to support joints and prevent further damage. ATs also develop and execute rehabilitation programs tailored to the patient's needs, incorporating and progressive exercises to restore optimal function. Prevention strategies form a foundational duty, where ATs design and oversee conditioning programs to enhance strength, flexibility, and endurance, while fitting protective equipment like helmets, pads, and braces to minimize injury risk during activities. These efforts include on proper techniques and environmental monitoring to avoid overuse or acute incidents. Record-keeping requires ATs to maintain detailed, confidential health records and progress notes for each , adhering to standards such as those outlined in the Health Insurance Portability and Accountability Act (HIPAA) to ensure privacy and accuracy in tracking treatment outcomes and compliance. often utilizes electronic health records and standardized codes, such as CPT codes 97169–97171 for evaluations of varying complexity and 97172 for re-evaluations, to facilitate continuity of care. For emergency response, ATs follow established protocols to manage on-field incidents, such as immediately removing athletes suspected of concussions for and implementing cooling measures for heatstroke cases by contacting services and initiating ice-water immersion to lower core temperature rapidly. These actions prioritize rapid intervention to stabilize patients and prevent complications.

Scope of Practice

The scope of practice for athletic trainers (ATs) delineates the professional boundaries within which they provide healthcare services, primarily focused on the prevention, examination, diagnosis, treatment, and rehabilitation of emergent, acute, or chronic neuromusculoskeletal injuries and certain medical conditions. Authorized activities include conducting clinical examinations to formulate differential diagnoses of musculoskeletal injuries, prescribing and implementing rehabilitation exercises, and delivering therapeutic interventions such as modalities and manual therapy, all aligned with the National Athletic Trainers' Association (NATA) Role Delineation Study and Board of Certification (BOC) standards. However, ATs are explicitly prohibited from pharmacological interventions, including prescribing or administering medications, which fall outside their allied health scope and require physician authority. Licensure requirements and practice autonomy vary significantly by state, governed by individual practice acts that define permissible activities and enforcement mechanisms. As of November 2025, athletic training is licensed or regulated in 49 states plus the District of Columbia, with remaining the sole unregulated state; New York is set to transition from certification to full licensure on December 22, 2025. These state laws establish the legal framework for AT practice, often incorporating NATA competencies while allowing variations in supervision levels, eligibility, and direct access provisions that enable independent evaluation without prior physician referral in some jurisdictions. Supervision rules typically mandate that ATs operate under the direction or collaborative oversight of a physician, ensuring integration within a broader healthcare , though they retain authority to act independently in situations, such as providing immediate care for life-threatening injuries. This structure upholds while leveraging AT expertise in acute settings. The has evolved post-2020 to incorporate screening and referral, as outlined in NATA's interassociation consensus statements, enabling ATs to recognize psychological concerns, implement interventions like goal-setting and relaxation techniques, and facilitate timely referrals to specialists. Similarly, updates emphasize chronic disease management, particularly for musculoskeletal and neurological conditions, allowing ATs to design long-term rehabilitation programs and monitor comorbidities under physician guidance, reflecting advancements in holistic care models.

Referral and Collaboration

Athletic trainers (ATs) are trained to identify situations where an athlete's condition exceeds their , necessitating prompt referral to appropriate healthcare specialists. Referral criteria typically include red flags such as severe head trauma indicators—like decreasing level of consciousness, repeated , seizures, or unequal pupil dilation—which require immediate emergency medical attention to rule out intracranial injury. For musculoskeletal injuries, ATs refer when clinical evaluation suggests structural damage, such as instability, significant swelling, or inability to bear weight, which may indicate conditions like an (ACL) tear requiring orthopedic assessment. Additionally, referrals occur for systemic issues, including suspected nutritional deficiencies or , where ATs direct athletes to registered dietitians or physicians for specialized evaluation. In interprofessional teams, ATs collaborate closely with physicians, physical therapists, and nutritionists, particularly in clinics, to ensure comprehensive care. ATs often serve as the initial , providing evaluation data to team physicians who oversee final decisions on , , or return-to-play clearance. This teamwork extends to coordinating rehabilitation with physical therapists for post-injury recovery and integrating nutritional guidance from dietitians to address performance or health concerns, all while adhering to state licensure boundaries. Such collaboration enhances outcomes by leveraging each professional's expertise, with ATs facilitating seamless integration in settings like collegiate or programs. Communication protocols emphasize secure, documented exchanges to support effective handoffs during referrals. ATs utilize electronic health records (EHRs) to share real-time patient data, including injury assessments and treatment plans, ensuring HIPAA-compliant transmission to referring providers and reducing errors in care continuity. Verbal updates are followed by written summaries, and multidisciplinary team meetings or shared platforms enable ongoing dialogue, such as weekly reports to physicians on progress. For instance, in a involving a soccer player with a suspected ACL tear—marked by a popping sensation, immediate , and positive anterior —an AT would stabilize the injury on-site, document findings in the EHR, and refer to an orthopedist for MRI confirmation and potential surgical planning. Similarly, for an athlete exhibiting post-concussion symptoms like worsening headache and confusion after a , the AT would withhold participation, perform sideline neurocognitive testing, and urgently refer to a neurologist or for advanced imaging to exclude complications like . These examples illustrate how referrals prioritize athlete safety through timely, evidence-based interprofessional coordination.

Education and Certification

Educational Requirements

To become an athletic trainer (AT) in the United States, individuals must complete an entry-level from a program accredited by the Commission on Accreditation of Athletic Training Education (CAATE), a requirement that took full effect for all new certifications starting September 1, 2022, marking the complete transition from undergraduate to graduate-level professional preparation. This shift ensures that aspiring ATs receive advanced clinical and didactic aligned with the evolving demands of the profession. Admission to these master's programs typically requires a from a regionally accredited , with common prerequisites including courses in human anatomy, human physiology, general biology, , physics, and introductory psychology, each completed with a grade of C or better. Many programs also recommend or require statistics and . A minimum cumulative undergraduate GPA of 3.0 on a 4.0 scale is standard for competitive admission, though some programs may consider applicants with slightly lower GPAs if other qualifications, such as relevant experience, are strong. The typical master's program in athletic training spans two academic years (often 24 to 36 months, including summers) and combines classroom instruction in areas like injury assessment, rehabilitation, and emergency care with extensive hands-on clinical education. Under CAATE standards, programs must incorporate clinical immersion distributed across multiple rotations under the supervision of certified ATs, with programs required to establish policies for minimum clinical hours, typically totaling around 1,500 or more hours, to develop practical skills in diverse settings such as sports teams or clinics. This structure builds on the prerequisites to prepare graduates for professional practice. While post-baccalaureate certificate programs exist for certified ATs seeking specialization in areas like orthopedics or rehabilitation, they do not qualify individuals without prior certification for initial entry into the profession and cannot substitute for the required .

Accreditation and Program Standards

The Commission on Accreditation of Athletic Training Education (CAATE) serves as the primary accrediting body for athletic training education programs , recognized by the (CHEA) to establish and enforce standards that promote excellence in clinical practice and health outcomes. Established to advance the profession through rigorous , CAATE professional programs at the baccalaureate and levels, with over 350 such programs holding as of 2025. This oversight ensures that graduates are prepared for entry-level practice via a standardized, evidence-informed educational framework. CAATE standards require professional programs to deliver a aligned with the five core domains of athletic training: , Prevention and , Clinical Examination and , of Injury and Illness, and Therapeutic Interventions. These domains integrate foundational knowledge with practical application, emphasizing psychosocial strategies, healthcare administration, and . Programs must incorporate immersive clinical experiences over a minimum of two academic years, involving real-time care under qualified in diverse settings such as sports teams, clinics, and environments to build progressive clinical proficiency. is woven throughout, requiring students to apply research-supported methods for clinical decision-making and outcome evaluation. The accreditation process operates on a 10-year cycle, during which programs submit detailed self-studies assessing compliance with standards, followed by comprehensive on-site visits from teams to verify implementation and outcomes. Annual reports supplement these reviews to monitor ongoing performance, including metrics like program completion rates and employer satisfaction. Programs that have a three-year aggregate BOC first-time pass rate below 70% must provide an analysis of the deficiencies and develop an for correction, with unresolved issues potentially leading to ; inadequate clinical hours per program policy may also contribute to non-compliance. By maintaining uniform educational quality, CAATE accreditation directly supports the portability of athletic training credentials nationwide, as graduates from accredited programs are eligible to sit for the BOC certification exam, enabling licensure reciprocity across state lines without redundant evaluations. This standardization enhances professional mobility and employer confidence in the competencies of certified athletic trainers.

Certification Process

The certification process for athletic trainers begins with establishing eligibility, which requires completion of a from a Commission on Accreditation of Athletic Training Education (CAATE)-accredited program, including the necessary clinical hours integrated into the . Candidates must also obtain confirmation from their program director or, for international applicants, through a credentials evaluation service to verify equivalence. This step ensures that individuals possess the foundational knowledge and practical experience aligned with professional standards before advancing to the examination phase. Following eligibility verification, candidates take the Board of Certification (BOC) examination, a comprehensive computer-based test administered five times per year in February, April, June, August, and October. The exam consists of 175 multiple-choice questions, including both scored items and unscored experimental questions, and must be completed within a 4-hour . It evaluates competency across five key domains of athletic training: Risk Reduction, Wellness, and (23%); Assessment, Evaluation, and (27%); Critical (14%); Therapeutic Intervention (25%); and Health Care Administration and Professional Responsibility (11%). The content emphasizes practical application and in scenarios relevant to athletic training practice. For the 2024-2025 exam year, the first-time pass rate was 74.6%, reflecting the exam's rigor in upholding professional standards. Upon passing the BOC exam with a scaled score of at least 500 out of 800, candidates receive initial certification as an athletic trainer (ATC®), valid for a two-year maintenance period during which they must comply with annual attestation to professional standards and pay a certification fee. This initial phase focuses on establishing the credential without immediate continuing education reporting, though annual fees support ongoing regulatory oversight. Successful certification grants the ATC® designation, recognized nationally as a mark of entry-level competence. In addition to BOC certification, athletic trainers must obtain state licensure to practice legally in 49 states and the District of Columbia, as these jurisdictions regulate the profession separately from national certification. Licensure applications typically require proof of BOC , a , payment of state-specific fees (often ranging from $50 to $200 initially), and sometimes additional documentation like CPR certification. remains the only state without licensure requirements, though BOC is still expected for professional roles there. This dual credentialing—national certification plus state licensure—ensures accountability and public protection while allowing interstate practice through emerging compacts.

Continuing Professional Development

Athletic trainers must engage in ongoing to maintain their Board of Certification (BOC) credentials and state licensure, ensuring they remain current with evidence-based practices in , assessment, and rehabilitation. The BOC requires recertification every two years, during which certified athletic trainers (ATCs) must complete 50 continuing education units (CEUs) for full cycles or 25 CEUs for partial cycles, depending on certification date. Of these, a minimum of 10 CEUs (or 5 for partial) must come from Category A activities offered by BOC-approved providers, such as live workshops, conferences, and online programs focused on clinical domains like prevention and emergency care. Remaining CEUs can be earned through Category B scholarly activities (e.g., publishing articles or presenting at events, up to 33 CEUs), Category C post-certification (up to 40 CEUs), or Category D non-approved programs (up to 28 CEUs), promoting a balanced approach to . State licensure renewal imposes additional or aligned continuing education obligations, which vary by jurisdiction to support public safety and professional competence. Most states mandate 20 to 50 hours biennially, often incorporating BOC CEUs; for example, requires 40 hours every two years, requires 24 hours biennially, and requires 50 hours biennially to align with national standards. These state-specific rules ensure athletic trainers adapt to regional healthcare regulations and practice scopes. Beyond basic recertification, athletic trainers can pursue advanced credentials to specialize and enhance career . The ATC designation serves as the foundational credential, but specialties such as the Certified Strength and Conditioning Specialist (CSCS) from the National Strength and Conditioning Association emphasize performance optimization and training program design. Other options include the NATA-BOC Microcredential Series, offering targeted competencies in areas like safety or clinical documentation. These advanced pursuits typically require additional examinations, experience, and CEUs, fostering expertise in niche domains. Key resources for continuing professional development include offerings from the National Athletic Trainers' Association (NATA), which provides accessible webinars, self-paced online modules through NATA EducATe, and major events like the annual Clinical Symposia & AT Expo. These platforms deliver BOC-approved Category A CEUs while addressing emerging topics such as and in athletes, supporting career-long growth and compliance.

Work Environments

Educational and Youth Settings

Athletic trainers (ATs) play a pivotal role in educational and youth settings, where approximately 50% of the profession is employed, including 26% in colleges and universities and 24% in secondary schools. In these environments, ATs are responsible for providing on-site , assessment, and emergency care during practices and games, as well as delivering programs on topics such as hydration, , and safe participation to large groups of student-athletes. This coverage extends to game-day events, where ATs ensure immediate response to injuries, often managing multiple sports teams simultaneously due to the high volume of participants in school programs. In , particularly recreational leagues outside formal school structures, ATs focus on preventive strategies tailored to developing bodies, such as programs to mitigate growth-plate injuries common in adolescents during rapid growth spurts. These efforts include monitoring training loads, promoting proper warm-ups and technique, and educating coaches and parents on recognizing overuse risks like apophysitis or , which are exacerbated by repetitive motions in sports like or . By integrating these interventions, ATs help reduce injury incidence and support safe return-to-play protocols, fostering healthier participation in community-based programs. Educational and youth settings present unique challenges for ATs, including budget constraints that limit staffing and resources, leading many to handle multiple-team assignments across diverse sports seasons. In secondary schools, the average salary for ATs is around $65,563 annually (as of 2023), reflecting the demanding nature of these roles amid financial pressures that often result in part-time or shared positions. Despite these hurdles, the benefits are substantial: ATs build long-term relationships with athletes, tracking their development over years and contributing to community health by promoting lifelong wellness habits and reducing time lost to injuries. This sustained involvement enhances athlete safety and social-emotional well-being, creating a positive impact on school and youth program cultures.

Professional and Collegiate Sports

Athletic trainers (ATs) in collegiate sports primarily serve student-athletes across , II, and III programs, where full-time staff are commonly employed to manage , treatment, and rehabilitation. In these settings, ATs collaborate with physicians and coaches to ensure compliance with standardized return-to-play (RTP) protocols, which are mandated by NCAA guidelines to prioritize athlete safety and evidence-based decision-making. For instance, the NCAA Sports Medicine Handbook outlines that ATs and team physicians hold final authority on RTP determinations, independent of coaching influences, to mitigate risks such as concussions or musculoskeletal injuries. This role extends to monitoring training loads and integrating academic considerations, as student-athletes balance rigorous athletic and educational demands. In professional leagues like the , NBA, and MLB, ATs provide comprehensive medical support to elite athletes, often requiring 24/7 availability to address acute injuries during games, practices, and off-season conditioning. These professionals utilize digital tools, such as injury tracking applications (e.g., SportsWareOnLine or ATGenius), to document and analyze data in real-time, facilitating quick interventions and long-term performance optimization. According to the National Athletic Trainers' Association (NATA), ATs in professional sports settings comprise approximately 3% of the overall workforce, reflecting the specialized and limited number of positions available in these high-stakes environments. Unique aspects of AT roles in professional and collegiate include extensive schedules aligned with team itineraries, which can involve frequent road games and international competitions, alongside irregular hours that often extend into evenings and weekends. ATs must also navigate media interactions, providing updates on player injuries and recovery statuses while adhering to league confidentiality protocols to protect . Salary ranges in these elite contexts typically fall between $70,000 and $150,000 annually, with variations based on league, experience, and position—such as head ATs in the earning up to $300,000—far exceeding general medians due to the demanding nature of the work.

Clinical and Industrial Settings

Athletic trainers in clinical settings, such as clinics and , serve as physician extenders by providing outpatient rehabilitation, injury assessment, and therapeutic interventions for a diverse population beyond competitive athletes. Approximately 16% of certified athletic trainers are employed in and environments, where they collaborate with physicians, nurses, and physical therapists to deliver comprehensive care in areas like orthopedics, , and urgent care. In these settings, athletic trainers emphasize injury , prevention strategies, and rehabilitation protocols, often adapting sports-specific techniques to general needs, such as post-surgical recovery or management. A national survey of athletic trainers in allied clinical roles highlighted the high importance placed on these competencies, with and rehabilitation rated as critical for effective outcomes in nontraditional healthcare environments. This integration enhances clinical , allowing for timely interventions that reduce recovery time and improve satisfaction. In industrial and occupational settings, athletic trainers focus on programs and within factories, distribution centers, and military operations, targeting repetitive strain injuries and workplace hazards to minimize lost workdays. For instance, they conduct assessments, implement and initiatives, and serve as . According to a 2008 National Athletic Trainers' Association survey of such employers, over 85% reported at least a 25% decrease in numbers and associated costs, with 81% utilizing athletic trainers for ergonomic programming, resulting in positive returns on exceeding $3 per $1 spent in the majority of cases and rapid impacts on within six months. No more recent comprehensive survey on these metrics was identified. Athletic trainers also work in other non-sports environments, including companies and fitness centers, where they adapt protocols for unique populations like dancers, actors, and recreational exercisers to address overuse injuries and promote wellness. In , they manage foot/ankle, hip, and back issues common to performers aged 6 to over 70, using and corrective exercises tailored to demanding roles such as or . In fitness centers, athletic trainers contribute to corporate wellness initiatives by designing and programs for employees, fostering a proactive approach to occupational health. Emerging growth in corporate wellness programs has expanded opportunities for athletic trainers, with 25th percentile salaries in industrial/occupational and health/wellness settings ranging from $57,830 to $60,000 annually (as of 2023 NATA data). Overall, the median annual wage for athletic trainers across all settings was $60,250 as of May 2024, according to the U.S. , with projected 11% employment growth from 2024 to 2034.

Professional Organizations and Ethics

Major Organizations

The National Athletic Trainers' Association (NATA), founded in 1950, serves as the primary professional organization for athletic trainers . Its mission is to represent, engage, and foster the continued growth and development of the athletic training profession and athletic trainers as unique providers. NATA advocates for policies that advance the profession, including efforts to secure research funding and improve access to athletic training services in various settings. Through initiatives like its strategic plan and publications such as NATA News, the organization supports professional development, education, and to enhance athlete care and outcomes. The Board of Certification, Inc. (BOC), established in 1969 as the credentialing body for athletic trainers, administers the national certification examination and maintains standards for entry-level and continuing competency. Its mission is to provide exceptional credentialing programs for healthcare professionals to assure protection of the public, with a vision of leading credentialing excellence globally. Since its , the BOC has certified tens of thousands of athletic trainers, ensuring adherence to rigorous standards through exams, renewal processes, and approved continuing education providers. This framework has been instrumental in establishing athletic training as a recognized allied across the U.S. The Commission on Accreditation of Athletic Training Education (CAATE), the accrediting body for athletic training programs, works to develop, maintain, and promote appropriate minimum education standards to ensure quality preparation of professionals. Its purpose is to advance and improve outcomes through excellence in athletic training , accrediting professional, post-professional, residency, and fellowship programs. CAATE standards emphasize core competencies in areas such as , assessment, and rehabilitation, facilitating program , diversity, and continuous improvement. By verifying compliance, CAATE helps align educational outcomes with the evolving demands of the profession. The NATA Research & Education Foundation, the philanthropic arm of NATA, focuses on advancing the athletic training profession through grants, scholarships, and educational resources. Its mission is to champion , support , and enhance knowledge to optimize clinical experiences and outcomes for patients served by athletic trainers. The foundation awards for projects addressing key areas like and treatment efficacy, having funded numerous studies that contribute to evidence-based practices; for instance, it supports master's student with $1,000 and larger awards for broader initiatives. These efforts have built a robust , with 416 awarded as of 2025. Complementing national efforts, state athletic trainers' associations operate within NATA's structure of 10 geographic , providing localized advocacy and support for members. Each state association, such as those in , , and , develops bylaws, elects officers, and implements programs tailored to regional needs, including collaboration with local policymakers and educational institutions. These groups foster , professional networking, and state-specific initiatives to promote athletic training services and licensure where applicable, ensuring the profession's growth at the level.

Ethical Guidelines

The National Athletic Trainers' Association (NATA) Code of Ethics, revised in May 2022, establishes foundational principles for ethical conduct in athletic training practice. This code emphasizes patient-centered care, professional , and , serving as a guide for decision-making in diverse settings. It outlines four primary principles that encompass key ethical imperatives, including patient primacy (prioritizing the and long-term health of patients above personal or organizational interests), competence (delivering care aligned with professional qualifications and evidence-based standards), (safeguarding patient information except where legally mandated), and societal responsibility (upholding laws, reporting unethical practices, and promoting the profession's for public benefit). The requires members to practice with , respecting the , , and of all individuals, regardless of protected characteristics such as race, age, , or . This includes rendering competent, quality care and advocating for , directly embodying patient primacy and competence. is explicitly addressed here, mandating that privileged be preserved and released only with or as required , such as in cases of mandatory reporting for suspected or imminent harm. The second mandates compliance with all applicable laws, regulations, and NATA standards, reinforcing societal responsibility by requiring athletic trainers to report illegal or unethical practices to appropriate authorities and to cooperate in investigations. The third focuses on maintaining high standards in service provision, which involves avoiding misrepresentation of credentials, pursuing to ensure competence, and educating supervisees on ethical obligations. The fourth prohibits conduct that creates conflicts of interest or harms the , such as prioritizing financial gain over patient needs or using professional affiliations for personal endorsement, further supporting societal responsibility through promotion of ethical , , and . In practice, these guide athletic trainers through common ethical dilemmas. For instance, in small secondary schools where athletic trainers often hold dual roles—such as serving as both healthcare providers and educators or coaches—conflicts may arise when educational or administrative duties compromise care, requiring prioritization of medical needs per the code's emphasis on patient primacy and conflict avoidance. Similarly, mandatory reporting obligations under the second compel athletic trainers to report suspected , neglect, or involving athletes, aligning with legal requirements like those under and state mandates, even if it strains professional relationships. These applications ensure that protects vulnerable populations and upholds the profession's credibility. Enforcement of the NATA Code is managed through the NATA Committee on Professional Ethics (COPE), which adjudicates complaints against members for violations, following a structured grievance process that includes investigation, hearings, and . Potential sanctions range from reprimands and mandatory education to suspension of membership or expulsion. Complementing this, the Board of Certification (BOC) oversees complaints related to certified athletic trainers under its Standards of Practice, with possible outcomes including revocation for severe breaches like repeated violations or failure to report abuse. These mechanisms ensure accountability and deter unethical behavior. Ethics education is integrated into athletic training curricula through Commission on Accreditation of Athletic Training Education (CAATE) standards, which require programs to incorporate training to foster ethical reasoning and compliance with the NATA Code. At the professional level, continuing education units (CEUs) offered by NATA, such as courses on ethical boundaries and dilemma resolution, are mandatory for certification renewal, ensuring ongoing adherence to principles like competence and societal responsibility. This systematic integration reinforces ethical guidelines as core to career-long practice.

Career Outlook

Employment Projections

Employment of athletic trainers is projected to grow 11 percent from 2024 to 2034, much faster than the average for all occupations, with about 2,400 openings projected each year due to both employment growth and the need to replace workers who leave the occupation. This growth is expected to add 3,800 jobs over the decade. The median annual wage for athletic trainers was $60,250 in May 2024, with earnings varying by work setting. For example, the median wage was highest in arts, entertainment, and recreation at $66,070, followed by educational services at $62,030 and hospitals at $59,890. Demand for athletic trainers is driven by heightened awareness of sports-related injuries, including the implementation of concussion management protocols that require specialized on-site care. Additional factors include the growing participation in sports among all age groups and an increasingly active middle-aged and older population seeking services. The profession's expansion into non-athletic settings, such as clinical rehabilitation and occupational health, further boosts demand. On the supply side, the shift to mandatory master's-level education has led to an increase in accredited programs, contributing to a steady rise in the number of certified athletic trainers, which reached approximately 56,900 as of 2023. This growth in professional preparation helps meet rising employment needs across diverse environments.

Challenges and Future Directions

Athletic trainers face significant reimbursement challenges, particularly with third-party payers such as insurance companies, where services are often not covered or reimbursed adequately due to varying state regulations and limited recognition of the profession's scope. In many cases, athletic trainers must navigate complex billing processes, resulting in financial strain for both practitioners and employing institutions, despite evidence that their services reduce overall healthcare costs through injury prevention and efficient care. Workforce shortages exacerbate access issues, especially in rural areas, where schools and communities struggle to hire qualified professionals due to low funding and geographic isolation. Burnout is prevalent among athletic trainers, driven by long work hours—often exceeding 50 hours per week—and inadequate sleep, leading to elevated levels of emotional exhaustion and reduced professional efficacy. Looking ahead, is emerging as a key trend to address , enabling remote consultations and monitoring for athletes in underserved regions, with projections for broader integration into athletic training services by 2025. offers promising applications in prediction, utilizing models to analyze and training data for early risk identification, thereby allowing proactive interventions. Athletic trainers' roles are expanding into , positioning them as frontline providers in wellness programs, , and population-level to promote broader preventive care. Efforts to enhance diversity within the profession include initiatives by the National Athletic Trainers' Association (NATA), such as scholarships and grants targeted at underrepresented ethnic minority students pursuing athletic degrees, aimed at fostering inclusion and addressing workforce disparities. To strengthen the evidence base, the field requires more randomized controlled trials (RCTs) evaluating rehabilitation efficacy, as current gaps limit the validation of protocols and their impact on recovery outcomes.

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