Sports

State rules limit athletic trainer Middlemiss’ treatment options

—By Vansh Bansal & Brandon Daley—

When the boys’ basketball team stormed back to tie Allentown, taking the game to overtime, athletic trainer Patricia Middlemiss kept her post near the action.  Middlemiss had been making her way around to various athletic events all afternoon.  “After 2:50, nothing is typical,” Middlemiss said.  A wrestler can sprain his wrist in a pindown.  A basketball player can land awkwardly on his foot.  The life of a trainer can be quite hectic, with different injuries calling for different solutions, and athletes buzzing in and out of the training room.

But due to limitations, Middlemiss cannot offer treatment or a second opinion if an athlete visits a doctor.  “I cannot trump what a doctor says,” Middlemiss said.  Family and even regular doctors are always more conservative in both their diagnosis and prognosis of the injury.  “With athletic injuries a lot of the time going to the doctor will result in just a note saying you can’t practice for a few weeks, which really hurts your training and your team,” junior Aashna Tilve said.  “By working with the trainer you can modify workouts to fit your injury without letting it impede your training.”

Because doctors have more freedom and luxury in prescribing X-Rays, MRI’s, and other high-end treatment options, they can often arrive at a better diagnosis, Middlemiss said.  In spite of these limitations, North coaches are never hesitant to send their athletes to the training room.  “When I send an athlete to the trainer, I trust that she will attend to the injury to the best of her ability,” soccer coach Trevor Warner said.

A sole visit to the trainer can be simpler and gets the athlete back sooner, because Middlemiss can modify workouts and practice regimens to keep injured athletes active.  “[The athletes] aren’t just sitting around,” she said.  According to Middlemiss, a conservative doctor who isn’t as “well-versed” in athletic injuries will shut down an athlete’s activity completely for a period of time.

However, due to practice laws, there are some things Middlemiss simply can’t, and won’t, do.  She’s not a chiropractor.  She can’t manipulate the joints of the back.  She also can’t pop in a shoulder.  She was not trained in many of the more advanced treatments, and by state law, she is unable to perform these tasks due to liability issues.  “I think she’s more for diagnosis.  If it’s really bad, then she’s going to tell you to go to the doctor,” one track athlete said.

Another common misconception among student athletes regards WW-P concussion protocol, Middlemiss said.  Based on New Jersey state law, the district policy overrides any doctor recommendation for concussion patients.  If an athlete reports even one symptom, he or she is sent straight to a doctor.  However, if a doctor clears the athlete to return within a few days, the athlete must still go through the district’s four-step process to return to play.

According to several athletes interviewed for this article, the process—which includes four days of light exercise, sprinting, no contact practice, and full practice—has proven frustrating.  But Middlemiss said she feels the steps are justified and necessary.  “We don’t do brain transplants in the medical industry. It’s better to be unbelievably conservative,” she said.  Once the athlete completes this process and feels no symptoms, he or she must take the imPACT exam, a computerized test that determines whether athletes have recovered from a head injury, and send the results back to the doctor for final clearance.  Recent medical studies show that concussions can no longer be taken as lightly as they were only a few decades ago.

Several athletes told The Knightly News their main concerns with injury treatment regard injuries that they feel require tape.  Some athletes interviewed voiced frustration that the athletic trainer wouldn’t allow them to simply have an injury taped so they could return to action.  Middlemiss clarified this issue, explaining that legal issues prohibit her from treating any injury without proper evaluation.  “If I tape an injury without evaluating it, and the injury gets worse, I’m liable.  It may be something that I can’t tape, and I might have to hold them out for,” she said.

Often times, athletes may go to the training room to have injuries taped that simply require more extensive treatment and rest, and because Middlemiss is required by law to evaluate every injury she sees, she has to tend to the injury appropriately, regardless of how long the athlete could be out for.  “Taping does not cure all,” Middlemiss said.

Some of the concerns athletes have expressed stem from Middlemiss being stretched too thin, she said, since she is but one person assigned to hundreds of student athletes.  “There are times, especially in the fall or spring, where we can have five or six games going at the same time,” Middlemiss said.  She explained that since she cannot be at every sporting event at the same time, she has to prioritize athletic events by possible risk of injury.  In the fall, football trumps all due to its physical nature.  Wrestling takes priority in the winter time, and in the spring lacrosse holds the highest risk of injury.

This system, though imperfect, is the only means for Middlemiss to split her time efficiently.  “A lot come[s] down to money,” Middlemiss said.  “I’ve heard parents say we need another [trainer].  I’ve heard coaches say it.  It just comes down to money.”  The National Athletic Trainers’ Association concluded that the average salary for a public high school athletic trainer was $52,935 in 2011, a figure that has gradually increased.  This annual salary, along with the likely cost of the second trainer’s ongoing education, makes the proposition of a training assistant somewhat unlikely, Middlemiss said.

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