What to Do When You Don’t Have an Athletic Trainer

In many education-based athletic programs, coaches and administrators operate without consistent access to an athletic trainer. This reality resonates with veteran coaches and school leaders, particularly those working in rural schools or small districts where resources are limited and expectations remain high. Although licensed athletic trainers are certainly beneficial to high school athletic programs, many schools across the country still function without full or reliable coverage.

Many coaches enter the profession with enthusiasm, passion and limited formal preparation in injury care, often relying on a single college course, handwritten notes, diagrams and practical experience. In numerous schools, many years pass before an athletic trainer is hired and some schools may never have an athletic trainer.

When athletic trainers are unavailable, injury care often rests squarely on the shoulders of coaches and staff. Ankles, fingers and knees are taped using textbook diagrams and reference materials. Injured athletes are referred directly to physicians for diagnosis and clearance, with a clear understanding that coaches are not qualified to make medical decisions.

Parents play an important role as well. Some are willing to carry over-the-counter medications so that pain relief can be administered appropriately through a parent rather than a coach. While none of these practices are ideal, they reflect the reality many programs face. One lesson becomes clear early: athlete safety cannot be managed alone. Systems, preparation and relationships matter far more than individual heroics.

An effective strategy is intentional engagement with the parent or local community. During preseason meetings, coaches should ask whether parents are medical professionals and whether they are willing to support athletic events. These conversations help build trusted relationships with local medical providers, and parents with medical backgrounds are often present on the sidelines at home contests. In return, schools may advocate for complimentary entry to games as a small acknowledgment of time and expertise. While this does not replace the need for a licensed athletic trainer, it provides a layer of support and reassurance for coaches, athletes and families.

Equally important is increasing the competency of the coaching staff. Recognizing the importance of medical preparedness in educationally based athletics programs ensure all coaches maintain certification in First Aid, CPR and AED use. Local EMTs should conduct hands-on first aid training, and partnerships with sports medicine clinics can help teach basic taping techniques. Coaches are consistently reminded that they are not trained to diagnose or treat injuries, but to provide temporary support and recognize when referral is necessary.

Every program should be equipped with a properly stocked medical kit, and the coaches should receive training on its contents and proper use. A properly stocked medical kit is only effective if the person holding it understands its purpose.

Even in the absence of an athletic trainer in order to further professionalize injury response, programs use accident and injury report forms to ensure incidents are documented accurately and consistently. Standardized communication scripts should be developed for coaches to use when contacting parents after an injury, ensuring communication remains calm, factual and appropriate during stressful moments.

Administrative systems play a critical role in athlete safety. When playing contests on the road, coaches should either have electronic access or carry folders containing copies of each athlete’s physical and available insurance information. When injuries occur and parents are not present, having documentation immediately available eases communication with medical providers and reduces confusion. Situations can arise in which coaches accompany athletes in ambulances, spend nights in emergency rooms during camps, or manage unexpected medical emergencies during out-of-season events. These moments reinforce a consistent truth: when athletic trainers are absent, safety must be built on structure – not memory or improvisation.

Emergency Action Plans (EAPs) should also be developed for each venue in the school. Many states require this for their member schools. Even when an athletic trainer is present, the EAP remains the most critical safety document in an athletic program.

Every venue (gym, field, pool, court, track, weight room) must have a written EAP that includes:

• Emergency contacts and communication procedures

• AED locations and access

• EMS access points

• Defined roles for coaches and administrators

• Crowd control responsibilities

EAPs should be reviewed annually and practiced regularly. In an emergency, clarity saves time, and time saves lives. When developing an EAP, collaboration with EMS and consistent training leads to documented life-saving outcomes for student-athletes.

It is important that coaches understand that while they are trained to recognize warning signs of injury conditions, they are not trained to diagnose injuries. At a minimum, schools should require CPR/AED certification, First Aid training, and annual concussion education. Additional instruction on heat illness, sudden cardiac arrest, and internal injury recognition helps coaches know when to stop participation and seek medical care. A guiding principle applies across programs: when in doubt, sit them out. Conservative decision-making must always be supported by school leadership in regard to potential injuries.

Families deserve honesty. Schools clearly communicate when medical coverage is available, what protocols are in place when it is not, and how injuries are handled. Transparency builds trust and protects both student-athletes and institutions.

It is important for a school with athletics that operating without an athletic trainer should become normalized. Athletic administrators should continue advocating for access through data, storytelling, and education of decision-makers. Athletic trainers are not an “extra” or a “luxury.”

Many schools do the best they can without athletic trainers, adapting and assuming responsibility because that is the reality they face. Experience across varied settings leads to one clear conclusion: when athletic trainers are absent, leadership, preparation and ethics must fill the gap; however, the goal is always access, not acceptance, of that gap. Until every school has consistent athletic trainer coverage, student-athletes deserve intentional planning, conservative decision-making and leadership rooted in care. Safety is not situational. It should be the standard.

David Walck, M.A. Ed, M.P. Ed, is the assistant principal/athletic director at Fossil Ridge High School in Fort Collins, Colorado.