Athletic Trainers

Athletics have a larger budget than you. My AT luckily had a RN sister, she didn't step on my toes, but I loved having her here for ortho issues, her knowledge base was WAY more than mine and I deferred to her. I miss having her here for PE. I find it odd that students leave class to go to the AT, as opposed to the nurse.

The ATC has an education in orthopedic evaluation that goes way beyond anything any RN will learn in nursing school. How do I know this? I'm both an RN and I was an Athletic Trainer. Also remember that Athletics has a much larger budget than you do. If an athlete that has been to the Trainer later comes to you for more ice and it's not an acute injury (within 3 days), refer them to the Trainer. If they want a rewrap because it's come loose, just rewrap with what's been provided and send them on their way.

One of the reasons why Trainers will wrap and ice an injury for DAYS is because they're trying to keep swelling to a minimum and swelling doesn't stop shortly after injury, it takes a few days to subside. Less swelling means less time to begin effective rehab and therefore less time needed before the athlete can return to play. The Trainer's only client base should be the athletes and nobody else. If an athlete is abusing your office, bring that to the Trainer's attention. If non-athletes are getting care by the Trainer and not you, that needs to stop too...

The research on icing injuries is shifting and some studies have show that inflammation is actually necessary for tissue repair. This article has a nice summary and links to the studies.

Should You Ice Your Sports Injuries?

Not that any of that helps with your current situation. I would reapply a wrap, but not give a new one. If they come in without a wrap and ask for one I would advise them to see the trainer next time she's available. As for ice, just give it as you see fit.

The ATC has an education in orthopedic evaluation that goes way beyond anything any RN will learn in nursing school. How do I know this? I'm both an RN and I was an Athletic Trainer. Also remember that Athletics has a much larger budget than you do. If an athlete that has been to the Trainer later comes to you for more ice and it's not an acute injury (within 3 days), refer them to the Trainer. If they want a rewrap because it's come loose, just rewrap with what's been provided and send them on their way.

One of the reasons why Trainers will wrap and ice an injury for DAYS is because they're trying to keep swelling to a minimum and swelling doesn't stop shortly after injury, it takes a few days to subside. Less swelling means less time to begin effective rehab and therefore less time needed before the athlete can return to play. The Trainer's only client base should be the athletes and nobody else. If an athlete is abusing your office, bring that to the Trainer's attention. If non-athletes are getting care by the Trainer and not you, that needs to stop too...

I totally agree with AT having more extensive knowledge of MS injuries than me. I have no problem icing areas that are swollen but how about when there was never any swelling at all? And these huge ice bags on a very small area with no barrier? What is the science behind that? Because they come to me after 1-2 hours when the huge bag is melted crying. I have to warm up the area with ice burn to try to asses the original injury. Is this just bad education on the AT's part?

The only follow-up we ever did for the AT was to give more ice. If the student had already been seen by the trainer we just had the teacher call and we'd send ice to the classroom (we had student aides). I didn't reassess unless something major happened and the AT wasn't there.

At our middle school, we have a visiting AT that comes a few times a week and attends games. Still, I do not treat athletic injuries unless they are new with obvious swelling, decreased ROM (such as a likely fracture), or a head injury, etc. The coaches have access to ice, so the students are instructed to ice old or non serious injuries at home before/after school and during athletics. In some rare cases, I will offer for a student to come eat lunch in the clinic and ice their injury for 15-20 minutes. Of course, if there is a doctor's note requesting treatment/ice during school hours, I'm happy to help. I'm kind of a stickler about ice in general though. I try to only give ice for swelling. Even then, only sometimes do I let them take the ice to class.

Honestly, this is one of the things I appreciate about being in middle school. Being able to teach kids that they will be okay to deal with discomfort without ice. Athletics and injuries go hand in hand. Especially muscle soreness (which I often have kids visiting for following football games). I often educate them on basic care for these injuries and refer them to talk to the trainer if symptoms don't improve in the next day or two.

Also, I'll have kids come to me claiming to have an injury, but they haven't told their coach about it. Either they are trying to avoid being benched or the injury isn't that significant and they are finding reasons to get out of class. I'm not interested in participating in that.

I should add that I have tons of respect for ATs. They have to have their masters in sports medicine to be certified. They are definitely WAY more knowledgable than I am on the MS injuries. I've been fortunate to always have ATs and coaches who have agreed that students should not be leaving class to see the nurse for ice/wraps. I can't imagine having an AT sending kids home with fevers or vomiting during school hours without sending them to the nurse.

Because they come to me after 1-2 hours when the huge bag is melted crying.

Ugh, that is SO frustrating. This is where I tell them they will be fine and that pain is a part of playing sports. I usually tell them that I have a friend who ran a marathon on a BROKEN foot (broke a small bone during mile 6), or I remind them of athletes playing football or basketball on sprained ankles. They may be upset/mad, but it's the truth. Injuries do not HAVE to be iced if they aren't swollen. They especially don't need to be iced longer than 20min.

I, too, am an RN who used to be an athletic trainer. When I was an athletic trainer, I never iced my athlete's with a barrier between their skin and the ice. As a matter of fact, I would WRAP that ice to their injured body part with an ace wrap. The maximum time I iced someone was for 20 minutes every couple of hours. So if students are coming to you and hour or two after getting ice with a melted bag- that bag should have been emptied and thrown away after 20 minutes of icing.

I wrapped body parts all the time as an athletic trainer. I rarely wrap as a nurse- only if I am stabilizing an injury for transport by parent for medical evaluation.

I would rewrap a swollen body part that already had an ace wrap on it. I would not rewrap if the body part is not swollen or there is no visible injury.

I don't have an AT here and when the kids come to me wanting me to step into that role, i politely refuse. I won't tape an injury or buddy tape fingers unless the very next stop is right to an ER or doctors office. I keep a very small stash of ace wraps, but that is for serious injuries, not sore ankles from football injuries that happened on Saturday and it's now Wednesday and we're just sore (and bored). I tell the kids when they want this type of service that I don't have the training for that and can't do it.

My AT thinks he's a doc. Young whippersnapper.

I, too, am an RN who used to be an athletic trainer. When I was an athletic trainer, I never iced my athlete's with a barrier between their skin and the ice. As a matter of fact, I would WRAP that ice to their injured body part with an ace wrap. The maximum time I iced someone was for 20 minutes every couple of hours. So if students are coming to you and hour or two after getting ice with a melted bag- that bag should have been emptied and thrown away after 20 minutes of icing.

I wrapped body parts all the time as an athletic trainer. I rarely wrap as a nurse- only if I am stabilizing an injury for transport by parent for medical evaluation.

I would rewrap a swollen body part that already had an ace wrap on it. I would not rewrap if the body part is not swollen or there is no visible injury.

Great info / insight!! May I ask why no barrier??