For years, at some Hamilton County public schools, when a player is injured at practice or during a game, it has been the coaches who respond. Coaches often spend time taping ankles and wrists, applying ice and working through player injuries — things they have knowledge about how to do, but aren't experts in or officially trained to do.
Some high schools have athletic trainers, professionals who are trained to provide such services, but such staffing hasn't been consistent in the district. In the fall, that will change for 14 Hamilton County high schools.
Brainerd High School
Central High School
Chattanooga School for the Arts and Sciences, Upper
East Hamilton High School
East Ridge High School
Hixson High School
Lookout Valley High School
Ooltewah High School
Red Bank High School
Sale Creek High School
Signal Mountain High School
Soddy-Daisy High School
The Howard School
The board approved a contract with Erlanger Health Systems last week for the hospital system to provide trainers for the district's schools.
"It's long overdue, it's excellent," said Tyrus Ward, Brainerd High School's football coach. Brainerd hasn't had an athletic trainer, and Ward, who previously coached in Nashville at schools that did have trainers, said coaches are dealing with injuries and needs of players every day.
"We take time out of practice ... every day there are minor nicks and pains here and there," Ward said. "It's been a strain on our program."
In February, the district started exploring a plan to put a trainer in every high school. A six-member committee reviewed the proposals received and made its recommendation to the board last week. The goal, said school board member Joe Wingate, of District 7, was to make sure every athlete in the district had access to a trainer.
"I want every student and family to have the same opportunity to be taken care of," Wingate said.
Some schools have had athletic trainers for years, something board members and district officials acknowledge was a problem.
"There are schools in our district who have a trainer in their building every single day, from noon to after 6 o'clock, and they start seeing kids, doing therapy, taping ankles," Wingate said. "But not every family and student had equal access to care."
It was previously left up to the schools to secure their own trainers. Schools such as Central High, East Hamilton, Hixson High, Ooltewah High, Red Bank High and Soddy-Daisy High have had trainers — others, including Brainerd High, Chattanooga School for the Arts and Sciences, East Ridge High, The Howard School and Tyner Academy, have not.
The Center for Sports Medicine and Orthopaedics, Benchmark Physical Therapy and CHI Memorial previously had provided those services at some schools, prompting some board and community members to push for keeping the established relationships. The three entities submitted a proposal as a group, but were turned down for Erlanger.
"They have been helping us for seven years, they helped us when no one else would and they have been great I think loyalty means a lot," said board member Rhonda Thurman, of District 1. "I wanted the coaches to have who they felt they've had an established relationship [with]."
The Center for Sports Medicine and the other institutions noted that they have provided services free of charge and developed relationships with the communities served.
"We've had a long history within the school system, over 30 years of experience, volunteering time and providing athletic trainers, sideline and field coverage for many of the schools in the school system," said Jason Robertson, sports medicine specialist at the Center for Sports Medicine and the team physician for the Chattanooga Lookouts and the Chattanooga Football Club.
The Center and the other groups had been providing services free of charge at the schools it has worked with, Robertson said.
According to Benchmark's proposal, the annual cost for an athletic trainer is about $66,000, but the return the provider gets from the county is only about $5,250 per trainer.
The district estimates about 2,500 students needing coverage, for which Erlanger will be paid $30 per student. The conglomerate's bid proposed $35 per student, but the board and the district said cost was not the main factor in which provider was selected.
Erlanger will have to hire the needed certified athletic trainers to meet the demand, said Dr. Bill Moore Smith, medical director of Erlanger sports medicine, in last week's board meeting. It already provides trainers to three high schools in North Georgia, McCallie School, Baylor School and Chattanooga Christian.
The hospital agrees the trainers will provide injury evaluation, intervention, practice coverage and coverage during games.
Football practice and games always will be covered, with trainers on call for other varsity practices and in attendance at most regular season home games for sports such as basketball, baseball, softball, soccer and lacrosse.
The district has liability insurance for its coaches and teachers, that also covers student athletes.
Also, the Tennessee Secondary School Athletic Association has catastrophic injury insurance for all athletes participating in events it sanctions.
Athletic trainers are also tasked with keeping track of the heat index at practices and games, per TSSAA policy. Players aren't allowed to practice when the heat index (humidity factored in with temperature) reaches above 104 degrees, something trainers track and enforce.
About 70 percent of public secondary schools in the United States employ an athletic trainer, according to a study published last year in the Journal of Athletic Training.
Wingate, who has coached for more than two decades, said trainers allow coaches to focus on what they're trained and paid to do.
"It makes the teacher and the coach much less effective in what we pay them to do when we ask them to be responsible for not just other duties, but for the health of their students," Wingate said. "Coaches need to be focusing on how they're developing and progressing players and teaching skills they need for their sport and for life."
Contact staff writer Meghan Mangrum at email@example.com or 423-757-6592. Follow her on Twitter @memangrum.