Athletic training

Athletic training has been recognized by the American Medical Association (AMA) as an allied health care profession since June 1991.[1]

"Athletic training is practiced by athletic trainers, health care professionals who collaborate with physicians to optimize activity and participation of patients and clients. Athletic training encompasses the prevention, diagnosis, and intervention of emergency, acute and chronic medical conditions involving impairment, functional limitations and disabilities."[2]

There are five domains of athletic training listed in the 7th edition (2015) of the Athletic Training Practice Analysis:[3]

  • Injury and Illness Prevention and Wellness Promotion
  • Examination, Assessment and Diagnosis
  • Immediate and Emergency Care
  • Therapeutic Intervention
  • Healthcare Administration and Professional Responsibility

An athletic trainer functions as an integral member of the health care team in clinics, secondary schools, colleges and universities, professional sports programs, and other athletic health care settings.[4]


Athletic trainers (ATs) are health care professionals who render service or treatment, under the direction of or in collaboration with a physician, in accordance with their education, training, and the state's statutes, rules, and regulations.[5] The practice of athletic training encompasses health promotion and wellness and examination, diagnosis, immediate care, and rehabilitation of clients/patients with emergent, acute, and chronic health conditions.

Athletic training in the United States began in October 1881 when Harvard University hired James Robinson to work conditioning their football team. At the time, the term "athletic trainer" meant one who worked with track and field athletes. Robinson had worked with track and field athletes and the name "athletic trainer" transferred to those working on conditioning these football players and later other athletes. Athletic trainers began to treat and rehabilitate injuries in order to keep the athletes participating.[6] The first major text on athletic training and the care of athletic injuries was called Athletic Training (later changed to The Trainer's Bible) written in 1917 by Samuel E. Bilik.[7] Early athletic trainers had "no technical knowledge, their athletic training techniques usually consisted of a rub, the application of some type of counterirritant, and occasionally the prescription of various home remedies and poultices".[8] In 1918, Chuck Cramer started the Cramer Chemical Company (now Cramer Products) that produced a line of products used by athletic trainers and began publishing a newsletter in 1932 entitled The First Aider.[9]

An organization named the National Athletic Trainers' Association (NATA) was founded in 1938 and folded in 1944. Another NATA was founded in 1950 and still exists.[10] The first athletic training curriculum approved by NATA was in 1959 and the amount of athletic training programs began to grow throughout colleges and universities in the United States. In the early development of the major, athletic training was geared more towards prepping the student for teaching at the secondary level, emphasizing on health and physical education. This program was first introduced at an undergraduate level in 1969 to the schools of Mankato State University, Indiana State University, Lamar University, and the University of New Mexico.[11]

Through the years athletic training has evolved to be defined as "health care professionals who specialize in preventing, recognizing, managing, and rehabilitating injures". During the 1970s the NATA Professional Education Committee formed a list of objectives to define athletic training as a major course of study and to eliminate it as a secondary-level teaching credential. By June 1982, there were nine NATA-approved graduate athletic training education programs. On July 1, 1986, this work was used to implement athletic training as a major course of study in at least 10 colleges and universities, and to only start the development of the major in a handful of others.[12]

Once athletic training was recognized as an allied health profession the process of accrediting programs began. NATA's Professional Education Committee (PEC) was the first to take on this role of approving athletic training educational programs. The AMA's Committee on Allied Health Education and Accreditation (CAHEA) was given the responsibility in 1993 to develop requirements for the programs of entry-level athletic trainers. At this time all programs had to go through the CAHEA accreditation process. A year later CAHEA was broken up and replaced with the Commission on Accreditation of Allied Health Education Programs (CAAHEP), which then lead the accreditation process. In 2003 JRC-AT, Joint Review Committee on Athletic Training completely took over the process and became an independent accrediting agency like all other allied health professions had. Three years later JRC-AT officially became the Committee for Accreditation of Athletic Training Education (CAATE),[13] which is fully in charge of accrediting athletic training programs in the United States. NATA produced the NATABOC in 1969 in order to implement a certification process for the profession for an entry-level athletic trainer. In 1989, became an independent non-profit corporation and soon later changed its name to the Board of Certification (BOC).[14]

Roles and responsibilities


The Board of Certification serves as the national certifying body for athletic trainers, and its Standards of Professional Practice outline the roles and responsibilities of certified athletic trainers. Such practice standards include practice expectations such as, "The Athletic Trainer renders service or treatment under the direction of a physician."[15] Regardless of the setting, limitations and restrictions on what an athletic trainer can do and who can be treated are in large part determined by the regulatory statutes governing professional practice in individual states.[16]


Some patients and clients need treatment or consults from people other than the athletic trainer, and in these cases it is the athletic trainer's responsibility to understand the limits of their scope of practice and recognize situations where a referral is necessary. "A number of support health services may be used 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, equipment personnel, referees, or social workers."[17]

NATA code of ethics

"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."[18]

Employment settings

  • Clinic
  • Hospital
  • Industrial/Occupational
  • Corporate
  • College/University
  • Two-year Institution
  • Secondary School
  • Professional Sports
  • Amateur/recreation/youth sports
  • Performing Arts
  • Military/Law Enforcement/Government
  • Health/fitness/sports/performance enhancement clinics/clubs
  • Independent Contractor


Undergraduate course descriptions

All courses may have prerequisites to be completed before taking further coursework. Also, those prerequisites and content of the courses will vary upon the institute and professor. The courses listed below are commonly taken to increase knowledge regarding athletic training.

  • Human Physiology- This course is designed to provide students with an understanding of the function and regulation of the human body and physiological integration of the organ systems to maintain homeostasis
  • Human Anatomy- The anatomical structures of the body will be studied in this course. Including the muscular systems, organs, respiratory, bony anatomy, veins and arteries. This course will help you to learn all components of the body and is almost always accompanied with a lab section to reinforce the lectures.
  • Exercise Physiology- This course investigates the acute responses and chronic adaptations of physiological functions to a wide range of physical exercise conditions, involving people of all ages and abilities.
  • Kinesiology- Structural and applied musculoskeletal anatomy relative to human movement and sports skill. This course concentrates on muscles, their origins, insertions, and actions.
  • Nutrition- This course emphasizes basic nutritional principles and concepts, their application to personal health and relationship between food and its use by the human body for energy, regulation, structure, and optimal health. Discussion of issues in nutrition during various stages of the life cycle and specific chronic diseases will be addressed.
  • Therapeutic Modalities- This is a course looks into the background for clinical application of therapeutic modalities in athletic training. Students will comprehend the underlying theories, physiological effects, indications, and contraindications of various therapeutic modalities utilized in the treatment of orthopedic injuries.
  • Acute Care of Injury and Illness- This course focuses on the emergency management techniques that are commonly implemented when dealing with trauma and illnesses suffered during/through sport participation. Included will be field evaluation of medical emergencies, such as cessation of breathing or circulation, shock, concussion, and spinal injury to the athlete. Students will review policies and position statements issued by the NATA, NCAA, ACSM, AAP, and AMA regarding prevention, evaluation, and management of acute athletic injuries and illnesses.
  • Physical Examination of the Lower Extremities- Intense in-depth study of the lower extremities including physical examinations, injury recognition, treatment, taping, bracing, and care. Laboratory experiences emphasize the methods and techniques in evaluating lower extremity injuries/conditions.[19]

Undergraduate athletic training programs

The Commission on Accreditation of Athletic Training Education (CAATE) website provides a list of all the accredited programs in the United States.[20] It provides the name of the college, whom to contact, and a link to the institution's website. An Undergraduate Athletic Training degree can only be received at an accredited school for athletic training.

Entry-level masters programs

Although the majority of athletic trainers receive a bachelor's degree in athletic training before taking the Board of Certification Exam (BOC), it is not the only way to receive an education in athletic training. An entry-level masters program is a two-year program that covers the same material as an undergraduate athletic training degree. Common prerequisite classes are human anatomy, human physiology, kinesiology, biomechanics, exercise physiology, nutrition, and personal health along with a certain number of observation hours completed under the supervision of a certified athletic trainer (ATC).[21] Prerequisites can vary by institution so be sure to research the prerequisites for your institutions of interest. There are 26 accredited entry level masters programs in the U.S.A. See below for a link to a list of these institutions.

Graduate school in athletic training and related fields

There are approximately 15 accredited athletic training masters programs.[22] These programs consist of students who are already certified athletic trainers that want to advance their academic and clinical experience.[23] These are two-year programs which culminate with a Master of Science degree (M.S.) in athletic training. Graduate programs in athletic training are not always specifically in athletic training, but in a related field. Some of these fields may include, but are not limited to, kinesiology, biomechanics, sports management, sport and exercise psychology, exercise physiology, health promotion, etc.[24] These programs are also two years in length. While enrolled in one of these programs, the athletic trainer may gain clinical experience and receive a stipend through a make some money by obtaining a graduate assistantship.

Link to schools

Graduate assistant position

A graduate assistant athletic trainer position is a position in which a graduate athletic training student is able to work as an assistant athletic trainer while taking graduate courses. Graduate assistant athletic trainers are responsible for providing the medical coverage of select teams at the institution where they are working. Responsibilities may vary, but include administering daily medical coverage for selected intercollegiate athletic teams (practice/event); traveling with the assigned team, evaluation and documentation of athletic injuries, administrative responsibilities, serve as Approved Clinical Instructor (ACI) or Clinical Instructor (CI) in a CAATE – accredited ATEP, and other duties as assigned by the head athletic trainer.[27] Other responsibilities may include working at a high school, clinic, teaching, or doing research. Graduate assistant positions are generally about 10-month appointments that are renewable after the first year, and may include additional summer work. Visit the National Athletic Trainers’ Association Career Center for job postings.[28]

Accredited programs

Athletic Training programs are evaluated by CAATE to ensure that they follow the standards for Entry-Level Athletic Training Programs. Evaluations may take place every three to seven years depending on the results of the last visit. Successfully 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.[29][30]


"The National Athletic Trainers’ Association (NATA) is the professional membership association for certified athletic trainers and others who support the athletic training profession. Founded in 1950, the NATA has grown to more than 35,000 members worldwide today. The majority of certified athletic trainers choose to be members of the NATA – to support their profession, and to receive a broad array of membership benefits. By joining forces as a group, NATA members can accomplish more for the athletic training profession than they can individually".[31]

Before the formation of NATA, athletic trainers occupied a somewhat insecure place in the athletic program. Since that time, as a direct result of the standards and ethics established by NATA, there has been considerable professional advancement.[32] Every year NATA works on behalf of all athletic trainers to enhance health care for both athletic trainers and those who receive care.

NATA is the professional organization for Athletic trainers across the nation. Each region of the USA has their own district under NATA but within their area, they have their own agendas and board members. Each district also has a director that serves on the NATA Board of Directors.[33]

There are 10 districts.

Every state has their own state athletic training association that acts similar to the district associations as they have their own board members. The state associations answer to the district associations and the National Athletic Trainers’ Association. Links to the state associations can be found through the regional websites.[34]

Current topics

Due to the physicality of athletics and the campaign for healthy well-being, there are issues that become hot topics in the media. Athletic trainers have to continually be aware of changes in laws, position statements of the National Athletic Trainers Association, and institutional policies.[35]

Current hot topics and topics to keep an eye on include:


  1. "What is an Athletic Trainer?". The Board of Certification Website. 2003 As defined by the Strategic Implementing Team of the National Athletic Trainers' Association (NATA) in August 2007.
  2. "Strategic implementation team defines profession". NATA News (12/2007): 14. 2007.
  3. Board of Certification (2015). "Practice Analysis, 7th ed" (PDF). Retrieved 2016-11-29.[permanent dead link]
  4. Prentice, W. (2011). Principles of Athletic Training. New York: McGraw-Hill.
  5. "About Athletic Training".
  6. Webber, Matt (2013). Dropping the Bucket and Sponge. Prescott, AZ: Athletic Training History. pp. 20–24.
  7. Prentice, William (2011). Principles of Athletic Training: A Competency-Based Approach. New York, NY: McGraw-Hill Humanities/Social Sciences/Languages. pp. 3, 27, 28.
  8. Prentice, William (2011). Principles of Athletic Training: A Competency-Based Approach. New York, NY: McGraw-Hill Humanities/Social Sciences/Languages. pp. 3, 27, 28.
  9. "Cramer Sports Med". Archived from the original on 2012-05-05. Retrieved 14 May 2012.
  10. Webber, Matt (2013). Dropping the Bucket and Sponge. Prescott, AZ: Athletic Training History. pp. 487–505.
  11. Delforge, G.D.; Behnke, R.S. (1999). "The History and Evolution of Athletic Training Education in the United States". Journal of Athletic Training. 34 (1): 53–61. PMC 1322875. PMID 16558550.
  12. Delforge, G.D.; Behnke, R.S. (1999). "The History and Evolution of Athletic Training Education in the United States". Journal of Athletic Training. 34 (1): 53–61. PMC 1322875. PMID 16558550.
  13. "Commission on Accreditation and Administration of Athletic Training Education Directory". Archived from the original on 2011-05-21.
  14. Delforge, G.D.; Behnke, R.S. (1999). "The History and Evolution of Athletic Training Education in the United States". Journal of Athletic Training. 34 (1): 53–61. PMC 1322875. PMID 16558550.
  16. Prentice, W. (2011). Principles of Athletic Training. New York: McGraw-Hill.
  17. Prentice, W. (2011). Principles of Athletic Training. New York: McGraw-Hill.
  18. "Code of Ethics". 2015-08-11.
  19. "Archived copy". Archived from the original (PDF) on 2020-06-20. Retrieved 2016-05-20.CS1 maint: archived copy as title (link)
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  25. {{cite web|title=Fitness trainer certification course |url= |access-date=20 April 2020 |archive-url=
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  36. "NATA Statements". NATA. Archived from the original on 2012-05-09. Retrieved 2012-05-10.
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  38. "Certified Athletic Trainers as a partner in the Athletic Department" (PDF). NATA. Retrieved 2008-08-01.