Number one question parents should ask a coach

Baltimore - Who will take care of your child if he or she gets hurt? "That should be the first thing a parent asks when they sign their kid up for a team at any level,'' said Marjorie Albohm, president of the National Athletic Trainers' Association. "If they don't have a ready answer, you might want to look somewhere else."

Steve Taylor, athletic trainer at Lee's Summit North High School near Kansas City, Mo., said, "The biggest issue is whether a certified athletic trainer is in the building regularly, not just swinging by a couple days a week."

In most states, it's fairly simple to check the licensing status of athletic trainers through state certification boards. Many allow online queries. Parents in California, Hawaii and Alaska need to be particularly diligent, because licensing of athletic trainers is not required and people with lesser qualifications may claim the title.

Cindy Clivio, who is a certified trainer at Kamehameha High School in Honolulu, said it's also important for parents to check out the training room. "Are the equipment and supplies organized?" she said. "Do they have an AED (automated external defibrillator)? If the athletic trainer welcomes your visit and questions, that's a good sign."

At the same time, parents need to do what they can to "injure-proof" their own kids, starting with encouraging a more active, healthy lifestyle that includes proper nutrition and hydration before and during sports seasons.

"We really do see extremes. There are future D-1 (Division 1, or major-college) athletes we're trying to protect from over-use injuries and there are kids coming out for sports so out of shape they can't run down a hall," said Laura Darby McNally, head athletic trainer at Middlesex School, a private school in Concord, N.H., that requires sports participation for all students.

Pre-season physicals, required at most schools, are also a good idea for younger athletes, too, experts say. A coalition of medical groups recently issued new guidelines for pre-participation screening of kids at all ages.

Taylor stressed that every school and team needs to have an emergency plan that spells out who's responsible for any "what-if" situation. If the point person is not an athletic trainer, "I'm not sure there is a next-best person, but you need to know their credentials, what they're prepared to do."

The reality is that student athletes have regular access to a certified trainer in only about a third of the nation's high schools with a sports program. Most schools try to have a part-time trainer, doctor or emergency medical technician on hand for games, or at least for games in sports that are considered to have a higher risk of injury, like football.

But statistics show that young athletes are two or three times more likely to sustain an injury during practice or conditioning than in competition. And most of the time that leaves coaches in charge of assessing and treating injuries.

“Every time a kid comes down with an injury, we can’t assume the kid isn’t hurt,’’ said Bill Kelley, football coach at Treasure Coast High School in St. Lucie County, Fla., after athletic trainers were eliminated last year. “We have to assume he is and stop play. We can’t take a chance.”

Most school systems and state athletic federations require coaches to get some training in first aid and certification in CPR. But the rules are not always enforced, particularly in smaller schools or inner-city schools.

"I'm concerned about some of the new legislation and rules coming out in various places that attempt to protect athletes from concussion or heat injury simply by requiring more training for coaches in recognizing symptoms," said Tamara C. Valovich McLeod, an associate professor of athletic training at A.T.

Still University in Mesa, Ariz. "It can give a false sense of security. You still need to be able to act on what you see."