Athletic Trainers and Preventing Work Injury


In this webinar, you will learn about:

  • Athletic trainers’ role, capabilities, and training
  • Tools athletic trainers use to reduce or prevent recordable injuries
  • Case studies showing the impact of athletic trainers on workforce safety

Presented by:

Chris Studebaker, DPT, OCS, PT, national director of onsite therapy and athletic trainers

Megan Abeln, MEd, AT-C, onsite operations director and athletic trainer


Hello, and welcome to the Concentra webinar, Athletic Trainers and Preventing Work Injury. Today’s webinar will be presented by Chris Studebaker and Megan Abeln. Chris has worked as a physical therapist and ergonomics consultant in heavy industry for more than 15 years. He is board certified in orthopedics and also has certifications in manual therapy and health coaching.

Megan is a certified athletic trainer who has worked in collegiate, high school, and industrial settings and has served as a physician extender in orthopedics.

At the conclusion of the presentation, we will have a 10-to-15 minute Q and A session. You can submit your questions throughout the presentation, to be answered during the Q and A. We will answer as many questions as possible within the time allowed. A recording of the webinar will be e-mailed to you after the presentation so you can view it again at your convenience.

Chris, Megan, we're ready to begin.

Chris Studebaker

Sounds good. Can you hear me okay? Yeah? Awesome. Well, thanks for coming out to the webinar today, guys. This is a topic that's near and dear to our hearts. We're going to be speaking about common issues that employers face in regard to musculoskeletal disorders. And then we'll be discussing how athletic trainers can help with some of those issues and also describing their background and capabilities, and how they're different from some other industrial healthcare professionals you're accustomed to. Ultimately, we will discuss some of our case studies and our successes using this model in a variety of different industries. Finally, we'll have a Q and A, if you have any questions afterwards. Next slide. One more.

Repetitive work injury cycle and the former model

Employers overwhelmingly come to Concentra for injury care around musculoskeletal disorders. The main things that we see from employers are strained backs, shoulder surgery, you know, torn knees, that sort of thing. Those are the things that are really the big cost drivers for most of our clients. Some of them have, you know, contact dermatitis or something gets in your eye but, by and large, when people get hurt on the job, it tends to be a musculoskeletal case. As you guys know, that can cost money right out of your pocket if you're self-insured. It can drive up OSHA recordability. It can impact your lost-time metrics. So it can hit you in the wallet, and it can indirectly hit you and your insurance, as well. Go ahead.

So, what we see is that the old way of handling musculoskeletal cases in the work environment was, “Well, we're here at Acme packaging. We’ve got a guy who slipped and sprained his ankle. We’ve got to send him into some outpatient occupational health center, and we hope it doesn't get expensive. We hope it doesn't turn into litigation. We hope it doesn't become a recordable injury.”

Well, that model was fine for treating an isolated injury and getting that person back on the job. But it really didn't always address some of the underlying issues that lead to people getting re-injured. So businesses, especially in the nineties but on through until today, started to look at a different model. They didn't like the reactive model, where you just wait till somebody gets hurt, and then roll the dice with controlling the case and with your OSHA metrics.

We see all of these employers that have a lot of issues with lost time cases, tons and tons of recordable injuries nationwide, and a lot of employers have just decided that this is not acceptable. They needed to find an alternate way of managing their workers' compensation musculoskeletal spend. Next slide.

And so, around the nineties, you started to see the use of onsite athletic trainers, in particular, which really began more in manufacturing, but has subsequently spread to warehousing and distribution, to municipalities, even to healthcare itself for dealing with people who get injured in the healthcare world. The athletic trainer has been brought into the work environment in a lot of forward-thinking workplaces, to help to mitigate against these musculoskeletal injuries.

Megan Abeln

All right. So, what is an athletic trainer? A lot of people have that question. I know I still get asked every day while I'm in the clinic. A certified athletic trainer is a health care professional who specializes in prevention and care of activity-related injuries. We are nationally certified and licensed providers. Our training and experience allow us to look at industrial workers as industrial athlete.

Athletic trainers’ skills and capabilities

As an athletic trainer, we do a lot more than just preventing injury. We assess those injuries. We treat those injuries through rehabilitation, and we have the opportunity to reduce the severity of injuries. As trained professionals on the first line of defense, we get a unique opportunity to impact the overall health and safety of industrial athletes on a day-to-day basis. Next slide, please.

So, a lot of people assume athletic trainers have minimal training, however, certified athletic trainers are required to have either a bachelor's or a master's degree. Our education as athletic trainers is to learn comprehensive patient care and five domains of clinical practice, which include prevention of athletic injury, clinical evaluation and diagnosis, immediate and emergency care, treatment and rehabilitation, as well as organization and professional health and well-being.

The National Athletic Trainers Association, which is in the United States, also sets the same standards internationally and has worked with other organizations globally to set a consistent standard of care. Since we are nationally certified and licensed with each state, there are sometimes some state regulations that differ. Your occupational health provider would be able to advise you on those different jurisdictional rules governing athletic trainers. Next slide.

Industrial athlete, or as we like to call them, our athletes here on site, they are very similar to your typical sports athlete. Both populations are at a high risk of musculoskeletal injury, both acute and chronic issues. Our industrial workforce is working in physically demanding jobs, and many of these employees want to continue working, even when they're injured. As an athletic trainer on site, we get to assist those employees with staying in the game, whether that is through rehab, modifying their work activities, and doing day-to-day check ins on their care. Employees just like most athletes, have their identities tied into their job. We're here to assist those employees, not only in the physical health, but emotional and mental aspects of injuries as well.

Next slide. As an athletic trainer, we have the knowledge and ability to design and implement preventative programs, which includes stretching and strengthening. Those can be done either before work during work or after work, depending on people's work schedule. We develop rehabilitation plans which are unique to each person. We can help assist with ergonomic assessment, and we assist with the overall management of work comp injuries and illnesses.

Since we're on the scene from day to day, we're here throughout the entire treatment program, which allows for continuous care and helps with building rapport with those employees. By building that rapport through day-to-day interaction, our communication with each employee improves. We get to know them a little bit better. They learn to trust us, which typically leads to seeing an increase in those early-reporting numbers. In turn, early reporting allows us to begin to treating them sooner and decrease the chance of an injury becoming more severe and potentially recordable. Next slide, please.

Athletic trainers differ from other health professionals

As an athletic trainer, I often get mistaken for a personal trainer. The main difference between an athletic trainer and a personal trainer is the level of education and training required for our profession. Personal trainers are not nationally board certified, nor are they trained in musculoskeletal disorders. Athletic trainers, on the other hand, are educated experts in those musculoskeletal disorders, which includes everything from a minor ankle sprain up to something, that needs to be surgically treated. And then we assist with that aftercare after surgery.

Athletic trainers require an advanced degree, which allows us to assess and treat, as well as prevent those injuries from occurring. The training and education an athletic trainer has far exceeds that of a personal trainer and, I believe, this difference in education alone is what allows us to be a great asset for all industrial employees and workplaces.

Chris Studebaker

So, unfortunately, in our line of business, you know, let's face it, most people don't really know what an athletic trainer does. Maybe they've seen them on the sidelines of their favorite sporting event. But it doesn't usually occur to most employers that this highly trained resource could work on site in their work environment. They oftentimes confuse athletic trainers for personal trainers, as Meg mentioned, or sometimes they think an exercise physiologist can do the same job. But an exercise physiologist does not have really much training in the musculoskeletal system from an injury management standpoint.

Exercise physiologist folks are great for cardiac rehab. They're great for measuring performance, but they're not trained to manage injuries. Next slide.

But probably the biggest difference that we tend to point out to employers is this. A lot of employers are very familiar with the concept of that on site occupational health nurse. Maybe they've got four, five, or six hundred workers, and they'll hire a nurse to be there in case there are boo-boos and things like that. The problem with that, for a lot of employers, is that nurses don't have much training in the musculoskeletal system. So, when you have an employer who's seeing 70, 80, or 90 percent of their workers' compensation cases being musculoskeletal in nature, a lot of them are turning more and more to the athletic trainer role. And we'll talk about what the athletic trainers can do in the work environment here in a second.

So, depending on the type of work environment you have, a lot of times we recommend to the client to take a look at the athletic trainer role. If you have a ton of audiometry and a bunch of non-musculoskeletal issues, stick with a nurse. But for clients that have a need for treating the musculoskeletal system or job analysis or just minor, scrapes and bruises, the athletic trainer role can make a lot of sense. The great thing about these guys, know – and I’m a physical therapist by background, so I'm not necessarily a Homer on this – I’ve seen them over the years really thrive in this environment, changing the entire dynamic of the occupational health system. They switch the emphasis away from being that reactive model we spoke of earlier toward one of prevention. You hear of prevention being thrown around all the time, but a lot of people don't really mean it. The athletic trainer role in the onsite setting really is the tip of the spear of prevention.

Early treatment, reducing OSHA recordables

They help to get in and get to work with employees immediately, the same day, or even the same hour sometimes. Joe pulled his shoulder. Can you take a look at it? Hey, I think I tweaked my back a little. Can you take a look at it? Because the athletic trainer is right there – they’re immersed in the work environment – they can help control not only workers' comp costs but also your OSHA metrics.

When we bring an athletic trainer in, we typically see a reduction in OSHA recordability anywhere from 50 to 70 percent in musculoskeletal cases. Usually a reduction in lost time by a significant margin, which we'll talk about in some of our case studies here in a minute. But, maybe more fundamentally, the athletic trainer becomes an extension of your occupational health program that's really immersed in the work environment. We always tell these guys when we hire him, “Hey, if you want to sit in a clinic all day, behind a desk, and wait for people to come to you, this is not the job for you.” We expect our athletic trainers to mix their time between being in the clinic and being out on the line, in the warehouse, where employees can see them and where they can learn about the employees’ jobs, analyze their jobs, and really become on a first-name basis with these employees.

Some examples of what we've done in some other locations. We've had our trainers work in a wide array of environments and doing a lot of different things. Some of them stick with patient care, and they only treat injuries. Others are really a Swiss Army knife of health services, doing drug screens, breath and alcohol testing, ergonomics, teaching pre-shift stretching programs, and working with your payor to make sure they have functional job analyses to know what the job requires. Athletic trainers may even act as health coaches to be the real boots-on-the-ground resource for an employer's wellness program. Teaching classes, giving one-on-one health consultations, all kinds of different things. So let’s look at one example. Next slide.

Successful athletic trainer case studies

This is one example where this was really successful. We had a semiconductor manufacturer. That sounds high-tech and probably with not much material handling. But it's actually a pretty physical place because it's a factory that makes machines for semiconductors, and it involves a lot of lifting, pushing, pulling, and a lot of awkward postures. We brought in an athletic trainer and cut the manufacturer’s workers' comp spend by more than in half when adjusted for the headcount they had there. We reduced their OSHA recordability. I don't think they had more than two lost-time cases that year, if I recall. And they continue to grow this program – not just treating injuries, not just using first aid to try to avoid OSHA recordability, but also for design. The athletic trainer works with the engineering department to try to quantify safe amounts of lifting, safe amounts of repetition, and helps to identify solutions to their awkward-posture issues that they have. It’s been a really big success at that particular location. Next slide.

We had another plant that made medical devices, ultrasound machines, all kinds of stuff like that. We brought in an athletic trainer, and he really knocked the cover off the ball. They went from 28 lost-time days to zero. I think they maybe had one OSHA recordable that year (his first year) after having seven, eight, or nine the year before. Our athletic trainer took the reins on developing their ergonomic program to the point where they ended up hiring him away from us to run their corporate level ergonomics program for their engineering in health, safety, and environment department. He worked with an onsite nurse. In the previous case I described, the athletic trainer as the only practitioner there, the only healthcare resource. Some of these guys work in a team in a bigger clinic, along with the nurse practitioner or a front office staff. Others are solo in the work environment. Next slide.

We had an athletic trainer at a distribution center. So, we’re not just limited to manufacturing. We serve warehousing and distribution, as well, and we saw a great reduction in their DART rate (Days Away, Restricted, or Transferred). We saw a drop in their OSHA recordability. We also really helped to control their workers' comp costs, as well. Again, we are most successful when we can use the athletic trainer to do a lot of different things. These guys tend to have one foot in the occupational health world and the other foot in the technical safety world, where they work hand-in-hand with your environment, health, and safety department. Athletic trainers also can partner with human resources when it comes to issues of return to work or work accommodation. They can work with your engineers to help bring that biomechanical model to your ergonomics program. They help to be the glue that holds together the communication between all the stakeholders on the employer side, with the payor, and even with the community occupational health providers when injured employees have to be referred out. Next slide.

Changing the dynamic of occupational health

In a nutshell, this is a different role. It's a different take on occupational health. When we explain the potential of the athletic trainer to larger employers with a lot of musculoskeletal issues, it's like a light goes off. “We could do that?!” We bring athletic trainers in, and they are very successful using first aid-level interventions. Sometimes they have to escalate to OSHA-recordable-level care but, 60 or 70 percent of the time, we don't need it. We get them better using first aid-level interventions. Athletic trainers have a lot to work with. You’ve got massage, flexible taping, ice, heat, topical analgesics, over-the-counter insets, soft splints, non-hinged braces. There is a lot athletic trainers can work with – if you can get ahold of the workers early – which these guys are usually able to do. It switches the emphasis away from being reactive and expensive, as in the old model, to being proactive and preventive. Everybody wins. The employer wins. The employee wins. They get care, a lot of times much quicker. The payor wins, Human resources wins. Everybody wins with this model because it truly does re-establish a different dynamic in the occupational health system.

So, obviously, we're not the only people who do this. But if you ever need this kind of program, if you want more information or want to hear more about it and how it could work for you, we're certainly here for you. Happy to talk through this in a more detailed, one-on-one manner. But I'm going to open it for questions and answers, Back to you. Anna.