Roles of Athletic Trainers and Strength and Conditioning Coaches
  • Roles of Athletic Trainers and Strength and Conditioning Coaches
    Two of the key people that an injured athlete will communicate with are the strength and conditioning coach and the athletic trainer. This article examines the roles of these two professionals in directing an athlete from an injury through the complete rehabilitation program and back to full participation in their sport.
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    Introduction

    In the complex environment of athletics today, many professionals work together in athletic departments. In any given athletic department, there will usually be athletic directors, head coaches, strength and conditioning coaches, position coaches, physicians, athletic trainers, equipment managers, and administrative personnel. Two of the key people that an injured athlete will communicate with are the strength and conditioning coaches and the athletic trainer. This article will examine the roles of these two professionals in directing an athlete from an injury through the complete rehabilitation program and back to full participation in their sport.

    In most high school, college, and professional sport environments, athletic trainers and strength and conditioning coaches work together in their respective athletic departments. Athletic trainers evaluate, treat, and rehabilitate sports injuries. Strength and conditioning coaches develop and implement specific strength and conditioning programs for athletes from a variety of teams. These two professions work closely together after injured athletes have completed rehabilitation from an injury and are progressing towards full participation in a sport training program. After the athletic trainer directs the athlete through the prescribed rehabilitation, he or she can communicate with the strength and conditioning coach to begin a progressive strength training program. The athletic trainer should clearly communicate the extent of the injury and the effectiveness of the rehabilitation, that way the strength and conditioning coach can start the athlete at the appropriate level of conditioning.

    There should be a protocol in place that bridges the communication between the athletic trainer and the strength and conditioning coach. This is called a treatment plan and it is individualized for the athlete. The treatment plan should involve an evaluation that includes an assessment of the injury either by the physician or the athletic trainer, or both; recommendations by the athletic trainer for training; and a time frame for the athlete’s return to either full or limited participation based on the decision of the physician. This communication should be in writing with all of the parties involved signing off on the treatment plan and acknowledging the input of each of the contributing disciplines. At this point, the strength and conditioning coach can formulate a specific strength and conditioning plan based on the recommendations of the athletic trainer and physician. Clear communication is the key to a successful transition from completion of injury rehabilitation to rejoining the current sport strength and conditioning program.

    The Role of the Athletic Trainer

    The athletic trainer is responsible for evaluating, treating, and rehabilitating athletic injuries. After evaluation by a physician and treatment of an acute injury, the rehabilitation can begin. Depending on the extent or grade of the injury, it could take days, weeks, or even months. All aspects of the injury are documented and the final release to return-to-play is given by a physician. It should be noted that in some programs, physical therapists are also used for rehabilitation programs. Once the athlete has completed all phases of the rehabilitation and been released to return to their sport for full participation, the athletic trainer and strength and conditioning coach can meet to design the sport-specific training program.

    The Role of the Strength and Conditioning Coach

    The strength and conditioning coach designs and implements the specific strength, speed, and conditioning programs for the athletic teams. The strength and conditioning coach can use the information from the athletic trainer and the injury information from rehabilitation to start the athlete at the appropriate level (e.g., sets, repetitions, number of exercises, total volume) of strength and conditioning. The strength and conditioning coach is then in charge of volume progression from that point on, barring any injury. The strength and conditioning coach should progress the athlete through their various phases of the sport training program as tolerated by the athlete.

    Interim Sport Training Phase with Deficits

    Occasionally, the athlete may have some limiting physical deficits after being released from rehabilitation. Sometimes, there can be minor range of motion (ROM), strength, or power deficits between the end of the official rehabilitation and the start of the strength and conditioning training (1,2). This is a gray area and requires the athletic training staff, medical staff, and strength and conditioning coaches to all communicate the exact deficits an athlete may have when released from rehabilitation. Some examples of deficiencies that the athlete may experience include:

    • Active and passive ROM deficits for any joint

    • Strength deficit of a specific muscle or group of muscles

    • Exercises that may not be done until a later time (e.g., maximum squats, power cleans, or bench press)

    • This is secondary to muscular strength, flexibility, and pain

    • Bracing and taping requirements

    • Other medical restrictions or conditions

    The athletic trainers and strength and conditioning coaches understand that these deficits will decrease as the injury heals and strength and conditioning training progresses (3). This will allow for continued progression of a physical deficit while training other areas in maximal capacity (3). There will be a period of time for a training phase that consists of sport-specific energy system training to further progress the athlete from the last phases of rehabilitation to full participation in the strength and conditioning program. The length of this phase is dependent on the extent or severity of the injury. There is usually a period of time that requires general conditioning for cardiovascular improvements between the end of rehabilitation and the beginning of sport training (3). Usually cardiovascular endurance and speed will decrease during the early rehabilitation phase of a given injury.

    Conclusion

    In all athletic departments, communication is vital for success. In regards to injured athletes, communication between the athletic trainers and strength and conditioning coaches is very important for a full return to sport participation without any restrictions. The athletic trainer’s primary role is to evaluate, treat, and rehabilitate sports injuries. The strength and conditioning coach designs and implements sport-specific training programs for teams and includes speed, agility, and conditioning. Various physical deficits may exist after the rehabilitation that need to be taken into consideration for the early phases of strength and conditioning programs. Strength and conditioning coaches need to know and understand the exact deficits in order to start the athlete at the appropriate level of conditioning and progress them accordingly. Injuries will occur at all levels of sport participation and athletic trainers and strength and conditioning coaches need to continue to communicate with each other to safely progress the athlete from an injury and the required rehabilitation to the full recovery and full participation in their sport without any restrictions.

    References

    1. Henriksson, M, Rockborn, P, and Good, L. Range of motion training in brace vs plaster immobilization after anterior cruciate ligament reconstruction: A prospective randomized comparison with a 2-year follow-up. Scandinavian Journal of Medicine and Science in Sports 12(2): 73-80, 2002.
    2. Kvist, J. Rehabilitation following anterior cruciate ligament injury. Sports Med 34(4): 269-280, 2004.
    3. Myer, GD, Paterno, MV, Ford, KR, Quatman, CE, and Hewett, TE. Rehabilitation after anterior cruciate ligament reconstruction: Criteria-based progression through the return-to-sport phase. Journal of Orthopaedic and Sports Physical Therapy 36(6): 385-402, 2006.

    This article originally appeared in NSCA Coach, a quarterly publication for NSCA Members that provides valuable takeaways for every level of strength and conditioning coach. You can find scientifically based articles specific to a wide variety of your athletes’ needs with Nutrition, Programming, and Youth columns. Read more articles from NSCA Coach »

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  • Gardner_PJ

    About the Author:

    P.J. Gardner, MS, ATC, CSCS

    P.J. Gardner has been the Athletic Trainer and Assistant Strength Coach at Liberty High School in Colorado Springs, CO for the past 15 years. He has designed and implemented various strength and conditioning programs for high school and collegiate athletes since 1986. He received his Master of Science degree in Fitness and Wellness from the University of Memphis and became a Certified Athletic Trainer (ATC) in 1999. He has published articles in Training and Conditioning, Athletic Therapy Today, Strength and Conditioning Journal, NSCA Coach, and Performance Training Journal.

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  • Disclaimer: The National Strength and Conditioning Association (NSCA) encourages the exchange of diverse opinions. The ideas, comments, and materials presented herein do not necessarily reflect the NSCA’s official position on an issue. The NSCA assumes no responsibility for any statements made by authors, whether as fact, opinion, or otherwise. 
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