Maximizing the AT-PT Relationship in the High School Setting



By: Zach Fox, PT, DPT, ATC, CSCS


When a high school athlete sustains an injury that will require surgery, a simple question from parents typically get asks: Where should we take him/her for rehabilitation?” As an Athletic Trainer, this may feel like a slap in the face, as you would expect to do the rehabilitation yourself. But is this best for your athlete, given all the other responsibilities you have throughout the day?

Athletic Training in the High School Setting

Certified Athletic Trainers, by definition, are healthcare professionals who collaborate with physicians to provide preventative services, emergency care, clinical diagnosis, therapeutic intervention, and rehabilitation of injuries and medical conditions. ATs are fully capable of returning nearly any injured athlete back to full participation. The education prepares not only to evaluate and assess on and off the field injuries, but to manage, rehabilitate, and return an athlete to their sport as quickly and safely as possible.

While many Athletic Trainers enjoy the sport coverage and on-site care of athletes, many equally enjoy the “behind the scenes” rehabilitation that takes place in the Athletic Training Room (ATR). But is this where they should be spending their time, in the ATR, rehabilitating athletes when others are on the field or court practicing? In a recent study, Pryor et al. revealed that athletic trainers worked more often at games and competition than at practices, placing athletes at a substantial risk of injury during a larger portion of sport participation.

This begs the question: What should be the primary role of the secondary school athletic trainer? Should the focus remain with the on field management and practice coverage, or the behind the scenes rehabilitation in the ATR?

What Is the Primary Role of an Athletic Trainer?

Based on the 5 (or 6 depending on the source) domains of Athletic Training, it can be argued that the primary role of the secondary school Athletic Trainer should be injury prevention, wellness protection, and immediate emergency care. Hence, the vast majority of time should be spent on the field or court observing the sport where the risk for injury is highest. Of course this mean time not spent in the ATR performing modality treatments or rehabilitation.

Other members of the sports medicine team, such as the physical therapist (PT), can and should be called upon to assist with rehabilitation. In the athlete-centered model of care, a team of healthcare professionals is responsible for returning an athlete to sport. In this model, a symbiotic relationship coexists with all the members of the sports medicine team where communication is imperative and everyone is working together towards a common goal. Any injury, acute or chronic, that you feel will take more than a day or two to heal, offers the prime opportunity to collaborate with a PT, MD, and other members of the medical team.

Using the athlete-centered model effectively not only makes an athlete’s quick and safe return to sport more likely, but also allows the secondary school athletic trainer to remain out of the ATR and on the field or court – limiting exposure to risk and liability.

What Does an Athletic Trainer Gain by Collaborating With a Physical Therapist?

So, what do you gain from “outsourcing” your athletes to a PT for rehabilitation a couple times a week? First, is more time on the field ,watching the action, and being available in case a situation arises where you are needed to provide care. By opening your time to be spent at practices, you can enhance relationships with your athletes and coaching staff. Second, you may also find that developing a relationship with a specific PT, clinic, or MD office, can have ‘trickle down’ benefits such as having them donate items like braces, crutches, and taping supplies to help you manage your (already limited) budget. Once a relationship is established, you may consider developing a weekly “doctor hours” triage clinic where you can have the PT come to the school and re-assess nagging injuries or complaints from your athletes. Taking this initiative will not only earn you respect with the coaching staff and medical community, but it can further help establish your relationships with the parents of your injured athlete. Finally, you may also ask the PT if the clinic would be willing to serve as an in-between, sort of a “second opinion”, for parents who think their child may need further diagnosis or imaging. This could save the parents hundreds of dollars, and demonstrate that you really are placing the athlete’s care and needs first and foremost, creating a positive image for yourself and the athletic training profession.


From personal experience, it can be hard to let another healthcare professional do a job that you are more than qualified to perform. If you are willing to share the responsibility in the rehabilitation of the injured athlete, you are creating a safer environment at your school. Taking the lead in this process helps you build stronger relationships with athletes and their parents, the coaching staff at your school, and the medical community as a whole.

Also, check out my Summit course, “Examination and Rehabilitation of the Shoulder and Knee,” here: