Knee injury in soccerRecently I discussed liability issues for doctors and other sports medicine personnel to consider when covering sporting events. Rachel Blakeman, an athletic trainer who listened to that show, shared these thoughts on the subject via Twitter.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier Working w/collegiate club sport, liability is a HUGE issue for me when opposing teams don’t have own AT/MD.
Have cut way back on what services I will provide to other team.
Know AT who was sued for taping pre-existing injury, injury worse from playing on it. AT had no idea of pre-existing injury

Those tweets led to a fairly passionate debate about the roles, duties, and liabilities of athletic trainers covering athletes on visiting teams when they travel without a medical staff. I thought it would be insightful for sports medicine physicians who work as team doctors – and for athletes, parents and coaches who travel for games and tournaments – to get a better idea of some of the issues that athletic trainers experience.

The following post is a collection of opinions, ideas and experiences I received from athletic trainers across the country. It might seem somewhat disjointed, as I collected them on Twitter and Facebook, as well as through the Contact form on my blog. But I thought it would be best to share them as written, in the words of the athletic trainers themselves.

Thanks to all of you who shared your thoughts! If you didn’t already, please leave your comments below!

Battery athletic trainer on the fieldBobby Weisenberger ‏@BWW_ATC – Charleston, South Carolina
I try to treat the visiting athletes as I would my own. Not their fault the organization they play for chooses to go without. I will however make them use their own supplies if possible. I will also have our office invoice their team for AT services. I could go on for days about some teams. David is lucky twitter limits how many characters I can use.

Kirsten Schrader ‏@SchraderKirsten – Greensboro, North Carolina
I agree with Bobby. I usually ask if they have their own supplies and expect reciprocal treatment on the other end. ps..come to Vegas and ask us all in person!!! 🙂

Zach Fox ‏@FoxDPT – Denver, Colorado
On the field, same as my own. RTP decisions, a little different. Give my best opinion to coach, and hope they agree. Then always f/u with SOAP to their ATC in email so it is documented. Must say from experience, VERY variable HS vs NCAA

Ron Hutchins ‏@mrronhutchins – Danbury, Connecticut
generally act as first responder and after eval communicate to coach, parent if possible, and AT if the school has one.

Brad Morgan MEd AT ‏@PirateATC – Northeast Ohio
Liability is not an issue with teams that my hospital system also covers, and they get full tx. Non contracted schools get eval only per Ohio practice act. Use their supplies when possible. Nothing more than prophylactic taping (although that can be ridiculously misinterpreted.)

Kristi Voigt – Maryland
In our county in Maryland all schools have an outreach ATC. The teams travel with their own med kits and our lines of communication are very open. If an injury occurs we treat the child/refer them and then communicate via text/phone call to the students home ATC. Coverage is required for all home games. If any of the athletes need anything we are there to help.

Walker Terhune ‏@WalkerTerhune
pregame supplies (taping, bracing) hopefully, will be provided by the visiting team but if not we use our own.

Joe Sabbatini ‏@5ATXHSATC – Houston, Texas
I take of the kids as my own kids. If I do the right thing I generally don’t have anything to be worried about.

Rachel Blakeman ‏@RachelATC – San Francisco Bay Area, California
I could write a book. Not sure if it would be in comedy or horror section.

And here is the mini-tweetchat that started the entire discussion:

David Webb ‏@trainerwebby
@DrDavidGeier @RachelATC not a problem within our network. Consent forms name group and not individual schools’ ATs.

TwitterRachel Blakeman ‏@RachelATC
@DrDavidGeier I wish I didn’t have to. No consent for care, no idea of injury/med hx, etc.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier I know of some varsity rugby programs where the ATs are prohibited by their schools from touching opposing team athletes…

Rachel Blakeman ‏@RachelATC
@DrDavidGeier …regardless of severity of injury. I couldn’t just do nothing in a catastrophic injury/ER situation, not & live w/myself…

Rachel Blakeman ‏@RachelATC
@DrDavidGeier ..but the taping & injury evals? Have cut way back on providing that to other teams.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier Had recent incident w/visiting team, no ATC. & ath was concussed. No indications to send to ER…

Rachel Blakeman ‏@RachelATC
@DrDavidGeier …but she reported to her club sports director she had LOC (never told me that, and she was up on a knee when I saw her)…

Rachel Blakeman ‏@RachelATC
@DrDavidGeier …so I was questioned as to why she was not transported.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier The kicker? Her team’s ATC was there as spectator. Not working because team/school would not pay her…

Rachel Blakeman ‏@RachelATC
@DrDavidGeier …to cover when tourney had an AT present. I wasn’t even tourney AT, there w/my team (we hosted)…

Rachel Blakeman ‏@RachelATC
@DrDavidGeier ..but tourney ATs were swamped, so I left my team to check on her (we weren’t even playing her team. My team was warming up).

Mike Hopper ‏@mnhopper1s
@DrDavidGeier @RachelATC Treat them as my own normally. Will try to get ahold of their AT if possible to let them know..

Barbara Wertz ‏@bwertz12
@DrDavidGeier we all work well together & it is nice to have AT call you if they think what the athlete is saying is partially B.S.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier There are a few varsity rugby programs back east where AT is prohibited from touching opposing team athletes.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier Have also been told by host schools (tourneys) under no circumstances would their ATs tend to my athletes.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier Fine by me since I was there, but not a lot of teams travel w/an AT because we’re largely a club sport at collegiate level.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier Most hire per diem ATs to cover home games, & most will only help in ER situation. They don’t even provide ice/water.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier Gotta love working with a club sport! LOL

Rachel Blakeman ‏@RachelATC
@DrDavidGeier We went to a school this yr who had the idea that appropriate med coverage were an EMT & student AT who played on the team.

Rachel Blakeman ‏@RachelATC
@DrDavidGeier No one introduced themselves to me before the game. I only knew of med “coverage” because of other ATs who were there before.

Head injury in soccerRachel Blakeman ‏@RachelATC
@mnhopper1s @DrDavidGeier That’s the problem — most teams we play do not have an AT. #ClubSport

Rachel Blakeman ‏@RachelATC
@mnhopper1s @DrDavidGeier I’m also typically swamped w/my athletes, so opposing team may or may not get taped.

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier Hell, I can’t even get ATs who cover for me when I have game conflicts to give me injury info #IsItReallyTooMuchToAsk

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier Found out abt 2 clavicle fractures from random friend of 1 of my aths when I was in Texas w/women’s team…

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier …and had to get games at home covered. AT who covered for me? Actually club sports AT at the school.

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier She didn’t update me on injuries until I asked her AGAIN for an update.

Barbara Wertz ‏@bwertz12
@RachelATC @DrDavidGeier that’s really a shame. Even though we work in two separate health systems we all try to have each other’s backs

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier I guess she thought it was a HIPPA violation to tell me, or something.

Phil ‏@kujoatc75
@RachelATC @bwertz12 @DrDavidGeier I guess I was spoiled, being educated by MiLB ATC’s. They would cover for the other guy, during games.

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier Only other team that has AT in same situation as me is Cal, & we have a good relationship w/them.

Barbara Wertz ‏@bwertz12
@RachelATC @DrDavidGeier wow… That’s just not cool at all…

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier I’ve found a lot of teams expect me to help them out, but there’s no reciprocation when we go to their house.

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier Have teams expect me to provide tape, gauze, flexiwrap, braces, crutches, elastic wraps, etc.

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier Then when we show up to their field for a game? Not even ice & water. Not even an AT sometimes.

Barbara Wertz ‏@bwertz12
@RachelATC @DrDavidGeier all I ask of an AT who has a team coming is to give me a heads up on what to expect & send a kit w/supplies

Jessica Aquino ‏@babyj9210
@RachelATC @DrDavidGeier quite often down here do the home ATs cover travelling opposing teams. Except for football (most of the time)

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier I think she doesn’t like spending any of her own time to update me.Always very quick to leave when she covers for me

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier Did have a team show up w/list of what aths needed. Very limited supplies, though. They all think I’m a supply shop.

Rachel Blakeman ‏@RachelATC
@bwertz12 @DrDavidGeier I used to be very accomodating. Not so much anymore for a lot of reasons..liability, zero reciprocation, etc.

Rachel Blakeman ‏@RachelATC
@kujoatc75 @bwertz12 @DrDavidGeier We used to do that, as well, & definitely what I was taught going through school.

Football injuryMike Hopper @mnhopper1s
@RachelATC @DrDavidGeier VFB only sport I *refuse* to do much for. Most schools bring AT for that. Otherwise, we tend to help each other

Brad Morgan MEd AT ‏@PirateATC
@RachelATC @DrDavidGeier Since I work for a hospital with several local schools, we can treat any of those schools equally.

Brad Morgan MEd AT ‏@PirateATC
@RachelATC @DrDavidGeier As for treating other visiting schools, not so much

Rachel Blakeman ‏@RachelATC
@PirateATC @DrDavidGeier I’m an independant contractor. Tempted to bill opposing teams w/no ATs for my svcs! LOL

Mike Hopper ‏@mnhopper1s
@RachelATC @PirateATC @DrDavidGeier In pro baseball, teams did! If team travelled w/o AT, it was $50/game plus $50/game for supplies!

Brad Morgan MEd AT ‏@PirateATC
@RachelATC @DrDavidGeier I would. I assume you have the expense of carrying your own liability insurance, so you should.

Rachel Blakeman ‏@RachelATC
@mnhopper1s @PirateATC @DrDavidGeier I’ve brought this up before as potential. I’d charge more, though. Closer to what my regular rate is.

Rachel Blakeman ‏@RachelATC
@PirateATC @DrDavidGeier Yep, own liability ins. Supposedly covered by school as gen contractor, but don’t trust that.

Bobby Weisenberger ‏@BWW_ATC
@mnhopper1s @RachelATC @DrDavidGeier We always roll out the red carpet, then get treated like crap by most of the other teams. We have class

Mike Hopper ‏@mnhopper1s
@BWW_ATC @RachelATC @DrDavidGeier I wont tape VFB and evals would be limited. But any other help to *support* the opposing AT I’ll do it!

Rachel Blakeman ‏@RachelATC
@BWW_ATC @mnhopper1s @DrDavidGeier That’s my conundrum, as well. We like to set the standard & do the right thing. Gets old when no recip.

Rachel Blakeman ‏@RachelATC
@mnhopper1s @BWW_ATC @DrDavidGeier I’ll always support visting ATs if there is one. Always.

Rachel Blakeman ‏@RachelATC
@mnhopper1s @BWW_ATC @DrDavidGeier Will only tape ankles now, no special taping, no stretching, no evals of pre-existing injuries…

Rachel Blakeman ‏@RachelATC
@mnhopper1s @BWW_ATC @DrDavidGeier …no STM, limited acute injury eval (then tell them to see MD back at school).

Bobby Weisenberger ‏@BWW_ATC
@mnhopper1s @RachelATC @DrDavidGeier We get treated well by Rochester, Dayton, Pittsburgh, and the MLS teams we play. Those ATs get it

Rachel Blakeman ‏@RachelATC
@mnhopper1s @BWW_ATC @DrDavidGeier ALWAYS provide H2
O, ice/bags/flexi. A lot of teams who up w/nothing,not even so much as gauze/bandages.

Rachel Blakeman ‏@RachelATC
@mnhopper1s @BWW_ATC @DrDavidGeier Have had a lot of visting aths lately get attitudes w/me for not supplying tape & for not stretching them

Soccer player stretching with athletic trainerRachel Blakeman ‏@RachelATC
@mnhopper1s @BWW_ATC @DrDavidGeier and not rubbing out their cramping legs.

Bobby Weisenberger ‏@BWW_ATC
@RachelATC @mnhopper1s @DrDavidGeier We get it bad sometime. No ice for our locker room. Then come to our place and ask to use whirlpool. #NO

Brad Morgan MEd AT ‏@PirateATC
@RachelATC @mnhopper1s @BWW_ATC @DrDavidGeier Sorry, not sorry!

Bobby Weisenberger ‏@BWW_ATC
@RachelATC @mnhopper1s @DrDavidGeier Players can get attitude with me if they want, but they will be doing it back in their locker room.

Brad Morgan MEd AT ‏@PirateATC
@RachelATC @mnhopper1s @BWW_ATC @DrDavidGeier Wow. Don’t even start with attitude over that. #NotHappening

Rachel Blakeman ‏@RachelATC
@BWW_ATC @mnhopper1s @DrDavidGeier All but Cal shows up & expects us to give them everything. We have good reciprocation w/them.

Rachel Blakeman ‏@RachelATC
@BWW_ATC @mnhopper1s @DrDavidGeier The attitudes just make me want to help them less. They can pay for their own AT if they don’t like it.

Rachel Blakeman ‏@RachelATC
@PirateATC @mnhopper1s @BWW_ATC @DrDavidGeier I always tell opposing coaches they have someone cramping, the get to deal w/it.

Bobby Weisenberger ‏@BWW_ATC
@RachelATC @mnhopper1s @DrDavidGeier In our league they are supposed to show up with an AT or cash and their own supplies. Rarely happens

Rachel Blakeman ‏@RachelATC
@PirateATC @mnhopper1s @BWW_ATC @DrDavidGeier Had 1 coach go ballistic on me for not running across field to rub out aths leg cramps…

Rachel Blakeman ‏@RachelATC
@PirateATC @mnhopper1s @BWW_ATC @DrDavidGeier …his ath w/dislocated elbow, though? Yeah, I ran across for that.Coach never even thanked me

Brad Morgan MEd AT ‏@PirateATC
@RachelATC @mnhopper1s @BWW_ATC @DrDavidGeier See if I ever treat another athlete of yours coach. I don’t answer to you.

Rachel Blakeman ‏@RachelATC
@BWW_ATC @mnhopper1s @DrDavidGeier I’ve a difficult time telling aths I can’t help them bec they don’t have supplies,but it got out of hand

Bobby Weisenberger ‏@BWW_ATC
@RachelATC @PirateATC @mnhopper1s @DrDavidGeier The beauty of pro soccer is that teams go a man down if AT goes on.

Rachel Blakeman ‏@RachelATC
@BWW_ATC @mnhopper1s @DrDavidGeier I know my budget is bigger than theirs, but I have 80-120 aths & I go through supplies. I order for MY #

Bobby Weisenberger ‏@BWW_ATC
@RachelATC @mnhopper1s @DrDavidGeier Now I just do it and tell our front office staff to invoice them for AT services.

Rachel Blakeman ‏@RachelATC
@PirateATC @mnhopper1s @BWW_ATC @DrDavidGeier He wouldn’t even look at me when I came back across after EMS took his player off. #LowLife

Rachel Blakeman ‏@RachelATC
@BWW_ATC @PirateATC @mnhopper1s @DrDavidGeier Ath has to come off if AT goes on, correct? Only sub on if ath is out for remainder of game?

Brad Morgan MEd AT ‏@PirateATC
@RachelATC @mnhopper1s @BWW_ATC @DrDavidGeier “Here is a copy of my state practice act. I like my job. I won’t risk for you, coach.”

Rugby scrumRachel Blakeman ‏@RachelATC
@BWW_ATC @PirateATC @mnhopper1s @DrDavidGeier In rugby, no subbing out & coming back on,unless for blood sub. I treat on field, during play

Bobby Weisenberger ‏@BWW_ATC
@RachelATC @PirateATC @mnhopper1s @DrDavidGeier Yep. Play man down until ok to return or sub out.

Rachel Blakeman ‏@RachelATC
@PirateATC @mnhopper1s @BWW_ATC @DrDavidGeier I’d like that in a state practice act. Heck, I’d like a state practice act. #GetWithIsCali

Rachel Blakeman ‏@RachelATC
@BWW_ATC @mnhopper1s @DrDavidGeier I need to bring up again charging opposing team for AT svcs.

Rachel Blakeman ‏@RachelATC
@BWW_ATC @PirateATC @mnhopper1s @DrDavidGeier That’s same in rugby, except for we have the blood sub.

Rachel Blakeman ‏@RachelATC
@PirateATC @mnhopper1s @BWW_ATC @DrDavidGeier I’ve been straight out advised by sports injury atty to not touch opposing team’s athletes.

Bobby Weisenberger ‏@BWW_ATC
@RachelATC @PirateATC @mnhopper1s @DrDavidGeier Where in Cali do you work?

Rachel Blakeman ‏@RachelATC
@BWW_ATC @PirateATC @mnhopper1s @DrDavidGeier Independant contractor with Stanford Rugby.

Brad Morgan MEd AT ‏@PirateATC
@RachelATC @mnhopper1s @BWW_ATC @DrDavidGeier Welcome to the great state of Ohio!

Bobby Weisenberger ‏@BWW_ATC
@RachelATC @PirateATC @mnhopper1s @DrDavidGeier Thats Northern Cali right?

Rachel Blakeman ‏@RachelATC
@BWW_ATC @PirateATC @mnhopper1s @DrDavidGeier Yes. San Francisco Bay Area.

Rachel Blakeman ‏@RachelATC
@PirateATC @mnhopper1s @BWW_ATC @DrDavidGeier I’ll stick with CA! 😀 #OnlyAMatterOfTimeBeforeCAATsHaveLicensure

Bobby Weisenberger ‏@BWW_ATC
@RachelATC @PirateATC @mnhopper1s @DrDavidGeier Got ya. Was just wondering. We have to make another West Coast swing to play LA.

Brad Morgan MEd AT ‏@PirateATC
@RachelATC @mnhopper1s @BWW_ATC @DrDavidGeier I hope it’s just a matter of time.

David Webb ‏@trainerwebby
@DrDavidGeier @PirateATC @RachelATC @mnhopper1s @BWW_ATC my network is covered as group but outside network I keep it simple.

The Dr. David Geier ShowWhat legal issues should doctors and sports medicine healthcare providers consider when covering sporting events? In the Zone segment from Episode 95 of The Dr. David Geier Show.

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