When paramedic Wendy Hedman of the Gainesville, Fla., Fire Rescue Agency tore cartilage in both of her knees and injured her back on the job, she had conventional medical care, including surgery. She also sought out a specialist—her employer’s on-site certified athletic trainer.
“I started seeing him for strength and flexibility therapy in June 2007,” Hedman says. “My recovery from the surgery has been faster and with less pain due to the therapy treatments before and after.”
Athletic trainers know the types of “muscles and endurance we need for the different jobs we do,” Hedman continues. “They can prepare a schedule of training to keep you fit [and] cut back on injuries. … They know what it takes to treat [employees’] injuries and get them back to work faster.” She adds two more pluses—“the availability,” because they’re on-site, “and the one-on-one attention.”
The city of Gainesville numbers among many employers using certified athletic trainers—known as ATCs, the initials representing their certification—to help keep employees healthy and minimize workers’ compensation costs. Athletic trainers’ success in doing so has led to a rise in the profession at workplaces. ›
A Growing Field
According to the Dallas-based nonprofit National Athletic Trainers’ Association (NATA), 25,000 athletic trainers have been certified in the United States. They have long been used in professional and amateur sports settings, but they are gaining popularity in industrial, commercial and office settings.
In a 2003 survey report—the latest available—from the NATA, all 32 respondents, including HR professionals and safety managers, said their athletic trainers provide a positive return on investment of about $3 for each dollar spent, and almost all said the severity of employee injuries had decreased by at least 25 percent since they brought an athletic trainer on-site.
Certified athletic trainers are not to be confused with personal trainers who often work in gyms. They differ in professional education requirements, training and roles. ATCs are allied health professionals who must hold a bachelor’s or master’s degree in athletic training and pass an examination by the Board of Certification Inc., the profession’s sole accredited certifying body. It began as a committee of the NATA but was incorporated as an independent nonprofit almost 20 years ago.
ATCs must maintain their certification through continuing education, and in some states they must be licensed.
Unlike personal trainers who focus on fitness, ATCs can diagnose, treat and provide rehabilitation for acute and chronic injuries. ATCs spend a good deal of time teaching people how to prevent injuries through proper ergonomics and physical conditioning.
Athletic trainers “are a one-stop health care provider,” says ATC Craig Halls, total health manager for Aurora Health Care, a not-for-profit integrated health care provider headquartered in Milwaukee. “Our education covers a lot of different areas of anatomy, physiology and nutrition. ATCs can do it all: ergonomics, rehab, injury prevention and fitness classes.”
Halls adds that ATCs “aren’t restricted by reimbursements from the insurance company.” For example, if an insurer’s treatment protocol for back pain calls for three visits per week for four weeks but the person needs more care, “We can see that person for as long as it takes for that person to get better,” he says. “We’re paid a flat rate that doesn’t involve the insurance company.”
Essentially, ATCs’ roles fall into three categories: injury prevention, triage and rehabilitation.
“We deploy ATCs to work with people one-on-one on their personal risk behaviors and injury management,” says Steve Chevarria, an ATC who directs East Coast operations for Wellness Coaches USA, an athletic trainers contractor in Blue Bell, Pa. “When we teach injury prevention, stretching is a big component. We want [employees] to loosen the muscles prior to a workday. Our goal is a pain-free range of motion.
“We find weight control is the underlying issue of most people’s problems, so we try to minimize people’s weight through exercise and nutritional education.”
Chevarria serves Roadway Express Inc., a freight services company headquartered in Akron, Ohio, that contracts with Wellness Coaches USA. “When I started working at Roadway, there was an average of 120 OSHA-recordable injuries per year, everything from minor abrasions to blown-out knees,” he says, referring to injuries that must be reported to the U.S. Occupational Safety and Health Administration (OSHA). “After three years of having two ATCs on-site, we had only 12 OSHA-recordable injuries.”
Chevarria attributes Roadway’s results to prevention education. “It just takes a minute to think about the best way to move something,” he says. “It’s easier and less costly to prevent something from happening than to fix it.”
Debbie MacLean, ATC/L—the L signifies she’s licensed by her state—is manager, operations, health management, for the Coca-Cola Co. in Atlanta. As a member of the company’s safety team, she affirms Chevarria’s point, explaining, “We have an ergonomics class to teach employees how to properly adjust their chairs and workstations so they aren’t straining to reach for things.” She evaluates the safety of the facility each month and develops prevention-oriented safety programs.
Back injury constitutes a leading risk for the workers who deliver Coke products to stores and restaurants, so MacLean developed Back@Work, a prevention program presented to many groups of employees. She also created a video that shows techniques of proper lifting and that supplies pointers for daily living, from setting up a computer at home to controlling weight.
A plus that employers find in having ATCs on-site is the personal attention and education they give employees. “When employees get hurt and seek medical care, they’re looking for answers,” says Margaret Adamson, an injury prevention specialist for Delta Air Lines in Atlanta. The athletic trainers explain “what is going on. When people get their questions answered, they don’t keep seeking medical care.”
Delta numbers among many employers who use ATCs for triage and rehabilitation, as shown in the sidebar above. And the results are evident, Adamson continues: “Our lost-workday claims have gone down significantly because our agents are remaining in the game. The athletic trainers provide care in between flights. There’s a significant drop in time lost for therapy appointments. People were blowing off injuries because they didn’t want the hassle. Now, it’s encouraging people to get treated early. They get better faster. It increases productivity. It makes the employees happy.”
Steve Varvel, the city of Gainesville’s risk management director, has received similar feedback from employees, noting, “I wish I got this type of response with everything I tried.”
Gainesville has 2,200 employees and 200 workers’ compensation claims per year. “Fortunately, not many [injuries] are catastrophic,” Varvel says. “We have a lot of strains and sprains.”
Since the early 1990s, certified athletic trainer Gary Porter Jr., who helped paramedic Hedman before and after her surgery, has provided it all—prevention education, triage and rehabilitation—for firefighters, police officers, utility workers and other city employees. “He works well with every demographic,” Varvel says. “He’s good about explaining what is wrong, not just fixing it.”
For example, Alice F. Murnahan, a senior legal assistant for Gainesville, says a pinched nerve in her neck was causing shoulder pain. “I had taken an anti-inflammatory drug and was also being treated by my chiropractor,” she says. “The condition was improving, but I felt as if my shoulder was becoming stiffer and I was losing my range of motion.
“The athletic trainer explained the problem. He used massage and electrical stimulation on my shoulder. Then he stretched and rotated my arm to ‘unfreeze’ the muscles, allowing them to relax and move more freely. After three sessions, I am already able to use my arm in several different day-to-day movements I was unable to do previously.”
Overall, Gainesville’s program has been cost-effective. The return on investment “is a 300 percent direct return—$160,000 to $175,000 per year,” Varvel says. Moreover, in the year after a full-time athletic trainer was hired, the city reported a 20 percent reduction in the number of workers’ compensation claims and a $300,000 reduction in claim amounts.
“Our goal was to save money for the city, but the employees value what Gary provides,” Varvel says. “Gary spends more time on average with a patient than you’d see in an external environment. We don’t have to say, ‘We want you to go to Gary.’ Instead, we hear, ‘Can I use Gary?’ His [internal customer base] has grown largely by referrals from his patients.
“We have a direct dollar savings, but there are intrinsic values,” Varvel says. “The employees feel they are getting better attention.”
The author, a former HR generalist and trainer, is a freelance writer in Wixom, Mich.