What’s A Life Worth To You? The Absolute Importance Of Athletic Trainers In High School Sports

{Editor’s Note: I can think of no one better to speak to the need and value of Athletic Trainers in high school sports than someone whose life was literally saved on the playing field by an AT. Kevin Saum can claim that honor. Kevin is a Knockout Project Round Table member and his bio is available on this page .- Jay}

By Kevin Saum

saummudMore than 50% of high school students in the United States do not have the luxury of having an athletic trainer on the sidelines of their games and practices.  Yet athletic trainers are standard in collegiate and professional sports.  This reality is highly questionable considering that the underdeveloped, youth brain is at the greatest risk of injury.  In addition, studies have shown that young athletes take longer to heal from brain injuries, compared to the brains of more physically mature athletes. Why is it that school districts and policy makers are willing to implement safety changes AFTER a fatal, or near death incident occurs?  I often wonder what would have happened to me if Miss Barba were not on the sideline the night I was injured.  I venture to guess that you would not be reading this blog post.

After reading The Concussion Blog’s March 4th post, which recognized March as National Athletic Trainers month and encouraged readers to give a shout out to their favorite athletic trainers, one AT immediately came to mind.  Despite my lack of punctuality, I would like to recognize an Athletic Trainer at a high school, “set in the valley” in Chester, New Jersey.  Suzanne Barba, “Miss Barba” to all the students, is West Morris Central’s Athletic Trainer of thirty years, and not only mends bumps and bruises, but also touches the lives of every athlete she tapes, rehabs and teaches. Suzanne is also responsible for saving my life in a high school football game on October 5, 2007.  I do not remember very much from this night, but it is a night that undoubtedly changed my life forever.

As an athlete, one place you never want to be is in the athletic training room.  Being in this room either means you are out of the game, multiple games, the season, and possibly forever.  Just ask Alex Smith of the San Francisco 49ers, what happens when you go into this room.  Players would rather risk their long-term health and careers to stay out of this room, and look  where that got Robert Griffin III. I was a senior captain and a product of playing in a sports culture, which frequently glorified playing through injuries.   I naturally felt obligated to play injured in what was our team’s last chance to make a run for the playoffs.  In week two of the season, I sustained a separated shoulder, and Miss Barba tended to this injury for the few weeks leading up to my last game.  In the meantime, I strained the rotator cuff in the opposite shoulder, which instinctively left my head as the only blocking/tackling tool to use.  Naturally, like any competitor, I refused to let these ailments keep me off of the field.  However, after playing with these injuries and leading every hit I made with my head, I sustained a concussion. It should be noted that I was never officially diagnosed with a concussion, because I did not inform anyone about the excruciating headaches I was experiencing.  I never told a doctor, my parents, my coaches and certainly not Miss Barba.  She would never have let me play if she knew about my headache.

As I have alluded to previously on this blog, I unsuccessfully attempted to suppress the pain with four Advil and ran out under the glow of the Friday night lights for what turned out to be the very last time.  Just before halftime in this game I received a significant blow to the head, which left me unable to feel my legs.  With my history of chronic leg cramps in hot-weather games, everyone assumed it was just another cramp, as my teammates helped me to the sideline.  Because of Miss Barba’s experience as an EMT and Paramedic, she knew my condition was something much worse than leg cramps.  Upon recognizing my right-sided gaze, a common sign of a subdural hematoma (brain bleed), Miss Barba called for Advanced Life Support, and luckily a helicopter was in the area, on its way back from another call.  The doctor on the sideline was initially surprised by this request, until moments later, when I began to seize.  Miss Barba’s role did not stop at calling for appropriate medical attention.  She was also the one assisting my breathing with a bag valve mask when I went into respiratory failure, because of the brain swelling that ensued from second impact syndrome. The breathing assistance prevented brain damage and ultimately saved my life.

At that time, In 2007, Miss Barba was only a part-time athletic trainer because she was also responsible for teaching health classes during the day.  Due to a lack of time and resources, this work schedule prevented her from implementing baseline concussion testing and working with athletes to rehab their injuries.  Fortunately, in the year following my injury, Miss Barba was made our high school’s full-time athletic trainer.  Now, thanks to Miss Barba’s exceptional work and overwhelming support from parents, our school has a very thorough graduated return to play (RTP) protocol for its athletes.  This RTP process includes input from the strength and conditioning coach, to aid in implementing the graded physical activity protocol. Athletic trainers and strength coaches spend a lot of time with athletes, both during the season and in the offseason.  During this time they get to know the athletes personalities and ability levels.  They can identify when athletes are not acting like themselves, similar to how parents can, but in an athletic environment.   ATs specialize in diagnosing and treating injuries, while strength coaches have a great understanding of each individual athletes physical capabilities.  This collaboration between AT and Strength Coach, during the evaluation of an athlete’s RTP, allows for an appropriately stringent evaluation. The intricacies of Miss Barba’s RTP procedure meet, and I feel exceed, the standards set in place by the AmericanAcademy of neurology.  As a result, Suzanne believes that athletes feel safer and more confident returning to their sports, after passing this test.

On average, 12 football players die every year due to heart conditions, brain injuries and heat-related causes. Most of these deaths could be prevented with an AT overseeing athletic operations.  Athletic Trainers carry AEDs on the sidelines and could save the life of an athlete who has a heart condition.  Without ATs, concussions cannot be adequately managed due to conflicts of interest that exist in sport. Although athletic trainers have limited control in preventing brain injuries, other than educating athletes, nearly all brain injury related deaths could be avoided if concussions are managed properly.  On hot summer days, AT’s monitor the heat index and have the authority to cancel practice if conditions are too dangerous.  In addition, ATs ensure athletes are properly hydrated, which also prevents heat-related deaths.

Recently, the AmericanAcademy of Neurology published their updated return to play guidelines for concussions.  Most notably, they make the following recommendations:

  • The use of baseline testing.
  • Immediately removing a player from play when a concussion is suspected.
  • Individuals supervising the athletes should prohibit an athlete with concussion from returning to play until a Licensed Health Care Provider (LHCP) has judged that the concussion has been resolved.
  • Licensed Health Care Providers should develop individualized graded plans for return to physical and cognitive activity.

These recommendations are based on research and when implemented, they undoubtedly will make sports safer to play.  However, without the presence of an athletic trainer, their feasibility and intended efficiency are significantly hindered.  Not all parents can afford to take their children to LHCPs.  Who will recognize and remove an athlete from play when a potential concussion occurs?  The coaches? Who are trying to win a game and have a million other things and kids to worry about?  Wouldn’t that be a conflict of interest?  Where is the accountability in returning an athlete to play without an AT? Are coaches now going to be responsible for recording injuries and validating their athlete’s medical notes?  Are physicians going to be responsible for administering graded physical activity tests, with no prior knowledge of the individual’s abilities? All of these questions are answered when Athletic Trainers are looking after players.

Clearly, every athletic program would choose to have an Athletic Trainer if they were not faced by budget constraints.  I owe my life to an Athletic Trainer, which is why I am very passionate about the issue.  Considering all the statistics in regards to the dangers on the sports fields and the obvious safety and life saving benefits an athletic trainer brings, I ask the school districts, policy makers and parents, how much is a life worth to you?

Alex Smith Link:


RG III Link:


AmericanAcademy of Neurology Guidelines:


Twelve football players die every year:




 Suzanne Barba takes care of Michael Burton, who currently plays fullback at Rutgers University


I think she did a good job. Ed Mulholland/US Presswire Photo






32 thoughts on “What’s A Life Worth To You? The Absolute Importance Of Athletic Trainers In High School Sports

  1. Linda Sardilli

    Kevin, what a well-written, informaative and motivating piece of articulation!!! This should be a “required reading” for everyone: for parents coaches, and athletes of ALL ages!!! I am so sorry that you went through such a horrific experience, but just like Jay Fraga, you (and others like you) will be honored and credited with preventing concussions, educating people with regard to the dangers and future side effects of concussions, and the Nessessity of Athletic Trainers being present at ALL sporting events (especially in youth sports). The words are powerful and they Will SAVE the lives of others! Bravo Kevin!!!

  2. Lori warchol

    As a mother of a high school student soccer athlete I recognize how impt this is .my daughter suffered her second concussion still in jan still not 100%. With each concussion getting back to being headache and neck free takes longer .terrible to go thru this as a 16 yr old . All the info is very helpful thank you.,,.

    1. jfraga Post author

      Lori, thanks for reading. If you click on the “high school” link on the nav menu to the right, it’ll bring up two additional stories below the one you just read from Kevin about AT’s. These two were written by high school girls detailing their experiences.

  3. Lisa Happy

    Kevin, This is a fantastic article. The night of your injury is still very vivid to me. Ms Barba has saved many lives on the athletic fields in our town. Every school distract should be so fortunate to have an athletic trainer like Ms Barba on their sidelines.

  4. John

    I like the idea of trainers but their word should not keep kids from playing or going back onto the field after they were hurt or a big hit occurred. It should be up to player if they well enough to get onto the field or ice and play.

    1. jfraga Post author

      John, with all due respect, are you kidding me? Asking a player who has been rocked if they’re ok to go back out and play is like asking a drunk driver if they’re ok to get back into the car and drive. It’s that simple. Most of us who have told our stories on this site are living proof of what happens when you think that you can go back in and play. And the reality of that isn’t good for most of us.

      1. john

        I’ve played through concussions and seperated shoulders and cracked colarbones, broken toes broken fingers and a couple broken metacarpoles and nothing ever happened to me. It got me to where I was in my sport and to win national titles not sitting on the sidelines. No pain and no gain in my mind.

        1. jfraga Post author

          John, I’m sorry, but so did we. I raced through 7 concussions before the 8th did me completely in. And I have national titles to my credit. You’re only as good as what happens the next time you get hit. And until that happens, you have no idea what you’re talking about

        2. Kevin Saum

          John, consider yourself lucky. I used to share your “No pain, no gain” mentality until it almost took my life. There comes a point of diminishing returns when it comes to playing injured. Athletes need to be saved from themselves, hence the RGIII reference. Athletic Trainers do not keep players off the field because they get some kind of sick satisfaction from doing so. ATs keep them off the field so they can heal, and perform optimally when they come back. Playing injured may have won you championships, but it ended the careers of everyone else who writes for this blog.

        3. jfraga Post author

          John/Jeff.. not sure what it is- your email address says Jeff and posting handle says John. Anyway,

          One thing I want to make clear here is that at one point, we all thought the same way you did. We’re not hammering on you for the sake of an argument. Unfortunately, we were all made to see the light after some rather harsh circumstances. Quite frankly, I was completely ignorant about concussions before. “Ignorant” doesn’t mean that I’m a moron, it just means that I really didn’t have any idea about them before. Right now, you’re ignorant to concussions, largely because you’ve never felt their full wrath.

          There have been many days since my 8th concussion almost three years ago where, quite frankly, I would have rather been dead than suck it up and live with the symptoms that I have going on. This website exists to show athletes and people like you the light, or rather, the dark side of all of this. People are not invincible. As athletes, a lot of times we believe that we are.

    2. Michele


      First of all it’s Athletic Trainers not “trainers” and yes, there is a difference because many people hear “trainer” and think personal trainer.

      Second: it’s not an ATs “word” that holds athletes out of play. It’s things like knowledge, years of education and experience (whether it be personal or professional) etc. that hold athletes out of play.

      Like someone said before me, consider yourself EXTREMELY LUCKY that you were able to play with all of these injuries you’re claiming to have played with and never have one that can cause permanent damage, paralysis and even death. There is NO comparison between an orthopedic injury (like all but one of the injuries you named) and a concussion. Is it smart to play with fractures? No not all, but I’m not going to get into the details on why that’s a bad idea. However, the details on why it is NOT SMART to play with a head injury are pretty self-explanatory (permanent damage, paralysis, DEATH).

      It’s because of that “No pain, no gain” mentality that so many people suffer from permanent damage and even die from head related injuries. There is a huge difference in playing through bumps, bruises and soreness and playing through a head injury. It’s because of the ignorance and lack of knowledge that you and TOO many other people have, that athletes do not report symptoms to their AT (or coach and parents if there is no AT).

      One can only hope that uneducated and ignorant people will take the time out to learn about concussions and head injuries so we can help to turn around the “no pain, no gain” attitude and have athletes be more honest about any possible symptoms. Athletic trainers do not, by any means, WANT to hold ANY player out of competition. ATs are there to be advocates for their athletes and only strive to keep them healthy both on the field and off the field. Not only while they’re playing where ever the AT is working but in their futures as well.

    3. J Peak

      John, I certainly hope and pray for your sake & the sake of your loved ones that you and God are on extremely close terms considering your attitude toward some of the professionals who care the most for you & your teammates. Sounds to me as though we ATs may even care for &about you more than you care about you.

    4. Jen

      Untrue. It IS up to the AT. We are the Licensed Health Care Providers on site, and we have the final word. The only people who are qualified to over-rule a Licensed/Certified Athletic Trainer is a Licensed physician, and sometimes, if it’s not our “team physician”, we make the call to over-rule a release (we know the athletes…they do NOT). Not a nurse, not a paramedic (we have more education and training, especially when it comes to athletic injuries, than both), and certainly not the athlete themselves. The decision of an LAT/ATC in a situation without a medical doctor in attendance trumps everything else. Contrary to popular belief, we’re not the old school “trainers”. We’re health care professionals who hold at the very least a Bachelors degree (over 80% of us hold post-graduate degrees up to a PhD.). It’s impossible to become an athletic trainer without formal education (at an accredited university or college), training, clinical experience, and passing a national board exam, and becoming licensed in our own state. Just an FYI. It’s too bad that the public is so uneducated about the role of AT’s in the health care world.

  5. Michael Hopper, ATC

    John, your comment is completely out of line. And frankly, it’s logic like yours that has led to the epidemic we now face. I am a Certified Athletic Trainer. I am also a former varsity athlete in 3 sports. One reason I got into athletic training is because of concussions. I was never formally diagnosed with a concussion in 6 years of football, 4 years of basketball, or nearly 15 years of baseball; most of that time spent behind the plate as a catcher. Those “dings, bell ringers, and pops” were likely a concussion each and every time. I’d guess I had at least 5 or 6 and not a single one was ever called a concussion. Why? Because I was ingrained to not talk about it. I can (now) remember specific incidents where I definitely had a concussion. I’m grateful to even be alive because some of them could have easily been knock-out blows.

    The mentality of “play through pain” cannot exist in regards to a head injury. That’s plainly STUPID. There was one incident where I took a foul ball off my facemask and had a horrible headache, blurry vision, couldn’t see straight. And I never said a word to anyone. I “sucked it up” because one of our other catchers had gotten hurt in that practice and my goal was to take his position right then and there. I wasn’t saying a word! That’s just dumb.

    I’ve also played through orthopedic injuries. There’s no comparison. NONE. I played a football game with an ankle so badly sprained that a teammate came and picked me up from the line of scrimmage after each play.

    Every Athlete Deserves an Athletic Trainer. #AT4ALL

    1. john

      I agree with what you guys have to say don’t get me wrong. But realize there is price to pay for the game you play and each sport is different. The headaches I deal with and the pains and aches daily its all worth it. If you can’t play the game the way its supposed to then alright accept that and move on.

      1. Michele

        “Playing the game the way it’s supposed to be played” has very little to do with this at all. Just because someone gets a head injury or an injury at all does not mean that they don’t play the game the way it’s supposed to be. Yes, playing a sport comes with risks and yes you assume that responsibility when you choose to play. But I don’t care who you are, whether you’re a child just starting out or a professional athlete, there is nothing more important than your life and no sport should come before it. What good is being good at a sport when you’re paralyzed from sustaining a head/neck injury? What good is being good at a sport when you’re DEAD because you decided to hide the symptoms of a head injury? It’s better to sit out until cleared to play then sit out the rest of your life or be killed trying to be tough.

        No ones saying that everyone should baby every injury, but there are certain injuries (like a head injury) that needs to be babied until the symptoms are gone and proper steps are taken to return to play.

        1. john

          There a price to pay to achieve greatness that’s my point and you can either deal with it or don’t and never experience what’s its like to win at a level that matters. I agree that trainers are needed a younger level but it won’t keep people from getting hurt. The headaches I deal with now and numbness in the hand and feet bring meet great pride because I think of all I went through and how much fun I had and I’m not the only one there is 23 guys dealing with the same issues but guess what it has helped us in real life . If you atr sick or hurting in the morning no matter what you get up and go to work no excuses in my book.

        2. Kelsey, ATC

          Michele, you said it right! Contrary to popular belief, as an ATC I don’t like to hold athletes out of games and practices. In fact, I like to push my athletes and have them play through injuries such as muscles strains and broken bones, but never concussions. This risks and potential consequences are too great when it comes to concussions. I actually prefer to have athletes with the “no pain no gain” mentality because I know I can push them and I know they are dedicated, but it my job to know when something is too much.

          There is nothing that can be said to “tough” people like John. He and many others are set in their ways and their opinions will never change until decades from now when they start to experience symptoms from chronic traumatic encephalopathy and the severe depression that goes along with it. Those people will one day suffer the consequences from their ignorance and will know something is wrong when they start to have mood changes and thoughts of suicide and at point it’s too late. The best we can do is educate the new generation of athletes and their parents and save those lives.

          1. Michele

            Thank you Kelsey, I too would rather have my athletes playing then sitting on the side line. I can’t think of one athletic trainer I know that enjoys having to hold people out. It’s a shame that ignorant people don’t want to do any research on the consequences of playing with a concussion before posting on a blog and giving terrible advice!

            1. Jen

              Right there with you guys! I’m definitely one who pushes my athletes to play as well. It’s the worst part of our job to tell an athlete they have to sit out. Muscle strains, little dings? Suck it up (unless it’s a hamstring or something really bad LOL). But concussion? Um…no.

              It’s unfortunate that the athletic community and the public in general is so uneducated about this. I’m incredibly blessed to work in a HS with terrific coaches who basically send every tiny thing to me. Even during a “big game/meet/match”, my football and wrestling and all the rest of my coaches say “Okay, he’s/she’s out” even if it’s one of our best players. It’s “Alright, you’re the boss!” Nice.

              Anyways, again, unfortunate that someone would post on a blog that’s celebrating our role with something that ignorant.

  6. Randy Bisnett MEd, ATC, LAT

    Unfortunately, John I think you are going to be one of the people we will read about in the papers one day, and not for the reason you think. You are a foolish young man that will one day pay the price for his attitude concerning in injuries. At this point all I can do is pay for you.

  7. Randy Bisnett MEd, ATC, LAT

    John do you think Junior Saau had second (third, forth, and fifth) thoughts about how he dealt with his injuries? Considering the note he left I’d say it’s a safe bet.

  8. Eileen Saum

    People see life through the lense of their own experiences. I’m wondering if John has a child who plays football. If that child was experiencing headaches he would most likely encourage him to suck it up and play through it. And that child then collapsed on the field from a grand mal seizure as a result of second impact syndrome. He would most likely search frantically for an AT to come to aid of his child …but sadly, his school choose not to employ one. Budget constraints. Tragically his child might not live to go on to college and graduate school. John would have to ask himself what did he gain having his child play through the pain? After going through this kind of experience, John’s response might be quite different.
    Kevin I am so exceptionally proud of you and all you have accomplished. Your courage, strength and determination inspire me everyday. Keep up your great work – you are making a difference. And to ‘Miss Barba’ I would always look for you on the sidelines before every game and as soon as I saw you I knew Kevin would be safe no matter what happened – I never realized how true that was until that night 5 years ago. Thank you for doing what you do SO WELL and for loving our kids like they were your own. I am eternally grateful.

    1. Jenn, ATC, LAT

      Athletic Trainers don’t hold athletes out of the game for fun, nor do we push athletes to play through injuries such as broken bones (as Kelsey suggested earlier)… Injuries take time to heal, whether its a strained muscle , a sprained ligament or a bruised brain AKA concussion!!! ATC’s aren’t the bad guys, we are protecting the athletes.

      1. jfraga Post author

        Jenn, absolutely. Thank you for what you do.

        We’ve had a resurgence of activity on this article from Kevin recently. Can you tell me how you found it? We’re aware that we’re getting many, many more hits from a page on Facebook lately, but can’t narrow down exactly which one.

        Thank you!

        Jay Fraga
        The Knockout Project

  9. Jill

    Jay, recently this has been passed around to athletic trainers. This is a very close knit group and has been forwarded on and on. This is a great blog and THANK YOU for this.

    I do have one comment. In the piece it was stated, “Not all parents can afford to take their children to LHCPs.” I am not sure if I misunderstood the intent of that statement, but, Athletic Trainers are Licensed Health Care providers. Athletic Trainers are regulated in 48 states, most with licensure. Additionally, we hold a National credential through the Board of Certification. I just wanted to clarify.

    Kevin, I am glad to hear of your extremely positive outcomes.

    Miss Barba thank you for representing the profession so positively.

    1. Kevin Saum

      Hello Jill,

      Thank you for your note and for keeping athletes safe. I appreciate you taking the time to read the article and passing it along to other Athletic Trainers. Also, thanks for pointing out the section about Licensed Health Care Providers. I should have made the distinction between “Clinical” and “Sideline” LHCP’s, understanding that both are Licensed Health Care Providers.

      – Kevin

  10. Jen

    Kevin, thanks for representing our profession so wonderfully! I too thought “What the heck?” about the LHCP’s, but I understand. I am amazed by your brilliant blog post. Thank you, thank you, thank you.


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