This post was written by Erica Marcano, MS ATC, CSCS, Athletic Trainer & Strength Coach at PHIT Well. If you've been a patient or client at PHIT, you may know Erica, but what you may not know is that she, Kim, and Larry all share the "ATC" (Certified Athletic Trainer) credentials, and that the Athletic Training model is a foundational piece of the vision Kim and Larry set forth for PHIT. It is a priority to us that each person who walks through our doors not only receives the standard of care that is often reserved for elite athletes, but also that you have access to the full continuum of care - including acute orthopedic rehab, maintenance for chronic injuries, return to activity, performance optimization, and injury prevention. Read on to learn more about how Athletic Trainers work, and how this model benefits you!
March is National Athletic Training Month, and the theme set forth this year by the NATA is
“FROM HEAD TO TOE.”
It’s true in the most basic sense – Athletic Trainers are qualified to assess and treat musculoskeletal and sports injuries, from concussions to turf toe. We also excel in collaborating on preventive measures to help decrease injury risk – from working with strength coaches on programming, to making sure our athletes have safe playing surfaces.
But in a deeper sense, this tagline also speaks to how we work with every athlete, patient, and client we interact with. If a pitcher comes to us with shoulder pain, struggling with velo and accuracy, we know that our assessment isn’t complete until we’ve done not only a thorough exam of the shoulder, but also looked at his core, his hips, and his mechanics.
This deep understanding of biomechanics is something we bring with us to every clinical setting, and apply to every person we work with.
It’s why we intuit that the repeat PT patient whose history says she has patello-femoral pain syndrome as well as chronic low back pain may actually have a labral tear in her hip, or that the patient arriving with a prescription that says, “bilateral shoulder pain,” may actually have a neck injury.
As AT students, we spend a significant amount of time not only studying anatomy and kinesiology, but also learning to understand the complex biomechanics of movements across different sports. Just as Tyra Banks taught America’s Next Top Models that a successful pose means always modeling “H2T,” the successful career of an athlete also depends on this through line – the strength, timing and grace from fingertips to feet of the player throwing the pitch or taking the shot.
When given the freedom to work H2T, as we do in Athletic Training Rooms across the country, without restrictions placed on us by 20 minute appointment slots and insurance payouts, Athletic Trainers can apply the same principles to ANY individual.
Being able to tolerate heavy weight on a knee extension machine will absolutely help an athlete build back the strength and power she needs to strike a soccer ball. But unless she can utilize that strength and power while out of breath, balancing on the opposite leg, with precise timing, while reading her teammates and opponents, it will not help her successfully return to play. In the same way, if a patient needs to get something from a high shelf at the grocery store, or put their luggage in an overhead bin, no amount of functional reaches with a weighted ball on a shelf will give them the ability to do so, unless they have ALSO successfully learned to incorporate the rest of their body into that movement, and transfer it to a setting outside of the clinic.
In school, all rehab professionals and clinicians are taught to evaluate the joints above and below the injured or painful area to accurately assess the cause or contributing factors. Everyone learns how to teach corrective exercises, and how to evaluate gait patterns. But regardless of current practice setting, ATs, who cut their rehab teeth working in sports, can’t help but look beyond just the joints above and below, to the true complexities of movement. An AT’s eye is trained to spot drivers in all movements. I know that if my patient tells me she’s hosting a dinner party in two weeks, she doesn’t just need to be able to sit for 2 hours and check that goal box on her insurance’s paperwork, she needs to be able to repeatedly deadlift and plate press the weight of her cast-iron pans…and she may need to do it in heels. After hours of watching practices, seeing the drills successful coaches run, and then being creative with incorporating them into an athlete’s rehab, it’s second nature for ATs to be able to break down the nuances of an every day activity for a patient who is struggling into bite-size drills, that can then be put together for a fluid movement, along with a sense of accomplishment and confidence in that movement.
And speaking of confidence, let’s talk about the biopsychosocial treatment model that is second nature to ATs, but often isn’t found outside of the Athletic Training Room.
All the research shows that this treatment model is BY FAR the most effective one a rehab professional can implement. In fact, it’s been shown that physical readiness alone is considered an incomplete rehab outcome, and an insufficient indication of successful return to activity. Yet the traditional injury rehab paradigm continues to address only the stages of physical healing, without the mental & emotional healing patients must do in tandem. Not so in the Athletic Training Room.
Visit any ATR, and you’ll find an injured athlete who is not only being put through a rehab protocol, but is also being supported and protected by their AT, receiving guidance both on how to navigate the busy hallways on crutches, AND how to navigate changing relationships with teammates and coaches. Athletic Trainers know that it takes a village to facilitate successful injury recovery and return to play – or successful retirement from the sport if indicated – and so develop both the skill set and the resource networks that allow them to implement a true biopsychosocial treatment model.
Athletic Training H2T isn’t just about the ability to provide physical treatment head to toe - it’s about having the skill set to provide care for the injury AND compassion for the impact the injury is having on all aspects of a person’s life; the skill set to treat their head and their heart, their surgery and their sense of self.
If you’re reading this as an Athletic Trainer, I hope that you take great pride in the way that the skills you’ve developed allow you to treat every patient, athlete, and client you encounter, truly, from head to toe.
In appreciation for everything my fellow ATs do, this month and every month,
Erica
PHIT Well, a home for orthopedic wellness located on the upper east side of Manhattan. was founded by 2 multi-certified AT’s, Kimberly Caspare DPT, ATC, CSCS, CES and Larry Discenza BS, ATC, NASM-CES, who have built a model where both physical therapy patients and personal training clients have access to the clinical skill set of an Athletic Trainer to support their rehab and performance goals.
