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08/4/2015

#AT4ALL - 15 Takes on Athletic Trainer Advocacy and More

A discussion with Michael Hopper, MS, ATC, LAT
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In the world of social media, everyone has the tools at their disposal to rally people from all over the country (not to mention the globe) around a common cause. Few, though, can maintain the level of energy required to make a message stick.

Michael Hopper is one example of someone who has succeeded where others have failed. In the short five years since graduating, Michael has become a powerful voice on social media, advocating for the cause of Athletic Trainers. Michael's promotion of the now ubiquitous hash tag #AT4ALL has served multiple purposes: from clarifying precisely what the role of the Athletic Trainer is to connecting the profession's crucial role in athlete safety.

Michael shared with us 15 takes on what it means to be an Athletic Trainer, the changing tide of public understanding, and the importance of advocacy.

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Michael Hopper, MS, ATC, LAT

Head Athletic Trainer, Bishop Lynch High School, Dallas TX
Twitter: @mnhopper1s

1. On why the profession of Athletic Training required advocacy

MICHAEL HOPPER: Many people will tell you that the Athletic Training profession is still a relatively new profession. The NATA traces its roots back to 1950 when it held its first national convention in Kansas City, MO but really the profession goes a little further back than that. The perception of the profession is multi-faceted and many do not fully understand what we do as professionals. We have to help the public understand the necessity and the qualifications of the Athletic Trainer. Our role has evolved over the last 65 years and we have begun to establish ourselves as experts in the realm of Sports Medicine. Now we have to continue to show the public what we are capable of.

2. On why it's important to make the distinction between "Athletic Trainer" and "Trainer"

I think it is very important that we make this distinction and I try very hard to help people understand the concept. We have a title and our title is “Athletic Trainer.” You wouldn’t walk up to the Athletic Director of a school and ask for the “Director.” Because you are likely to get sent in a multitude of directions. Many will tell us to quit being so picky, but my stance is that in a formal setting (i.e. publication or presentation, etc) the appropriate title should be used. On the field in what might be considered an emergent situation? Get my attention plain and simple.

Many times Athletic Trainers have been confused with personal trainers and this is where the NATA and all of our profession wants to see separation. Athletic Trainers are required to possess a minimum of a bachelor’s degree and hold some form of higher credential. In most states, that means be certified by the Board of Certification for Athletic Trainers (BOC) and regulated by that individual state. For example, I hold a state license in both Illinois and in Texas. Texas is just a little bit different in that you can become a Licensed Athletic Trainer in Texas without sitting for the national certification exam because Texas has its own licensure exam. Regardless, Athletic Trainers at the entry level require much more significant educational requirements than personal trainers do. Therefore, it is important that this is recognized to allow for that separation between professions, that are truly vastly different.

3. On who the audience is for his advocacy efforts: Athletic Trainers themselves or the public?

My “intended audience” changes constantly. I’m asked this question all the time and really I don’t know who I’m targeting the most. Obviously, with my #AT4ALL campaign, we’re fighting for every school and every league to take the steps that we feel are necessary—biggest one is to hire a full-time Athletic Trainer. But yes, it is also important that we target our professionals as well and get them on board. If Athletic Trainers don’t respect our profession enough to use proper terminology, then why should be expect the general public to do so? So in that way, yes I want Athletic Trainers to use “Athletic Trainer” rather than just “trainer.” And for many of them, that is something we are working through. Have there been improvements? Yes. But we still have a long way to go.. both inside and outside of the profession.

4. On the goal of his Athletic Trainer advocacy efforts

The “end result” will have many different results. And we are already starting to see some of that coming to light. First and foremost, Athletic Trainers are advocates for the athletes. And we have to take that very seriously. We have to help others understand that we are that advocate. We are starting to see that in the way of grants coming from the National Football League and other groups who are working to fund Athletic Trainers in “underserved” areas. The New York Giants, St. Louis Rams, and Jacksonville Jags are three teams who are launching programs this year in this effort. I believe the Minnesota Vikings and the Chicago Bears have also been involved, and there may be more as well. Much of what I do is about Athlete Safety. I do believe that better jobs will be created out of this, and while I would really like for that to happen, the job creation comes along with the Athlete Safety improvements.

5. On how he became such an influential voice, even though he graduated just five years ago

Amazingly, it actually happened in even less time than that. I didn’t begin to get involved on Twitter until the fall of 2012. Somewhere along the lines, I came up with the hashtag #AT4ALL and that really resonated with a lot of different people and groups. While I don’t write on my blog a ton, my concept of #AT4ALL and “Every Athlete Deserves an Athletic Trainer” has led a lot of people to want to talk or want me to write an article for them, just like this. I came into this profession thinking I was going to work with high school kids or at the college level and just go about my business. Enjoy life in sports and that was it. When I got to college, something clicked. All of the sudden, I wanted to learn everything there was to learn about Athletic Training and the next thing I know I’m busting down doors to do it. I attended my first “professional conference” in 2010 in Atlanta, GA where I was fortunate to meet a lot of great people. Between that, and having a great Clinical Instructor in Ashley Rockey and a great Clinical Coordinator in Carlen Mulholland, I got very excited. My first job out of college was working in a PT clinic and providing outreach services to a local high school. That is where I came to grasp my passion and my love for working with high school athletes. From there, I enrolled in the Masters in Medical Sciences program through the University of South Florida Morsani College of Medicine and completed my masters degree in 2014. That program had a specialization in pediatric sports medicine. Also, in 2014 my friend Kristi Messina and I started #ATtalk which is a monthly tweet-chat where we discuss various topics in our profession. I am very blessed to be in a situation today where not only does my employer recognize my voice, but it is embraced. And we live it each day by putting the health and safety of our student-athletes as a major priority.

6. On whether or not there are those who still don't understand the role of the Athletic Trainer

Sure there are. Parents aren’t completely sure of what is going on. Especially freshmen parents. But we’re working on that. Between myself and my assistant, we will continue to hammer this home. Best thing we can do is educate. I love to do just that. Sometimes, that is more important than the treatment itself. We want to give the very best care we can give, but helping the kids and the parents to understand that we are there to be advocates and to care for the kids is the best thing we can do. And they really are grateful for it too! Most of our co-workers understand what we do and in fact most will tell us that they wouldn’t want our jobs. If people don’t want to listen and understand, quite frankly there’s not much I can do about it. Some days I have to let that roll off my back. And it’s hard, but I’m trying to get better at that.

7. On progress for the cause of Athletic Trainers

Progress is best measured in seeing the number of schools who are adding Athletic Trainers. I have also been able to have some great conversations that made people on the other side go “hmm.. I guess that makes sense.” Like I said, one of my pet peeves is proper terminology. Earlier this summer, this discussion came up in our office with the head football coach and our sports information director. I let them know my thoughts and the football coach agreed. The SID has been fantastic about using “Athletic Trainer” on social media and such, so in our school we are making progress.

8. On whether or not he sees people are making the connection between Athletic Trainers and player safety

I definitely do! Athletic Trainers are on the forefront of Athlete Safety and we are the advocates. We’re fortunate that there are several big groups out there who are pushing for our inclusion as well. MomsTeam and the Advocates for Injured Athletes are two such groups. Our school just this year has taken a major step in Athlete Safety by employing a second full-time Athletic Trainer. I’m very grateful for that because it allows us to provide a higher level of care to a greater number of our student-athletes. We are a profession that is most often in the shadows and while we prefer to operate that way, we must find ways to become visible. I may shy away from the accolades as best I can, but at the same time I want to let everybody know about our profession. On a daily basis, I’m educating somebody about the profession. Because it really is a great profession and it really does have a major impact on the athletes themselves.

9. On where Athletic Trainers fit into the larger sports medicine picture

Athletic Trainers have to remember that we are a major component in the Sports Medicine Team. Not the only component, but we are the front lines. We must work together with the other professions including doctors, physical therapists, EMS, etc. Always remember to put the student-athlete first, after all they are the reason for our being.

10. On what's different about the Athletic Trainer's job than he expected when he was a student

This is going to sound weird, but I never thought I’d care as much as I do. I become emotionally attached to a lot of kids and I feel for them greatly. But that’s what makes our profession as great as it is. Unlike other medical professions, Athletic Trainers get to develop great relationships with kids. I have been in three different schools now in my career, and I can tell you the hardest part about leaving the previous two schools was leaving those kids.

11. On what he'd tell a student who was interested in becoming an Athletic Trainer

I would tell them to dig deep and really see if this is what you want to do. I don’t mean to scare anybody away from our profession, but rather I want the right people to be in our profession. Make sure they understand that it takes a lot of effort to be good in Athletic Training. Take the time to learn everything you can. We can never quit learning in our profession.

12. On tricks of the trade

I am a big fan of instrument-assisted soft tissue mobilization (IASTM). I use this with a lot of soft-tissue injuries such as muscle strains and also have found it to be very effective in the treatment of plantar fasciitis. I tend to combine IASTM with kinesiology taping and have had some excellent results. Two things that early on in my career I wouldn’t have done, but now I use them both on a regular basis.

13. On the changing role of Athletic Trainers in concussion management

Concussions probably represent the biggest way that Athletic Trainers are spreading our wings in the “traditional” setting. In many places, Athletic Trainers may only deal with the athletic-specific issues that arise from injury. But with concussions, there is so much more involved. Here, I am a part of the group that is responsible for the day-to-day management of our concussed student-athletes not only in the athletic realm, but in their day-to-day lives and on the academic side of things. I work regularly with our school nurse, the guidance department, and our academic dean to help our kids succeed after injury.

14. On dealing with conflicts around return-to-play decisions

Fortunately this is not all too common here. People have bought into “Our Athletic Trainers are here to make those decisions.” But you have to be rational with parents, coaches, and athletes. They aren’t going to always agree with you. And sometimes, it’s a matter of showing them they are not ready. I have done that plenty of times with kids who think they are ready to play. Begin them on a functional progression and they fail. But they can see those results.

15. On the most important experience of his career

Funny story: Back in 2008 I was a sophomore at SEMO. I was in the habit of buying stuff on Ebay on a regular basis. My clinical instructor at the time told me that I should “quit buying stuff on eBay and join the NATA.” Well, I did. As they say, the rest is history.

A Legal & Ethical Review of CONCUSSIONS & SPORTS
A Legal & Ethical Review of CONCUSSIONS & SPORTS
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