Eating Disorders in Female Athletes

weight loss

Eating disorders are a group of abnormal and harmful eating patterns. They are typically used in a misguided attempt to lose weight or maintain a lower than normal body weight. The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating.

Anorexia Nervosa

Anorexia is severe weight loss and refusal to maintain body weight. It often includes an intense fear of gaining weight even if the person is under weight. Coupled with this is a negative self-image due to body shape or appearance, known as “body image disturbance.” Most females will also stop menstruating.

Outwardly, an athlete suffering from anorexia may avoid eating in public and wear baggy clothing to disguise their body. Inwardly, people diagnosed with anorexia are often in denial, depressed, withdrawn, irritable, and have difficulty sleeping. In addition, they can also experience fatigue, low blood sugar, thinning hair, and a slowed heart rate.

Bulimia Nervosa

Bulimia, defined as binge eating followed by self-induced vomiting and laxative use (purging), includes a feeling of being out of control. Dehydration, vitamin and mineral deficiencies, damage to vital organs, or blisters in the throat, are a few typical physical signs of the disease. Notably, the body weight of someone suffering from bulimia is usually in the normal range, and can even be higher than normal. Regardless, there will be obvious fluctuations in weight, both up and down. Depression and anxiety are also typical with bulimia.

Binge Eating Disorder

Binge eating is the most common eating disorder in the United States. It is similar to bulimia in that it involves recurring episodes of eating significantly more food in a short period of time than most people would under similar circumstances. However, people with binge eating disorder do not typically purge after an episode. Like bulimia, sufferers will say that they feel out of control. Symptoms include eating too quickly even when not hungry, feelings of guilt, embarrassment, or disgust. Many people occasionally overeat, and may even have feelings of guilt or embarrassment after. For this reason it is important to note that to be considered an eating disorder, the behavior has to occur at least once a week for three months.

Female Athletes and Eating Disorders

Individuals suffering from all three eating disorders can be difficult to identify. This is because they go to great lengths to eat alone and hide the behavior from others. With this in mind, it is important for the athletic trainer to understand the signs and keep an eye on their athletes. Studies show that female athletes are at the greatest risk. Perhaps this is because of the number of sports for women that emphasize slim bodies such as gymnastics, swimming, and track and field. Likewise, athletes that tend to be perfectionists, have obsessive-compulsive behavior, social withdrawal, depression, and high-achievers are at a greater risk for developing eating disorders.

Female Athlete Triad

Eating disorders in female athletes can lead to what is known as the “female athlete triad.” The triad’s three elements are eating disorders, the absence of a menstrual cycle, and osteoporosis or bone loss. Eating disorders can lead to chronic fatigue, dehydration, anemia, and decreased bone density as mentioned above. When this happens, there is less iron in the blood. Lower iron combined with less body fat can result in loss of menstrual cycles, or amenorrhea – defined as the absence of three or more consecutive menstrual cycles. In an effort to maintain menstruation, the body will begin to break down bone for nutrients. The result is osteoporosis – premature bone loss. One sign of osteoporosis in a female athlete is repeated stress fractures that don’t heal.


Once a young person starts an eating disorder it is very difficult for them to stop. This is because they gain a false sense of control over situations that becomes addicting. Due to the severe health risks and possibility of death, it is critical to seek treatment as soon as possible. Treatment for eating disorders is different from person to person. The good news is that most eating disorders are treatable. With the help of a qualified health care professional, many people are able to recover and regain their health.


Ultimately, prevention is best. With this in mind, athletic trainers can help by educating athletes about nutrition and weight. Helping young athletes understand that being skinnier isn’t always better for their performance can go a long way towards heading off an eating disorder. Furthermore, teaching athletes the difference between body fat and body weight helps to create a healthier self-image. Finally, coaches play a role as well, by taking the focus off body weight, eliminating group weigh-ins, recognizing individual size and shape differences, and acting on signs of eating disorders before they get worse.

Written by: Nicole Porter, MS, ATC, former athletic trainer for The Center Foundation . Learn more about our Team HERE.

The Center Foundation places dedicated athletic trainers in local high schools to provide sports medicine services to young athletes at no charge to the students or their families. Learn more about our work HERE.



  1. (accessed online 12/12/2018)
  2. Beals KA. Subclinical eating disorders in female athletes. Journal of Physical Education, Recreation & Dance. 2000;71(7):23-29.
  3. Pearson FC, Rivers TC. Eating disorders in female college athletes: Risk factors, prevention, and treatment. College Student Affairs Journal. 2006;26(1):30-44.
  4. Feeding and Eating Disorders. In Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C.: American Psychiatric Association; 2013.
  5. Beals KA, Brey RA, Gonyou JB. Understanding the female athlete triad: Eating disorders, amenorrhea, and osteoporosis. J Sch Health. 1999;69(8):337-40.


Nutrition and Injury Recovery

Nutrition and rest are key when recovering from any injury. From a muscle strain to a concussion – providing your body with the optimal environment for healing is essential. When injured, your body becomes unbalanced, and requires more energy to heal. By being mindful of good nutrition and rest, you give your body the best chance for full recovery. The nutrients you need to recover, called macronutrients, are protein, fat and carbohydrates. Remember, the best and easiest way to get these nutrients into your body is by eating whole foods instead of processed or fast foods.


Protein helps with muscle growth and prevents muscle breakdown. Healthy lean proteins include fish, white meat chicken and turkey, milk, cheese, yogurt, eggs and lentils.nutrition healthy proteins


Studies have shown that healthy fats like those found in nuts, salmon, and avocados, help reduce inflammation in the body. They also improve mental function, protect heart health, and provide long-term energy. Great sources of healthy fats also happen to be delicious foods! Healthy fats can also be found in cooking oils such as olive and sunflower, and seeds like flax and chia.nutrition healthy fats


Carbohydrates are the primary source of fuel for the body, and they are essential to giving the body the energy it needs to heal. Healing carbohydrates are the “complex carbohydrates” found in whole wheat breads and pastas, brown rice, quinoa, and lentils.nutrition healthy carbs

As you can tell from the lists of healthy macronutrients, some of these foods are the source of two or more macronutrients. This makes it easier to get more healing from the foods you are eating. By eating healthy sources of these three macronutrients, you help your body fight off the inflammation associated with injury, improve the body’s ability to heal injured muscle tissue, and give those injured tissues the energy they need to recover.


However, in addition to diet, plenty of sleep is vital to healing. Your body does the majority of its healing while asleep. Therefore, it is essential to get the best quality sleep you can when recovering from injury. While the required number of hours of sleep depends somewhat on the individual, experts recommend getting at least eight hours of sleep each night. So, when recovering from injury, don’t short yourself on sleep!

In summary, by providing your body with healthy foods and getting enough sleep, you can keep your body balanced as you heal from injury and fully support the body’s recovery process.

Written by: Tessa Cashman, ATC, athletic trainer for The Center Foundation and Bend Senior High School in Bend, Oregon. Learn more about Tessa HERE.

The Center Foundation places dedicated athletic trainers in local high schools to provide sports medicine services to young athletes at no charge to the students or their families. Learn more about our work HERE.



Meet the Team – Ross Dexter

Ross Dexter athletic trainer for The Center FoundationRoss Dexter is a native Central Oregonian and a graduate of La Pine High School. After high school, Ross left the area to attend Southern Oregon University. There, he studied Health and Physical Education while also competing in cross-country and track. After receiving his bachelor’s degree, Ross’s love for athletics took him to Vancouver British Columbia to continue his education. In 2010, he completed a Master’s Degree in Human Kinetics at the University of British Columbia.

For the next several years, Ross worked in healthcare while simultaneously coaching at several institutions. His coaching experiences included University of British Columbia, Florida State University, St. Mary’s College, The University of California, Berkeley, and Bend’s own Summit High School. During this time, Ross developed a keen interest in athletic training as a profession. With this in mind, Ross decided to continue his education with the University of Idaho’s Athletic Training Program. There, he received both his Master’s of Science in Athletic Training and Doctor of Athletic Training degrees.

As part of his doctoral studies, Ross enjoyed the opportunity to develop the first athletic training program to serve the middle and high school students of Troy Idaho. Rewarding opportunities like this one helped him realize his belief in delivering the highest quality sports medicine services to young athletes. Ross was eager for the chance to return to Central Oregon and pursue his athletic training career with The Center Foundation and Summit High School.

Ross Dexter fly fishingWhen not at work, Ross is a kettle bell training enthusiast, an avid runner, cross-country skier, and fly fisherman. Ross is also looking forward to honing his paddle boarding skills. He is excited to be back in Central Oregon where he can enjoy all of his favorite activities.

First job?

Hydro-ceramic Technician (a.k.a, “dishwasher”) at Michael’s in Sunriver.

Favorite food?

The kind I am currently eating…but I especially enjoy Japanese cuisine.

Something quirky or interesting about you?

I have lived in 10 cities in 6 states and 1 province.

What is one thing you would like people to know about athletic trainers?

The value of Athletic Trainers to our patient population and the communities we work in. When we are utilized, supported, and collaborated with by our stakeholders, regardless of practice setting (e.g. secondary school, college and university, professional sports, industrial, police, fire, and military, and medical practices) Athletic Trainers save a great deal of resources, not only financially, but in the form of lost time from work, participation, etc.  Support your local Athletic Trainer!


Ross Dexter, DAT, MKin, LAT, ATC, CSCS is an athletic trainer with The Center Foundation and serves Summit High School in Bend, OR. Find out more about Ross and our entire athletic training team here.

Meet Our Team – 2019 Fall Line-Up

athletic trainer team We are excited to announce our Sports Medicine Program line-up for 2019-20! Once again, we have dedicated certified athletic trainers at eight of our area high schools; Bend Senior High, Crook County, La Pine, Mountain View, Sisters, Summit, Culver and Madras. In addition, we have three new athletic trainers to introduce this year. With our amazing team, we are proud to be serving more student athletes in Central Oregon high schools than ever before.

How Far We’ve Come

Thanks to YOUR support, we have increased our funding by more than 50% since 2015. Due to this increased capacity, the number of high schools we serve and athletic trainers we employ has doubled. Consequently, more than 5,000 student athletes at over 1400 sporting events benefit from our Sports Medicine Program each year. But, we have more work to do! Specifically, a new Central Oregon high school is slated for construction in the coming years, and middle schools and club sports teams still need our help. Reaching more young athletes means we are ensuring the safety of kids in Central Oregon by keeping them healthy and active in the sports they love. Most importantly, we deliver our Sports Medicine Program at no cost to the students or their families.

Our Athletic Trainers

Athletic trainers are the heart of our Sports Medicine Program, and they work hard each day to protect and support young athletes. Sometimes, athletic trainers are confused with personal trainers. However, they are vastly different. As highly qualified, multi-skilled, healthcare professionals, athletic trainers specialize in injury prevention, recognition, and evaluation. Our athletic trainers collaborate with physicians to make appropriate immediate-care decisions for a young athlete’s illness or injury. Additionally, their responsibilities include treatment, rehabilitation, and reconditioning post-injury.

Our certified athletic trainers are highly educated. They have a bachelor’s degree in athletic training and most have a master’s degree in athletic training and other areas related to sports medicine. All athletic trainers employed by The Center Foundation hold national certification from the Board of Certification (BOC) and have obtained registration to work in the State of Oregon by the Oregon Health Authority (OHA). Drawing on this combination of education and credentials ensures that we are placing excellent athletic trainers in our local schools.

The 2019-20 Line-Up

The Center Foundation welcomes our newest athletic trainers, Amanda Rodrigues, Ross Dexter, and Rich Rainville. In addition, we proudly announce our returning team members, Tessa Cashman, Michael Estes, Lindsay Hagler, Nicole Porter and Alex Walker. You will find each of them on the sidelines of practices and high school sporting events, bringing their vast knowledge and experience to care for your young athlete.

Athletic Trainer Supervisor, Stuart Schmidt, MS, ATC, CSCS
Bend Senior High School, Tessa Cashman, ATC
Crook County High School, Michael Estes, MS, ATC
Culver High School, Rich Rainville, ATC, CSCS
La Pine High School, Amanda Rodrigues, ATC
Madras High School, Nicole Porter, MS, ATC
Mountain View High School, Lindsay Hagler, MS, ATC, CSCS
Sisters High School, Alex Walker, ATC
Summit High School, Ross Dexter, DAT, MKin, ATC, CSCS
Per Diem Athletic Trainer, Kathleen Thompson, ATC
Program Administrator, Shawn Taylor

To learn more about our team here.
Find out how you can support the work of The Center Foundation here.


Written by: Shawn Taylor, Program Administrator for The Center Foundation. Learn more about Shawn HERE.

Meet the Team – Amanda Rodrigues

Amanda Rodgrigues in Venus ItalyAmanda Rodrigues was born and raised in Rhode Island, where her family still resides. She stayed on the east coast to attend Springfield College, graduating in 2016.  On top of tackling two majors, Athletic Training and Physical Education, Amanda served on the Eastern Athletic Trainer’s Association (EATA) District 1 Student Delegation Committee. In her third year on the committee, she accepted the Student Program Chair position and assisted in designing the student program for 2015. In addition to her academic and committee work, Amanda enjoyed her experiences helping a wide variety of athletes at the college as part of her athletic training curriculum.

After graduation, Amanda took a temporary position with a physical therapy office. Her duties included running preventative training programs for youth and assisting with sports return-to-play rehab. Amanda officially started her career as an athletic trainer when she joined a small boarding school outside of Boston, Massachusetts. The position made use of both of her dual degrees to help young athletes at the school. During the same period, Amanda served as a preceptor for the Lasell College Athletic Training Program.

Through these early professional experiences, Amanda realized her passion for helping young athletes. Her favorite part of each day is talking with her athletes and educating them in a non-traditional setting – the athletic training room.

Amanda Rodrigues paddling with Milo Following her desire for outdoor adventure, Amanda stumbled on Bend, Oregon and immediately fell in love. She is excited to join The Center Foundation Sports Medicine Program as the athletic trainer for La Pine High School. She is also thoroughly looking forward to her new life on the west coast. In her free time, Amanda enjoys anything she can do outside. Her favorite activities include both playing and watching sports, yoga, photography, travel, reading, and spending time with her pup, Milo.

First job?

Worked at my hometown’s nonprofit summer camp as a counselor for five years, then as program director for five years. It still holds a very special place in my heart!

Favorite food?

Picking an absolute favorite is too hard – I have too many favorites! But, since I’m 100% Portuguese my favorite Portuguese dish is Shrimp Mozambique from my favorite restaurant in Rhode Island.

Something quirky or interesting about you?

I can draw cartoons freehand.

What is one thing you would like people to know about athletic trainers?

We are the first very specialized, and personalized, line of care for young athletes, and we often have a special daily connection with the kids. Athletic trainers offer an array of knowledge to give kids the proper care for injuries in a supportive and approachable manor. I feel ALL athletes should have access to athletic trainers!


Amanda Rodrigues, ATC is an athletic trainer with The Center Foundation and serves La Pine High School. Find out more about Amanda and our entire athletic training team here.

Strength Training for Runners

girl runningIn an effort to improve fitness, many people decide to try running. Its easy, right? Just lace up a pair of shoes and head out the door. However, every sport comes with the potential for injury no matter how “easy” it may appear. And, running is no exception. This is especially true for the runner who ignores strength training for injury prevention.

Forces of Running

Running requires a substantial amount of stability and strength to withstand the enormous amounts of impact. In fact, the body can experience impacts equal to three times the body weight during running. Imagine the extreme pressure this puts on muscles and joints! With each landing step, the pressure moves from feet, to knees and hips, and up through the trunk. Within the hips and core are some of the biggest muscles in the body, and they do most of the work during running. For this reason, strength training for injury prevention should focus on the hips and core.

pistol squatTo put it another way, imagine doing a single leg squat with one leg off the ground. If a person is not strong enough to perform this move, then they will likely experience aches and pains from running. In essence, the motion of running is equal to performing a single leg squat repeatedly, with the addition of heavy impact. The risk for injury seems obvious.

Effects of Sitting

Many of us spend a large part of our day sitting. Sitting at work, sitting in the car, and sitting at home in front of the TV. All of this sitting makes the muscles on the backside of our body weak from lack of use. In addition, the sitting posture contracts the muscles on the front of our body. Together, the weak back and contracted front muscles create an imbalance. During running, this imbalance can lead to poor bio mechanics and, over time, injury. While that 30-minute morning run may be good for the heart, without a stable core and strong hips, it might be doing more harm than good.

Strength Training for Injury Prevention

Most research on strength training for injury prevention in runners focuses on hips. Strengthening the hip muscles (hip abductors and external rotators) does help keep the knee in line with hip. This is good advice to prevent mild knee pain from patellar tendonitis and shin splints. At the same time, if a runner only works on hip strength, ignoring core stability they haven’t gained the full benefit.

Think of the body like a tree in a hurricane. The roots are the legs and the branches are the arms. The only thing connecting root and branches is the trunk, or core. The roots can be super strong, but if the core is weak, shearing and compressive forces will still destroy the tree. The best injury prevention comes from having both strong hips and a stable core.

Written by: Shauna Ericksen MS, ATC athletic trainer for The Center Foundation and Summit High School in Bend, OR. Learn more about Shauna HERE.

The Center Foundation places dedicated athletic trainers in local high schools to provide sports medicine services to young athletes at no charge to the students or their families. Learn more about our work HERE.



Willy, R. W., & Davis, I. S. (2011). The Effect of a Hip-Strengthening Program on Mechanics During Running and During a Single-Leg Squat. Journal of Orthopaedic and Sports Physical Therapy, 41(9), 625-632. Retrieved December 3, 2018, from


Brain Trust Program Highlight

The Back Story

Years ago, a car hit a young boy from Bend while he was riding his bike. He was not wearing a helmet. The boy arrived in the ER where one of The Center Foundation’s board members, a neurosurgeon, was on call. Tragically, the boy did not survive in spite of the surgeon’s best efforts. As a result, The Center Foundation developed their Brain Trust Program, which includes education, outreach, and concussion management protocols.

Train Your Brain

train your brain programWith the intention of preventing further tragedies like this one, The Center Foundation adopted programs to educate grade school kids on the importance of protecting their brain and spinal cord.  The resulting program, called Train Your Brain, provides age-appropriate, research-based curriculum.

Today, The Center Foundation brings Train Your Brain presentations to third-grade classrooms across Central Oregon. The goal is to reach young people early enough to create a lifetime of safety habits. To achieve this, kids learn brain and spinal cord anatomy and injury prevention techniques. These active and fun sessions conclude with a melon-drop helmet demonstration.

mom and kid on bikeSessions focus on teaching the importance of helmet use, proper fitting, and overall safety. If children do not have a helmet, The Center Foundation gives them a new helmet free of charge.

Each year, Train Your Brain comes to over 2,000 students in area schools, and distributes more than 1,200 multi-sport helmets to those in need. If your child needs a multi-sport helmet, please call Stuart Schmidt at 541-322-2323.

Concussion Protocol

Protecting student athletes from closed head injuries begins well before an athlete actually suffers a concussion. The Center Foundation uses the following best practices to manage concussions and reduce the incidence of Second Impact Syndrome:

  • Athletes in high-risk sports take a pre-season baseline ImPACT test every two years. Comparing baseline results to post-injury results at the appropriate stage in recovery helps guide the rehabilitation process.
  • Next, athletic trainers and physicians work with teachers, coaches, and athletic directors to identify the signs and symptoms of a concussion.
  • In addition, The Center Foundation educates students and their parents on concussion awareness, signs and symptoms, and the importance of reporting their injury immediately.
  • Most importantly, the moment a concussion is suspected, a young athlete is removed from play until assessed and cleared by a qualified health care professional.

ImPACT Testing

impact group baseline testingThe Center Foundation believes that it is important for young people to participate in an active lifestyle. In fact, studies have repeatedly shown a positive correlation between sports participation and academic outcomes. Moreover, young people who play sports are at decreased risk for drug and alcohol use.  Unfortunately, it is also true that the speed, power, and momentum required for excelling in sports sometimes results in serious head injuries.

With this in mind, The Center Foundation partnered with the University of Pittsburgh Medical Center in 2000. The result was the first high school concussion baseline testing program west of the Mississippi. Today, Central Oregon high school athletes are part of a progressive program setting new standards for concussion diagnosis and treatment.

ImPACT is a computerized evaluation system. When used to capture the baseline state of a child’s normal mental function, it becomes a powerful tool in deciding when it is safe for an athlete to return to contact sports. Therefore, high school athletes competing in high risk sports are tested every two years between the ages of 12 and 18. This helps maintain a current baseline test for each student on file. In most cases, tests are conducted by the school’s athletic trainer at no cost to the student or their families.

In addition, The Center Foundation offers community baseline testing days several times per year. Any child between the ages of 12 and 18 that has not been tested at their school can participate. The cost is $15 per child and space for upcoming test dates can be reserved by calling 541-322-2323.


Brain Trust Program – Protecting the Young Brain

Unfortunately, concussions do occur in nearly all physical activities. Concussions are serious injuries that can affect a person in all areas of their lives, including physical, emotional, and mental. Once a concussion occurs, it is imperative to remove the young athlete from play until their brain heals. If this doesn’t happen, the child is at risk for a devastating secondary concussion. Second Impact Syndrome occurs when a person suffers a second concussion before they have fully healed from the first concussion. During this condition, the brain swells rapidly, and sometimes even fatally.

girl on bike

Thanks to Max’s Law in the state of Oregon, protocols require at least seven days off from sports following an initial concussion. While it might not be possible to prevent concussions from occurring in the first place, it is possible, and imperative, that secondary concussions are avoided at all costs.

Overall, the goal of the Brain Trust Program is to protect the brains and health of young people and reduce catastrophic brain injuries. Through education, management protocols, and increased symptom awareness, the foundation strives to achieve its mission to keep kids safe in sports.

Written by: Shawn Taylor, program administrator for The Center Foundation in Bend, OR. Learn more about Shawn HERE.

The Center Foundation places dedicated athletic trainers in local high schools to provide sports medicine services to young athletes at no charge to the students or their families. Learn more about our work HERE.



Bernstein, Lenny. “A growing body of evidence links exercise and mental acuity,” published May 25, 2010 at . Access date: May 6, 2019.

“Exercise ‘boosts academic performance’ of teenagers,” published October 21, 2013 at . Access date: May 2, 2019.

“The Association Between School-Based Physical Activity, Including Physical Education, and Academic Performance.” July 2010, available at Access date: May 7, 2019.

Multiple Sport Athletes vs. Single Sport Athletes

multi sport athleteNot long ago, it was normal for a young athlete to play multiple sports throughout the school year, and take summers off from formal athletics altogether. This no longer seems to be the case. From a young age, athletes are committing to a single sport for 12 months of the year. By doing this, they hope to gain skill and progress more quickly. Unfortunately, there are negatives to this changing trend.

Research Agrees

While it is seductive to think that focusing on a single sport will make you a better athlete, evidence shows that this isn’t the reality. In fact, research confirms that single sport athletes have a higher career rate of injury than multiple sport athletes. Specifically, in a recent study published in the Orthopaedic Journal of Sports Medicine, evidence suggests an association between “early single sport specialization and overuse injuries.” The author goes on to point out that single sport athletes are associated with higher rates of psychological burnout and dropping out of sports altogether.

Benefits of Multiple Sport

Playing multiple sports is beneficial due to the changing demands on the body and mind. Indeed, it pays off because it trains the body to be stronger and faster in more diverse ways. Playing multiple sports keeps you fit and strong, while also avoiding overuse of the tissues you need for the sport you want to focus on. It can even hone skills that help you in your primary sport; like speed, endurance, balance, and hand-eye coordination.

Single Sport Athletes

However, if you do chose to focus on a single sport, what can you do to stay healthy? Certainly, the best solution is to include as much rest time between seasons as possible. In addition, include cross training in your plan to work muscle groups that you don’t use in your sport. Giving your body this “active rest” between seasons allows the opportunity to heal fatigued muscles, ligaments, and tendons.

While many young athletes believe that focusing on a single sport is important for advancing into collegiate and professional athletics, for most, it is probably doing more harm than good. In conclusion, keeping athletes as healthy as possible, for as long as possible, and enjoying their sport should be the ultimate goal. A well-rounded routine, plenty of recovery time, and a healthy mental outlook are the ways to accomplish this.

Written by: Tessa Cashman, ATC athletic trainer for The Center Foundation and Bend Senior High School in Bend, OR. Learn more about Tessa HERE.

The Center Foundation places dedicated athletic trainers in local high schools to provide sports medicine services to young athletes at no charge to the students or their families. Learn more about our work HERE.



Patrick S. Buckley, MD, et al.(2017) Early Single-Sport Specialization: A Survey of 3090 High School, Collegiate, and Professional Athletes. Orthopaedic Journal of Sports Medicine. 5(7): 2325967117703944

Rugg, Kadoor , Feeley, Pandya  (2017) The Effects of Playing Multiple High School Sports on National Basketball Association Players’ Propensity for Injury and Athletic Performance. The American Journal of Sports Medicine. 46(2):402-408

Athletic Training Education

lindsey hagler athletic trainerHave you ever wondered about the credentials of the person rehabbing your strained hamstring? On the other hand, maybe you’ve been curious about what regulatory oversight there is for the medical professional on the sports field with your high school athlete. What are the athletic training education requirements, and how does one become an athletic trainer, anyway?

Athletic Training Education Basics

The goal is to create highly skilled and knowledgeable allied health care professionals. To achieve this, athletic training education requires at least a bachelor’s degree from a nationally accredited program. This accreditation ensures that all athletic trainers meet the same minimum competencies required for their job. However, most athletic trainers have exceeded this minimum education requirement. In fact, nearly 70% of all athletic trainers have their master’s degree, as well.

The Commission on Accreditation of Athletic Training Education (CAATE) oversees the core skills in which each athletic trainer must demonstrate proficiency. CAATE also performs regular audits of accredited programs to guarantee compliance. In addition to learning the required skills, athletic training students must pass a national exam through a separate organization, the Board of Certification (BOC).

Athletic Training Education New Requirements

As of 2015, the National Athletic Trainers Association, CAATE, and the BOC, jointly agreed that a master’s degree is the new minimum level of education. CAATE accredited programs have until 2022 to comply with this new degree requirement. Of course, an exception is in place for the 30% of athletic trainers currently practicing without a master’s level education. They will continue to work under the pre-2015 requirements.

Continuing Education

BOC approved providerIn addition to the national exam, the BOC is also responsible for ensuring that all athletic trainers complete at least 50 credit hours of continuing education every two years. This continuing education requirement ensures that athletic trainers remain current in their ability to recognize and treat injuries.

State of Oregon Oversight

Individual states also have requirements of athletic trainers. For example, in Oregon, all athletic trainers must register with the Oregon Health Authority (OHA). In addition, they must sign an affidavit verifying that they have kept up with continuing education requirements. The OHA may audit athletic trainers, and request that they provide records of compliance with BOC requirements.

As you can see, athletic trainers are subject to many layers of education and oversight. They must complete a rigorous course load, pass a national exam, register with the state, provide proof of compliance with agency requirements, and complete 50 credit hours of continuing education every two years. The result is a professional, knowledgeable, and competent athletic trainer caring for you or your young athlete when you need them most.

Please visit if you would like to learn more about athletic trainer educational requirements, CAATE, and the BOC.

Written by: Michael Estes, MS, ATC athletic trainer for The Center Foundation and Crook County High School in Prineville, OR. Learn more about Michael HERE.

The Center Foundation places dedicated athletic trainers in local high schools to provide sports medicine services to young athletes at no charge to the students or their families. Learn more about our work HERE.


Mental Health for Athletes

female softball player aloneKeeping an athlete’s physical body strong and healthy is the primary focus of athletic trainers. However, they also take care of what can’t be bandaged or splinted – the athlete’s mental health.

Injury and Mental Health

It is true that many young people will deal with mental health issues at some point in their lives. In fact, one study on the mental health of young athletes suggests that as many as 10% will experience mild to severe depression and anxiety at some point in their high school career. If left untreated, the results can be devastating.

For that reason, mental health in young athletes is worth studying and understanding. Often, injury can open the door to underlying emotional issues. For example, when a young athlete becomes injured, their mental health can suffer for a variety of reasons, including; chronic pain, loss of ability to participate, pressure from not performing as well as they would like, or as a symptom of concussion.

The Role of Athletic Trainers

Athletic trainers are not the main provider that an athlete will see for help with mental health issues. However, they are often a person that the athlete sees daily. Many young athletes confide in their athletic trainers, and injured athletes may visit them daily. Because of this consistent contact, an athletic trainer can quickly recognize changes in mental state. Athletic trainers often spot a struggling athlete and point them in the right direction to get help. Recognizing early and referring appropriately can make all the difference in getting the young person back on track and feeling better.

Warning Signs

There are different warning signs for different mental health issues. Generally, keep an eye out for sudden changes in thoughts or behaviors, feeling extreme highs or lows, social withdrawal, dramatic changes in eating or sleeping habits, inability to manage responsibility, frequent outbursts of anger, confused thinking, excessive fears, worries and anxieties. A number or resources are available for athletes to utilize when they are having any issues like depression, anxiety, eating disorders or not feeling quite right. Mental Health America, NCAA Sport Science Institute, and are a few online resources that can help if you or someone you know is struggling.

Protecting Mental Health

There are a few ways that you can proactively protect your mental health. For example, eat a well- balanced nutritious diet, avoid sugar, caffeine and processed foods, exercise regularly, meditate or practice mindfulness, and establish a strong support network. Above all, never hesitate to seek counseling or the help of a mental healthcare practitioner when needed. Finally, it is important to remember that it is okay to not be okay. Sometimes young athletes have injuries that are not visible to anyone else. Athletic trainers are there to help with all injuries, visible or not.

celebrating softball players

Written by: Alex Walker, ATC athletic trainer for The Center Foundation and Sisters High School in Sisters, OR. Learn more about Alex HERE.

The Center Foundation places dedicated athletic trainers in local high schools to provide sports medicine services to young athletes at no charge to the students or their families. Learn more about our work HERE.



Weber, Stephanie et al. “Symptoms of Anxiety and Depression in Young Athletes Using the Hospital Anxiety and Depression Scale” Frontiers in physiology vol. 9 182. 7 Mar. 2018, doi:10.3389/fphys.2018.00182. (accessed online 12/12/2018)