Delaware's high schools have begun fall sports practices, but while some schools are sorting out who will be their quarterback or goalkeepers, others are simply looking to find someone to make sure they are healthy.
The First State has joined in a nationwide trend in seeing a decline in the number of available athletic trainers to help with high school athletic programs.
Currently, football is the only high school sport in Delaware where a qualified healthcare professional must be present or face a $250 fine, and that's only for games.
Mandy Minutola, Past President of the Delaware Athletic Trainers Association, has been part of the lobby to turn that into either all of the contact sports, or in their preference, all of them.
"You can't find a school that doesn't have a school nurse, they have someone there, but there's no requirement to have a medical professional when the students are the most active? It doesn't make sense."
Minutola said finding respect for athletic trainers has been an issue in some parts of the athletic community.
"Athletic trainers have always struggled with getting people to truly understand what we do. We're always confused with a gym teacher or personal trainer. The pay has not been that great for a medical professional that has to have a degree, be board certified, and licensed by the state."
According to a 2021 National Association of Athletic Trainers study, an athletic trainer with a bachelor's degree makes an average of $56,769, up from $39,096 back in 2008.
That cost has helped many schools make the decision to outsource their athletic training needs to a company like Minutola's employer Premier Physical Therapy, ATI, First State Orthopedics, or others."
"Everyone knows this is important, we need to provide this for our athletes, but how? Unfortunately, one of the biggest barriers is financial, how do we do this?"
Economics are a factor, but Minutola said there remains a misconception by many as to the role and importance of an athletic trainer, and if a school doesn't have one available, it could hurt a hurt athlete even further.
"We are trained in the prevention of injuries, first aid and emergency care, evaluation of injuries, referral process, who is going to treat them like an athlete and return them as quickly, but safely, as possible?"
Delaware has been a leader in athletic trainer access, with the state second to only Hawaii in the percentage of schools (93%) having access to an athletic trainer for practice, according to a 2013 study.
That could change, as Minutola warned there are still around a dozen or so schools still looking to find an athletic trainer this fall, which is still better than just 31% of schools nationally having someone in that position.
She said there are a few factors creating a drought in available talent. She notes the hours of sports can be difficult for a family or social life.
"It's a young person's profession because the hours are usually afternoons, evenings, weekends, and people get to a point in their lives where they don't want to do that any more. They have families and they don't want to miss their kids' events. Unfortunately, that means we're seeing a shortage in Delaware, but not just Delaware, but nationwide."
Minutola also pointed to a pandemic-era decision to require master's courses in athletic training to be fully certified, which caused some colleges to drop their programs.
"There's been a lot of programs dropping athletic training because they don't want to transition to a master's program. We've lot a lot of programs which means we've lost the amount of athletic trainers graduating from universities and being out there eligible for employment."
That void has caused DATA and their counterparts in other states to press legislatures to treat athletic trainers like teachers, and find a way to make the position as common in a school as a teacher or counselor.
"All sports should, and deserve, to have a sports medicine professional there for them. Injuries don't just happen in football, they can happen in any sport."