Sonoma Academy athletic trainer Sarah Goble treats student athletes prior to a soccer game at the Santa Rosa high school where she has been an athletic trainer for two years.
Brian L. Frank/Special to the Chronicle
Kevin Gorham remembers the grief of the Encinal High School community like it was yesterday. When freshman football player Giovani Pulido suffered cardiac arrest at a practice at the Alameda school in 2016, there was little anyone at the field could do.
There was no defibrillator nearby, and though there were eight CPR-trained coaches, none had the skill of a medical professional to properly assist Pulido, 15, who died. Gorham, a teacher at the time, recalls vigils in the following days and weeks in the community. He especially remembers the feeling of helplessness, because it hasn’t faded.
Eight years later, Encinal has a defibrillator at the practice field but still does not have a full-time athletic trainer, and Gorham, now the athletic director, worries they’re still underprepared to help if another emergency occurred.
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“I wish we did, but it’s not in the budget,” Gorham said. “The district doesn’t give us the money.”
Sonoma Academy athletic trainer Sarah Goble treats Victor Jennings prior to a soccer game.
Brian L. Frank/Special to the Chronicle
It’s the same story for many schools in the Bay Area and throughout the state, where the California Interscholastic Federation does not require full-time, certified athletic trainers. For schools that do employ athletic trainers, there are no regulations for who can be hired for those jobs. In those regards, California — home to more than 800,000 high school athletes — stands alone.
Every other state has some sort of mandate for schools to employ athletic trainers, and rules to certify who is qualified to hold that title. Some experts argue California student-athletes are vulnerable given the lack of oversight.
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Assembly Bill 796, which Gov. Gavin Newsom has until Monday to sign, would catch California up to other states by creating a regulatory board to oversee the licensing and certification of athletic trainers, but it doesn’t address the overall shortage in schools.
A 2023 study by the Korey Stringer Institute found that California ranks last in the nation for high school athlete safety, primarily because of the shortage of certified athletic trainers.
“If you were having heart palpitations in an emergency room, you wouldn’t want a dentist treating you,” said Christianne Eason, KSI’s president of sport safety. “Athletic training is no different.”
In 2023, the CIF reported to the California Athletic Trainers’ Association that only 21% of the state’s high schools had a full-time athletic trainer, while 49% had no access to one whatsoever. Most schools cite budgetary reasons; the median pay for athletic trainers is $53,840 per year, according to CATA.
“You can’t get the best out of an AT when they are part-time,” said Sonoma Academy-Santa Rosa athletic trainer Sarah Goble said. “At most, they’re just covering games, and if you have multiple games at the same time, not all sports can have that access. It’s a small safety blanket.”
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Sonoma Academy athletic trainer Sarah Goble’s medical bag for treating student athletes on the field hangs at the Santa Rosa high school where she has been an athletic trainer for two years.
Brian L. Frank/Special to the Chronicle
The CIF does require a licensed physician to be present at all football games, but not at practices or for other sports. Many football games are played with just an ambulance and EMTs on site who can’t diagnose a sports injury, but can transfer players with emergency situations to the hospital.
Encinal’s booster group is paying half of the salary of a part-time athletic trainer just for football games for this school year. Gorham is hopeful that the passage of AB796 would inspire school districts to invest in full-time athletic trainers knowing they’d have a pool exclusively filled with qualified candidates.
CATA estimates that 20% of athletic trainers that do have positions in CIF schools lack the proper education or certification.
The California Assembly passed bills similar to AB796 in 2010, 2014 and 2015 only to see them vetoed by former governors Arnold Schwarzenegger and Jerry Brown, who said they would have put too many limits on the profession. CATA believes Newsom will sign this version of the bill.
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“To put it bluntly, if you wanted to work as an athletic trainer in California, you could do that without any proper education, training or experience,” Eason said. “That means that these student-athletes are potentially being provided care by people who don’t have the proper education or the proper training to provide that care. Oftentimes that means that it’s left to coaches or inexperienced people.”
Gorham was reminded of this when Encinal’s football team traveled to Hercules for its season opener on Aug. 30. After the game, Gorham learned from his team’s head coach, Derrick Lyons, that one of the players on the opposing team had been injured.
Gorham asked if there was a trainer on site; the answer was the same as it always seemed to be.
“No,” Gorham said, “they didn’t have one.”
Hercules assistant athletic director Dean Greco said, “We would love to have a training staff … but as far as hiring an outside person, I don’t even know how that would work here.”
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Sonoma Academy athletic trainer Sarah Goble measures Alexa Torres’ range of motion in her neck.
Brian L. Frank/Special to the Chronicle
The uncertainty over whether a trainer will be onsite creates a situation where “every game we play is stressful,” Gorham said, and he suspects he’s not alone in that feeling.
“I gotta believe that any athletic director like me, any coach, anytime we host an event or are at an away event, and it doesn’t matter the sport, you just hold your breath and hope everything goes well,” he said.
There are 12 high schools in San Francisco that do not have any athletic trainer, according to CATA.
Athletic director Sean Moler at the Jewish Community School of San Francisco said he would love to have one but it is “cost prohibitive.” The Drew School AD Andrew Heath said the school previously had part-time athletic trainers, but can’t afford one now, and relies on coaches’ CIF-mandated training in first aid and CPR.
At Serra High School in San Mateo, football coach Patrick Walsh said the student-athletes benefit from a full athletic training staff, but he worries for smaller schools where students have little support beyond what their coaches know.
“You look at a state like Texas, they’re building $60 million football facilities for their kids, and we can’t even hire athletic trainers,” Walsh said. Texas is “over the top, but I think this is a problem with California and there not being an investment especially for public high school sports. It’s the seventh-largest economy in the world, and we can’t even have trainers for everyone to keep our kids who play sports safe?
“It’s an absolute failure for these kids.”
Sonoma Academy athletic trainer Sarah Goble carries her on-field supplies to a soccer game.
Brian L. Frank/Special to the Chronicle
Alonzo Carter, a longtime Bay Area high school football coach and current assistant head coach at Arizona, can remember the struggles from his time at McClymonds High in Oakland and at Berkeley High.
“You’ll often find coaches are the trainers, and they can’t do more than tape an ankle,” Carter said.
Since 2002, the San Francisco Unified School District has had an agreement with UCSF to provide part-time athletic trainers. At Lincoln High School, that means certified athletic trainer Elise Hammond is there three times a week, which does not cover every football practice or most home games for other sports, according to football coach Phil Ferrigno.
Gina Biviano, who runs the UCSF program, said that her staff also tries to cover sporting events at other districts’ schools where San Francisco Unified School District teams are playing if there wouldn’t otherwise be a certified athletic trainer on site.
“If we really want to start to improve the hiring climate for athletic trainers, we need positions that are well-funded and that take care of the employee,” she said.
Campolindo High School in Moraga sometimes contracts a part-time athletic trainer who is mostly at football home games, but football coach Kevin Macy said the school struggles to have someone available for every practice, and on days when there are multiple sports playing, most teams just go without.
“We get plenty of game day help during the season, but during the week, that’s harder to find,” Macy said. “For our teams who play more than once a week too, that’s a lot for one person to deal with.”
Sonoma Academy athletic trainer Sarah Goble stands on the field at the Santa Rosa high school where she has been an athletic trainer for two years.
Brian L. Frank/Special to the Chronicle
Goble, the trainer at Sonoma Academy, also sees this as a major issue: “It’s not just about (having a full-time athletic trainer for) emergency situations, it’s about the everyday injuries. (Treating) the bumps and bruises keep kids not only on the field playing their sport, but in the classroom. They’re not having to miss school to go to an unnecessary doctor’s appointment if that’s treated the right way.”
Goble is optimistic the bill will create space for more qualified athletic trainers and a safer environment for the students. Until then, she said she agrees with Gorham — when her team is on the road, she holds her breath, and that will remain true until regulations are closer to what they are in the rest of the country.
“I know my kids are safe because I’m here,” Goble said. “But when they go out on the road, they’re on their own. You have to hope the coaches’ first-aid training is enough.”
Reach Marisa Ingemi: [email protected]; Twitter: @marisa_ingemi
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