That Coach
Building Trust and Respect Between Coaches and Athletic Trainers to Prioritize Athlete Safety
A strong working relationship between a coach and athletic trainer is built on communication, trust, and mutual respect. While their responsibilities may differ, both play an important role in supporting the athlete. When rapport is absent, clinical recommendations may be challenged, communication may become fragmented, and professional disagreements can compromise continuity of care. For the athletic trainer, navigating these relationships requires maintaining professional judgment while continuing to advocate for the athlete’s health and safety.
Research in collegiate athletics demonstrates how the relationship between coaches and athletic trainers can influence the delivery of healthcare. A study published in the Journal of Athletic Training examining 434 collegiate athletic trainers found that coaches were among the sources of pressure surrounding medical decision-making, particularly when an athletic trainer determined an athlete was not ready to participate. The National Athletic Trainers’ Association has also reported that, among collegiate athletic trainers who experienced pressure from nonmedical personnel, 57.81% reported being pressured by an administrator, coach, or coaching staff member to make a decision that was not in the best interest of the student-athlete’s health.
The coach–athletic trainer relationship presents similar challenges in secondary schools. A study published in the Journal of Athletic Training surveyed 725 secondary-school athletic trainers and found that 53.9% identified coaches as a source of workplace conflict. Yet the findings also demonstrated the value of positive professional relationships, with 92.56% of athletic trainers either agreeing or strongly agreeing that they felt supported by coaches in their role. The contrast is important. Conflict and collaboration can exist within the same working environment, and a difficult relationship does not necessarily define the relationship between coaches and athletic trainers as a whole. Establishing rapport, maintaining open communication, and recognizing the distinct responsibilities of each profession are essential to ensuring disagreements do not interfere with the care provided to the athlete.
One of the most difficult dynamics for an athletic trainer is working with a coach who is unwilling to follow established safety protocols. Heat and lightning policies are designed to provide objective parameters for when activity should be modified, delayed, or suspended, yet some coaches may view these guidelines as obstacles to practice rather than safeguards for the athlete. When a coach disregards Wet Bulb Globe Temperature (WBGT) recommendations or pressures an athletic trainer to resume activity before lightning protocols have been met, the issue extends beyond a difference in opinion. These decisions place the athletic trainer in the position of having to defend established safety measures while attempting to maintain a professional relationship with the coach. This type of noncompliance not only undermines the purpose of established safety protocols but also places competitive priorities ahead of the athlete’s health and safety.
A significant concern arises when a coach does not recognize the athletic trainer as an integral part of the team. Advocacy extends beyond supporting an athletic trainer in moments of injury or disagreement. It encompasses recognizing the clinical value of athletic training, supporting access to appropriate facilities, equipment, and supplies, and contributing to an environment in which the athletic trainer can effectively perform their role. It may also involve reinforcing the importance of medical recommendations, supporting decisions related to athlete health and safety, and communicating confidence in the expertise of the athletic trainer. When an athletic trainer is viewed as an essential component of the program rather than an ancillary resource, the relationship between coaching and sports medicine becomes more cohesive and better positioned to serve the athlete.
A clear boundary is crossed when a coach assumes authority over areas of care that fall outside the coaching role. Rather than involving the athletic trainer in the evaluation and management of an athlete, the coach independently recommends outside providers, initiates referrals, or seeks treatment options without communicating with the healthcare professional responsible for the athlete’s care. In some cases, the coach attempts to interpret symptoms or determine the nature of an injury through online searches, effectively positioning personal research as a substitute for clinical assessment. When a coach assumes responsibility for decisions outside their professional role, the athlete ultimately pays the price.
For the athletic trainer, working with a difficult coach can create an environment where professional credibility feels as though it must be continually established. Clinical decisions may be met with skepticism, requiring the athletic trainer to repeatedly explain assessments, recommendations, and the rationale behind medical decisions. Over time, this expectation can take a significant mental and emotional toll, contributing to frustration, self-doubt, and professional fatigue. The constant need to defend clinical judgment can shift the focus away from athlete care and toward proving professional competence. An athletic trainer should be able to perform their role without feeling as though their education, expertise, and clinical judgment are continually on trial.
A common challenge arises when a coach recognizes the value of an athletic trainer without respecting the profession. An athletic trainer cannot be appreciated only for what they provide while their education, expertise, and professional judgment are dismissed. Respect for athletic training requires recognizing the profession as an essential component of athlete healthcare and supporting the role with the same clinical regard afforded to other healthcare disciplines.
Ultimately, the greatest breakdown occurs when winning becomes more important than the athlete’s health and safety. Competition should never come at the expense of an athlete’s long-term well-being. Coaches and athletic trainers may have different responsibilities, but they share a common goal: the health and success of the athlete. When both professions respect their roles, communicate effectively, and work together, everyone wins. The strongest teams are not built on competition between coaching and healthcare, but on collaboration between the two. Be the coach who values the team, respects the sports medicine profession, and puts the athlete first—because when athlete safety comes second, everyone loses.
