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Strength Coach Chronicles – Working with Sports Medicine

I want to establish that an Athletic Trainer that gets their CSCS is not productive or helpful to us as S&C coaches. The way NSCA has set up their accreditation is to get as many people as possible a part of and opening their flagship certification is a business decision. The second order is that you have a dynamic that one side feels it can do its job better than the person who is paid to do that job in the first place. 

This is my personal experience, but from what I see, most S&C is much more proactive in regards to continuing education, more so than our counterparts within an athletic department. Books, seminars, certifications are all common practice for a college S&C coach. This is not the standard, or at least not as a rigorous pace, as the rest of the athletic department. In some regards it can create tension between departments. 

There is a fear that S&C coaches learn systems such as FMS, FRC, PRI, ELDOA or concepts from Gary Gray, Lee Burton, Greg Rose, or Charlie Weingroff and thus enter a domain we are not clinically trained for. The one aspect that is lost in all these systems and concepts creates the limits of the S&C coaches. What is evident is that S&C coaches are the predominant audience at these seminars and clinics. This is the case so much so that these frameworks are re-engineered to meet the demands of the S&C coach and have pulled away from sports medicine. 

For the most part, when an S&C coach incorporates an FMS or FRA it is to better prescribe a S&C program. It is not to infringe upon a Sports Medicine staff’s expertise or job responsibilities. Personally, the idea of working with someone in pain is not exciting to me. Understanding how to create a more well rounded program is 100% the reason why I attend seminars or acquire resources to help with understanding things from more of a sports medicine background. I can easily see how this would be interpreted as trying to cross a threshold that is outside our scope of practice. 

There is a lot of gray area between rehab and performance. The lines are really blurred. Scope of practice limits the S&C coach from diagnosing or treating injuries, which is correct. Scope of practice does not limit ATs or PTs from prescribing performance training programs. This creates a power dynamic that makes one feel inferior. Just because someone can do another’s job from a legal standpoint does not mean they can do it at a high level. 

There is another massively dysfunctional aspect between Sports Medicine and S&C in who each is hired by. Sports Medicine is hired from the Athletic Department; S&C is hired by the coach. Sports Medicine answers to the athletic department; S&C answers to the coach. This creates a natural division between the two departments in where allegiance lies. Survival for the S&C coach means a drastically different thing than Sports Medicine. The balance to appease your direct supervisor and execute best practice is very difficult and often not appreciated by our counterparts. 

A symbiotic relationship between Sports Medicine and S&C can occur if there is a respect amongst both parties. I remember an Athletic Trainer explaining to me that he was the voice of reason; my response was: who is to say that your reasoning is more reasonable than another? I find this is emblematic of the lack of respect for S&C in general. This stems from multiple dynamics such as hiring and accreditation, but I think a large part is the presumption that one can do another’s job better than the person hired to do the job in the first place. 

Perception is massively influential between the two parties. Ask for help and you come off as incompetent. Don’t include and you come off as rigid or set in your ways. The way you are perceived as S&C is a very delicate thing to manage with Sports Medicine. The imbalance of perceived balance makes you the S&C coach: the one that has to manage the relationship. How to Win Friends and Influence people is just good etiquette here. 

Negative astigmatisms are based on some truth. There are bad S&C coaches, there are S&C coaches who over step or are disrespectful, and there are S&C coaches that incompetent. The Athletic Trainer that job is worse because the S&C coach is unnecessarily putting athletes in harm’s way or the Physical Therapist rehab plan is railroaded by a stupid decision from the S&C coach is not fair to say S&C is completely blameless. Being bad at your job makes whatever power dynamic from Sports Medicine necessary to protect the athlete. 

As I re-read this, I see the first hand negative experiences scream here. This is probably more of my inability to work or communicate with Sports Medicine effectively. Not the other way around. I am sure there is some level of truth in that all the above examples were actually completely in reverse and I was the hard one to work with. That I was the arrogant one and acted like I knew more than Sports Medicine. My seeking out information gave me a false sense of confidence that I knew more than Sports Medicine. 

Taking each interaction as something to learn from and not this battle for territory is key. Coming back to the central premise of our jobs – help athletes. The Athletic Trainer is the first person that an athlete sees when they are hurt. This is such a critical moment for the athlete: they are hurt and therefore feel vulnerable. They need confidence and assuredness that it will be ok. The PT is there with them directly after they come out of surgery and guiding them through an arduous time. But they have to understand the extent of their job does cross over into improving performance. 

The S&C coach needs to understand the consequences of bad programming. Their job is to make the athlete more resilient and capable. Sports Medicine is not there to make up for our inability to do our jobs effectively. They are there for inevitable injury and the process of getting back to normal function. Having an appreciation of their job is paramount to them having an appreciation for your job. Training should be positive, not net negative. That is how we bridge the gap between one side feeling compelled to get certified in something unrelated to their job.

 

That AT or PT getting CSCS should be to have understanding on how one does their job better. It’s how we understand our job better to in effect help others do their job better.