Sports Medicine Athletic Training in Montana

by ih-mis admin

Athletic training (AT) in the United States began in 1881. The National Athletic Trainers' Association was formed in 1950 to govern the profession. Many of us growing up did not have access to an Athletic Trainer or understood the importance of this health care profession. We had health care professionals or “team docs” that would look at injured athletes after a sporting event. Many athletes were allowed to return without proper diagnosis or rehabilitation. Many rural high schools did not have access to Athletic Trainers until the mid 90’s. Some of these smaller schools began to ask for “Sports Medicine” coverage to help their coaches and administrators protect their student-athletes. Bigger schools in the state did have Athletic Trainers who were most likely educators interested in athletics. Growing up in a small town in Eastern Montana, we did not have an Athletic Trainer or a Sports Medicine Team. Many rural schools still do not have access to Athletic Trainers. Missoula Bone & Joint has partnered with a few big schools and many rural schools in Western Montana to provide this health care service. 

Sports safety and the health of student athletes have increased over the past 20 years. The media and social media have heightened awareness of these safety concerns resulting in a rise of healthcare professions in the high school and youth sports settings. 

Conflicting research findings make it difficult to determine the exact epidemiology of youth sport injuries, however several trends are seen in the literature (Patel & Nelson, 2000):

  • 48% of youth sport athletes have been found to have at least one injury during an athletic season.
  • 65% of injuries in youth sports are minor and if managed properly, will not become serious.

Today, more than ever, parents are talking about injuries. Why are we seeing more high school and youth athletes being injured than in the past?  Concussions are a common topic at Friday night football games. What is a concussion? How do we know if a child has one? How is it treated and when is the child “safe” to return to their sport? Anterior cruciate ligament (ACL) injures is another hot topic at high school events. What do we do to properly manage an ACL injury?  School administrators, coaches, and parents are happy to have a Licensed Athletic Trainer to help manage these injuries. It truly takes a TEAM of health care individuals to manage all injuries and return student-athletes safely back to competition. Some injuries are not just orthopedic in nature and will be referred to the proper health care professional. The athlete, parents, teammates, coaches, school administrators, athletic trainers, physical therapists, and team physicians all play important roles in the Sports medicine Outreach program at Missoula Bone and Joint. The Emergency Room, Pediatricians, and General Practitioners are additional resources.

The National Athletic Trainers’ Association (NATA) is confident the best way to protect the public is to allow only Board Certified athletic trainers and state licensed athletic trainers to practice. The NATA is not alone in these beliefs. The American Medical Association has stated that certified athletic trainers should be used as part of a high school's medical team. The American Academy of Family Physicians agrees and states,“The AAFP encourages high schools to have, whenever possible, a BOC certified or registered/licensed athletic trainer as an integral part of the high school athletic program.” 

In the state of Montana, Athletic Trainers must hold a state license to cover a Montana High School Association (MHSA) governed event. Despite the fact that MHSA does not require an Athletic trainer to be at high school events in the Missoula area, Missoula Bone & Joint has partnered with many schools to provide these health care services. This is in part due to an increase in awareness of the importance of health care services within the schools.

Athletic training is a relatively young profession that is expanding at all levels of athletic competition. In 1994, only 35% of high schools had AT services. In the most recent study of schools using AT services, the NATA reported that 42% of high schools employed athletic trainers.2

Missoula Bone & Joint currently employs 12 Licensed Athletic Trainers, servicing 17 area high schools: Sentinel, Hellgate, Loyola, Valley Christian, Stevensville, Florence, Frenchtown, Alberton, Superior, St. Regis, Arlee, Charlo, St. Ignatius, Ronan, Drummond, Seeley, and Granite High School. MBJ also provides medical coverage to the local youth football, rugby, and lacrosse events in Missoula. We are proud to partner with all of these communities to provide the best health care possible. 

By Bob Botkin, Missoula Bone & Joint Sports Medicine Director, PT, LAT


  1. Patel, D.R., & Nelson, T.L. (2000). Sports injuries in adolescents. Medical Clinics of North America, 84, 983-1007.
  2. Lyznicki JM, Riggs JA, Champion HC. Certified athletic trainers in secondary schools: report of the Council on Scientific Affairs, American Medical Association. J Athl Train. 1999;34(3):272-276.
  3. Athletic trainers fill a necessary niche in secondary schools. National Athletic Trainers' Association website accessed September 17, 2014.