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A couple of years before Jen Robertson came to St. Mary’s College of Maryland as an assistant athletic trainer, she already had embarked on a career of helping student athletes.

On a trip to the University of North Carolina at Chapel Hill, she was off from work and playing there as a member of a club handball team in a tournament. Until she saw a cadet from West Point collapse on the court.

“The girl’s eyes rolled back, and she fell face first on the ground,” Robertson said.

“Nothing mentally prepares you for that moment,” she added, but she knew what to do, quickly providing CPR to the fallen cadet.

“We had to shock her,” Robertson said, and the patient ultimately regained consciousness at a hospital, and later received a pacemaker for a previously undetected heart disorder.

Robertson, now interim head athletic trainer at St. Mary’s, is one of the many people who not only provide initial care for student athletes’ injuries at schools and colleges nationwide, but just as importantly, help them regain, retain and often take to new levels their ability to play their chosen sport.

Robertson, 29, originally from Binghamton, N.Y., was playing basketball and softball while attending a community college when she got the idea of becoming a physical therapist, until she saw what an athletic trainer does.

“You don’t usually see a physical therapist going out and kicking a soccer ball with someone who’s coming back from an ACL,” Robertson said during a recent interview at her office on the St. Mary’s campus.

She earned her bachelor’s degree in athletic training at The State University of New York College at Cortland, and a master’s in education at Le Moyne College in Syracuse, N.Y.

Hers is a job that can require a response to not only ankle sprains, dislocated shoulders and ACL tears, but to asthma attacks, shock, concussions and even the possible onset of an arrhythmic heartbeat brought on by a lacrosse ball striking an athlete’s chest.

“It’s one of those things that I hope that we never have to do,” Robertson said.

While most conditions arise from isolated mishaps during a practice or game, the trainer said, she has to be on the lookout for problems that quickly could become widespread, such as skin infections.

“Luckily, there haven’t been any outbreaks, but there’s always a potential,” Robertson said. “All you need is a small little entry hole in the skin. These tables get cleaned several times a day. This is a highly populated area, and [an infection] can spread quickly if it’s not treated.”

During the first week of the semester, Robertson was working on the latest protocol from the National Collegiate Athletic Association’s sports medicine handbook on the appropriate response to a possible concussion.

“It’s definitely been a lot more in the forefront. There’s a lot more recognition,” Robertson said. The timeline for letting an athlete who has suffered a concussion get back on the field begins only after they have no noticeable after-effects from the injury.

“It’s getting to the point where we implement certain steps each day,” she said. The time period has increased from a couple of days to closer to a full week.

“The length of time [from an apparent full recovery to a return to play] has gotten longer,” she said.

If an athlete starts having headaches on the third day of that timeline, she said, “We call it quits right there and then. We try again, back to Day One.”

The college tries to have a Ridge volunteer rescue crew on hand during major events, and Robertson said that an incident of a dislocated shoulder last spring prompted a call to the college’s public safety office and a response by an ambulance.

Just as Robertson was drawn to her career during her days as a student athlete, she sees students at St. Mary’s drawn to what she’s doing.

“The fact that they’re in athletics is what piques their interest,” she said. “We have a lot of bio[logy] majors, so they’re always interested in the mechanics of how injuries happen.”

If a serious injury occurs, there’s a plan in place to get the athlete to a hospital, and a protocol to help them recover, from the onset — both physically and mentally.

“The biggest thing is reassuring them that they’re not done for life,” she said. “Every one of our athletes has come back, to some degree of where they were, if not better. When those athletes do come back, I’m the first one there to watch them go.”

A little prevention now can avoid a lot of pain later

On a recent Wednesday afternoon, amid the din of younger students shooting baskets, kicking soccer balls and throwing a football in a gymnasium at The Calverton School near Huntingtown, high school athletes crowded into a small room with Stacie Rector to have ankles taped, legs massaged and a knee treated with electrical stimulation.

Rector, a 26-year-old Dunkirk resident originally from Montgomery County, was tending to the group before the kids went out to play soccer, field hockey or golf, or run cross-country. She asked one student who overdid it during the first day of soccer practice if she had been icing down her thigh injury, as the trainer applied ultrasound with a freezing lotion.

Rector uses electrical stimulation to reduce pain and ultrasound to promote healing of strained muscles.

Rector became certified as an athletic trainer three years ago, graduating with a degree in that field, and now is licensed like her peers throughout Maryland with an orthopedic physician. In her case, that’s a doctor in Anne Arundel County who is just a phone call away.

“They take the responsibility of making sure that we are up to date,” Rector said after her pre-practice treatments were completed. “We send our athletes to [the doctor] to be evaluated if they need more medical treatment. Or I can send them pictures and videos if I have a question.”

While attending Towson University, Rector had an internship with another university’s football and men’s lacrosse teams, plus a high school rotation with a school’s football team, where she met trainer Lori Bristow. “She’s my mentor,” Rector said.

Rector was hired through a sports-care rehab and physical therapy firm in Anne Arundel County to work at a school in that county before arriving a year ago at Calverton, where she is a full-time physical education teacher, an interim co-athletic director and the school’s first head athletic trainer.

“I’m here all day, and I don’t leave until all the athletes are finished,” she said. “That can be 6 o’clock. That can be 10 o’clock. It just depends on which sports are in season.”

Rector also serves as the athletic trainer for the Hogan lacrosse tournaments held throughout the year in Anne Arundel and Queen Anne’s counties.

Her own athletic participation in high school in Montgomery County included setting records in diving, competing as a junior Olympic gymnast and winning national titles at 16 in 2003 in trampoline and tumbling. It also gave her first-hand knowledge of what can happen.

“I’ve had surgeries, and that’s what made me want to be an athletic trainer,” Rector said. “I was always injured from gymnastics. I had knee surgeries. I had back injuries, ... wrist and ankle injuries. I was pretty much injured all the time. That’s why I chose to do sports medicine, and not continue on with athletics.”

For Rector, it’s a job of responding to trouble, but also helping to prevent it.

“If 911 needs to be called, I’m the one who makes that call,” she said, but most of her communications are with the athletes, right from the beginning of a sports season.

Rector does “baseline testing” on all athletes to measure their cognitive function, so if they do suffer a possible concussion, she knows what their normal level is even before they go through a graduated series of evaluations toward recovery and a return to play.

There are about 345 students at the school from prekindergarten to 12th grade, including 220 high schoolers, she said, and more than half play sports, with most of that group playing two or more sports during a school year.

“I talk to them about nutrition and hydration,” she said. “I evaluate kids as they’re playing sports to see if they’re prone to any injuries because of their biomechanics [or] incorrect techniques. Runners, we look at their feet to see if they should be in orthotics or if they should be doing rehab for their weak ankles [and] knees. We do a lot of injury prevention [and] a lot of injury education.”

Putting the help where it’s needed, when it’s needed

Just as student athletes line up for therapeutic help before practices and games, they also check in to get some treatment afterward, such as later that Wednesday afternoon at North Point High School in Waldorf.

“I’m getting the after-practice rush here,” Todd Wogamon, the school’s head athletic trainer, said as soccer players filed into his office, pointing to where they were hurting. He told them to sign in on a sheet and list their “name, sport and body part.”

“What I really need is a whirlpool to throw you all into,” Wogamon quipped.

“That would be nice,” one athlete agreed.

What the students do have is a University of South Carolina graduate with a four-year degree in athletic training. Wogamon exemplifies the continuing efforts throughout Maryland and in each county to improve the on-site availability of good care for student athletes.

Kevin Hook, supervisor of athletics for Calvert public schools, said this month that in addition to a care-and-prevention class mandated by the state, all coaches in that county must take online training on concussions. Some coaches also may have emergency medical services training, he said, through service as fire and rescue volunteers.

In St. Mary’s, public school coaches take the required course in care and prevention of athletic injuries, and expand on that with online training in heat acclimatization and concussion awareness, plus local training on first aid, CPR and the use of a defibrillator, according to Andrew Roper, the county schools’ supervisor of physical education, health education and athletics. Each high school receives about $3,300 a season, he said, to spend at its discretion on the hourly wage of athletic trainers to be present for specific games and practices.

At North Point, Wogamon, a 27-year-old Bryantown resident, handed a bag of ice to a student after checking out the swelling on her ankle and advising her to return to his office before practice the next day.

“I know that you’re going to limp on it a little bit,” Wogamon said. “If you can walk halfway normal, try to do that.”

Last year, Wogamon split his time between North Point and Thomas Stone high schools, but he now works full time at North Point. Thomas Stone also has a full-time trainer.

“We’re very fortunate in Charles County to have a school board that recognizes the importance of athletic training ... [and] to have athletic trainers at every school,” Wogamon said. The full-time position at North Point “allowed me to focus just on this group of athletes,” he said, “instead of going back and forth between two schools.”

Maryland does not require schools to have athletic trainers, but emergency medical technicians are required at football games, Wogamon said. He teaches the care-and-prevention class that all coaches must take, and some coaches recognize him and his peers when they bring their teams to Charles County for a game.

“Coaches that come here from other counties are excited to see us on the field,” Wogamon said.

“Us being here every single day is a tremendous help. The athletes know that I’m going to be here,” he said. “It’s also great for my teams to know when they’re traveling to [other] Charles County schools, there’s going to be a trainer there, too.”