Sudden Death

Trainers are often all that stand between athletes and injury — or death
Sunday, July 17, 2005 | 12:00 a.m. CDT; updated 1:17 a.m. CST, Tuesday, February 24, 2009


Rex Sharp, MU’s director of sports medicine and head athletic trainer, has been helping to prepare college athletes for the rigors of competition for a quarter century.


In 2000, Sharp’s staff was recognized by the Big 12 Conference as the athletic health “Staff of the Year.”


For Sharp, the death Tuesday of MU football player Aaron O’Neal after a voluntary workout was “the most devastating thing I’ve dealt with in 25 years,” he said.


Sharp would not say exactly where he was standing when O’Neal collapsed, saying he was not ready to talk in detail about the tragedy. But, he said, MU officials were generating a report.


“We keep pretty detailed records of everything involving sports medicine, (and these) were given to the powers that be,” Sharp said.


NCAA regulations require an athletic trainer — someone specially trained to intervene in a medical emergency — to be present for all non-mandatory workouts.


Sharp said Tuesday’s workout started with three athletic trainers. “One left,” he said, “and then there were two of us.”


After graduating in 1979 from Ball State University, Sharp spent three years as a graduate assistant athletic trainer at Michigan Tech before becoming the head athletic trainer at what is now Truman State University. In 1985, he returned to Ball State University, where for 11 years he coordinated sports medicine, working primarily with the football team. In 1996, he was hired as MU’s head athletic trainer.


MU’s full-time athletic trainers are nationally certified by the Board of Certification Inc. and licensed by the Missouri State Board of Registration for the Healing Arts.


To be nationally certified, applicants must graduate from an accredited university and pass a three-part test. In order to retain the license, athletic trainers must take 80 hours of additional health care education every three years.


Pat Forbis, president of the Missouri Athletic Trainers’ Association, said that an athletic trainer in Missouri does not have to be nationally certified in order to work. However, he says, a large percentage are.


“It’s kind of a standard thing, anymore,” he said.


“(Athletic trainers in Missouri) have to be licensed in order to work, and they have to have a license in order to practice in Missouri,” said Kim Brester, administrative coordinator for Missouri’s Board of Registration for the Healing Arts which grants state licenses.


Brester said athletic trainers in Missouri have to reapply for their license annually.


“We are not a fitness trainer,” Forbis said. “We are licensed health care professionals.”


Shannon Leftwich, director of credentialing services for the Board of Certification Inc., said all athletic trainers are required to be certified in handling cardiac care and CPR.


“One of the domains for athletic trainers is immediate care,” Leftwich said. “That includes training to assess emergencies and decide whether a situation merits outside intervention. The athletic trainer is there to be the first responder to the emergency and should be able to handle any situation. They are the go-between between athlete and other health care officials.”


New training guidelines



Even with all their training, certification and licensing, athletic trainers are still faced with the unpredictable.


In July 2001, Eraste Autin, 18, a freshman fullback at the University of Florida, collapsed from heatstroke on a practice field after jogging 300 yards from Ben Hill Griffin Stadium following a voluntary workout. He died six days later.


The workout consisted of six long sprints with 95 seconds rest in between. According to those on hand, Autin showed “no visible signs of distress,” during the 45-minute workout that took place in 88-degree weather.


The death of Rashidi Wheeler, 22, a safety at Northwestern, occurred in August of 2001. Wheeler had also completed a voluntary workout of “fast-paced jogging,” in 82-degree weather when he experienced a fatal asthma attack. Northwestern contested that report.


The two incidents came on the heels of the February 2001 death of Devaughn Darling, 18, a linebacker at Florida State University who died after a workout of a blood disorder.


What resulted was a new level of scrutiny on the safety and intensity of college football training programs, especially out-of-season conditioning and voluntary practices in the summer.


The man charged with ensuring that MU athletes are at their physical peak is alumnus Pat Ivey, who designs and implements the strength and conditioning regimen for the Tiger football program. His role also includes acting as a general overseer for athletes involved in 15 other varsity sports. Ivey could not be reached for comment.


The university would not provide a copy of an explicitly outlined training program, but a basic program philosophy is available at MU’s athletic Web site,


According to this philosophy, Ivey’s program seeks to increase “overall body development,” “enhance performance” and reduce injury.


Also included is a section called “The PR Paradigm,” the underlying goal of which is to use each athlete’s performance records as a catalyst in training and to inspire other athletes “to strive for personal records.”


Strength and conditioning coaches are certified by the College Strength and Conditioning Coaches Association.


In order to attain certification all coaches must have a bachelor’s degree, pass a written and practical exam, complete an eight- to nine-month internship and be certified in CPR. They are required to understand body systems including muscle physiology, metabolism, aerobic and anaerobic systems and nutrition.


Ivey has been associated with MU for the past 10 years as a defensive end, graduate assistant and assistant strength director.


From 2002 to 2004 he served as head strength and conditioning coach at Tulsa University, before being hired by MU to replace Jeff Fish who was hired by the Oakland Raiders.


Getting with the program



Jerry Weber, head athletic trainer at the University of Nebraska, said voluntary summer workouts are necessary in a conditioning cycle that lasts from winter workouts in January to pre-season camps in late summer and early fall.


“The goal of any summer conditioning program is to see that the student athletes are going to be ready for the rigors of fall practice,” Weber said.


Weber has been head athletic trainer since 1996 and has worked with the program since 1977. Weber also said that any acclimatization process is necessary to ensure that players can handle conditioning drills that involve pads, helmets and other assorted protective equipment.


Weber, in addition to his role as a trainer, was asked to sit on the NCAA Division I Football Issues subcommittee created in 2001 to examine out-of-season conditioning. The panel was made up of head coaches, administrators, strength and conditioning coaches and other athletic trainers.


“It was a matter of looking at the current problem as it existed and the current rules as they existed and trying to do as much as possible,” Weber said.


He said that while the committee tried to “legislate” as much as possible, some circumstances are beyond human control.


“At some point there is some serendipity involved,” Weber said. “You can’t micromanage every institution and how they run their program.”


According to the subcommittee’s guidelines for out-of-season conditioning workouts, the voluntary workout period cannot exceed eight weeks. Also, players cannot participate in more than eight hours of lifting and conditioning activities per week.


Weber said the committee also emphasized the importance of gathering as much medical data as possible about incoming and current athletes by requiring a medical exam before the season.


O’Neal’s last physical was in August 2004 before his first season at MU. He was due for another physical next month.


“All of our football players’ physicals take place in August prior to the start of fall camp,” said Chad Moller, director of media relations for MU athletics.


Sharp said that the physicals are conducted at the Student Health Center. The standard physical includes vision screening, dental screening, a general medical exam of height, weight and blood pressure, an orthopedic exam and substance abuse testing.


“A fairly extensive written medical history report must be submitted (by the athlete) prior to the physical,” Sharp said.


That information can prompt more in-depth tests, such as X-rays or cardiograms, he said.


The NCAA guideline changes also sought to increase the number of athletic trainers, with extra medical training at such practices and to give them the power to override coaches — both official coaches and those coaches who direct strength and conditioning — in “curtailing” or ending conditioning activities when an athlete’s health is in jeopardy. According to the guidelines, the trainers can even stop a practice over a coach’s objection.


The question is whether an athletic trainer will exercise that authority, especially if he or she is a graduate assistant.


“They just have to understand that they do have that power … given to them by the NCAA,” Weber said. “As far as working around personalities and working around athletics, I’m sure it’s tough.”


Another obstacle, which perhaps no guideline, trainer or coach can fully overcome, is the attitude of the driven athlete who wants to achieve his physical and competitive best.


“Any athlete that’s going to achieve or try to achieve this level of competitive readiness is going to have a certain psychological makeup,” Weber said. “And they will push themselves to achieve everything they can.”


The only way to mitigate the risk is to know which athletes will burn the candle at both ends, he said.


Summer workouts come with some uncertainty because for many athletes it is their first exposure to the rigors of college training and athletic staff — although that was not the case with O’Neal who was beginning his second year with MU.


O’Neal never showed signs of pain, fifth-year defensive lineman Scott Wheatley said.


“He was a quiet guy, that’s something everybody respected about him,” Wheatley said.

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