On Board Online • February 23, 2026

By Alan Wechsler
Special Correspondent

Not long after the final school bell, seventh-grader Yazeed Ibrahim lays down on a mattress to be examined by Rick Knizek, head athletic trainer in the Shenendehowa Central School District in Saratoga County. A few hours earlier in gym class, he had tweaked a knee. Knizek gently moves the student's knee through various positions, asking him to gauge the pain level.

"You got lucky. You dodged a bullet," Knizek says after a few minutes. He advises Ibrahim to ice his knee twice after exercise and to "practice in tolerance" for two weeks.

A generation ago, a coach might have told an injured athlete to "walk it off" if the injury seemed minor or tell the student to see a pediatrician, orthopedist or physical therapist if the injury appeared to be serious. Today, most schools have staff trained to make such judgments. About 60% of public secondary schools in the state have athletic trainers, according to the New York State Athletic Trainers' Association (NYSATA). Large districts may staff several full-time positions, while smaller ones may find a part-timer through a nearby orthopedic or physical therapy practice.

In December, the State Education Department launched a new license requirement for the 2,500 athletic trainers who work in the state, including those in PK-12 school settings. To qualify, potential licensees must possess at least a bachelor's degree in athletic training and pass a nationally recognized Board of Certification exam.

Knizek is among athletic trainers who welcome the new licensing requirement because it recognizes the importance of schools hiring professionals to keep athletes healthy.

"The district hires a mechanic to maintain its fleet of buses," he said. "Why wouldn't you have someone who can maintain your fleet of athletes?"

Chris Napoli, athletic trainer for Garden City High School and president-elect of NYSATA, noted that the new licensing regulations authorize athletic trainers to perform initial evaluations and triage potential neurological injuries including concussions and injuries that involve the spinal cord. And once an athlete has been cleared by their physician to resume play after an injury, the AT is qualified by their license to work with that individual to manage, monitor and treat the injuries.

Aimee Brunelle, an athletic trainer at Colonie Central High School in Albany County, serves as the co-chair of governmental affairs for NYSATA. She said her group began work with state officials to redefine the scope of practice of athletic trainers in 2012. At that time, New York was one of only three states in the country that did not license athletic trainers. This led to people claiming to be athletic trainers without having the same kinds of training as most in the profession, she said.

Having the new license designation helps to provide clarity and protection for school districts, Brunelle said.

"It removes the guesswork," she said. "You say 'athletic trainer' now, you have to be licensed. Everybody can be confident you've met the education, examination, everything that needs to be in order to support the schools. It guarantees a minimum of competency."

Standards have been rising. Since 2022, new athletic trainers must have a master's degree in the field to earn national certification, which is now part of state licensure.

A big part of the job involves concussions. State law dictates how such injuries are evaluated and treated, and it details protocols for return to play.

Athletic trainers routinely deal with fractures, dislocations, muscle tendon injuries, strains, sprains and connective tissue injuries. They also are trained to diagnose skin conditions, everything from athlete's foot to a staph infection. They cannot, however, prescribe medications.

Shenendehowa is an example of a district that keeps its athletic trainers busy. The district has 36 varsity sports, more than 100 coaches and about 1,000 student-athletes. Knizek and another athletic trainer, Shannon Kane, are available to work with those students as well as those injured in intramural sports or gym class. While coaches are trained in basic first aid and CPR, it's the responsibility of Knizek or Kane to examine injuries and prescribe rehab.

Typically, a coach or a school nurse will send an injured athlete to be evaluated in the athletic training office, which is located next to a gymnasium. At many afternoon or weekend games, Knizek or Kane will be on the sidelines, ready to step in if needed.

They use a motorized cart to make their way around the 232-acre main campus and show up at as many games as possible. One of them travels with the high school football team to away games as well.

When Knizek first started at the district 26 years ago, he was working with a local orthopedic group that contracted him out to the district. He became full-time nine years ago, and he helped write his own job description. His day begins at 11:15 a.m. and ends no earlier than 6:30 p.m. On busy days, he might stay as late as 9 or 10 p.m. to cover night games.

There are many benefits to a district of having a full-time athletic trainer, Knizek said. "It allows the coaches to really focus on coaching and not worry about injury management," he said.

Other benefits can include fewer legal claims against school districts by parents and lower premiums on liability insurance. At a minimum, good calls by athletic trainers can reduce the number of injuries that keep students out of school and ultimately have to be referred out to a private physician or therapist.

"We try to manage as many of our kids here as we can," he added. "If an athlete comes in with an injury that we feel requires imaging, our first line is to refer them to an orthopedist. If surgery is involved, we can do rehab."

They also assign homework. "Hardly anyone will walk out the door without having a home exercise program," Knizek said. "We make it very easy for kids to go home, open up their phones and pull out their exercises. There's been really good buy-in here. They realize if they want to get back into their sport quickly, they're going to have to follow instructions."

Shen senior Gianna Winter can speak to that. She tore a ligament in 2024 while playing basketball. She ignored the pain for two weeks before seeking treatment and credits Knizek with getting her back on her feet.

"I was basically here every day to get treatment so I could play," she said. "I was scared I would be taken out."

Working with the district's athletic trainers "is what got me through and made me able to play." Next year, she's attending Saint Michael's College in Vermont on a full basketball scholarship.

Joseph Cintron, a high school junior, is also a frequent flyer in the athletic training office. He loves to play football but has a history of straining his tendons and various ankle issues. The athletic trainers helped him figure out why and learn what he could do about it. "I had no idea my feet were flat until I came here," he said.

After seeing a podiatrist, taking private physical therapy and getting orthotics (plus taking August off) he is able to run and play football.

"I feel so much better. Last year it was iffy," he said. "I can move the way I'm supposed to now. It's a huge step."