21.06 September 2011

Women on the Field

Female athletic trainers who cover football explain the ins and outs of working in a male-dominated environment.

By Mike Phelps

Mike Phelps is an Assistant Editor at Training & Conditioning. He can be reached at: mp@MomentumMedia.com.


When Sue Stanley-Green, MS, LAT, ATC, was a student at Ohio State University in the early 1980s, female athletic trainers weren't allowed near the football facility. Even if Stanley-Green wanted to do something as simple as go into the building for tape, she would be denied entry. Although she eventually became the first full-time female athletic trainer in the Southeastern Conference when she joined the sports medicine staff at the University of Kentucky in 1982, Stanley-Green's early experiences with football left a sour taste.

"I was told consistently, as were my fellow female athletic trainers, that we weren't good enough to work with the football team," says Stanley-Green, who is now the Athletic Training Education Program Director and an Associate Professor of Athletic Training at Florida Southern College. "We were female, so we weren't good enough. That made us all pretty angry."

Since its inception, when the ball was actually made of pigskin and the forward pass was a foreign concept, football has been a male-dominated sport. With rare exceptions, the players are almost always male and the coaching staffs follow suit. But what about in the athletic training room?

While the current situation isn't nearly as dire as it was during Stanley-Green's college years, in many cases, women still aren't fully accepted into male-dominated environments, such as a football team. Stereotypes continue to exist, including feelings that women may be a distraction on the field or pushovers in the athletic training room.

"A lot of those beliefs are due to the culture surrounding football," says Ariko Iso, MA, ATC, Head Football Athletic Trainer at Oregon State University, and former athletic trainer for the Pittsburgh Steelers. "Everything about it is very masculine. In the long history of the sport, players and coaches have never had to think about a female presence. Some coaching staffs or support staffs prefer not to adjust or make any changes."

But change is definitely occurring. Following Iso's departure from the Pittsburgh Steelers, the team hired another female athletic trainer and more women are working with football teams at the high school and college levels.

BE AUTHORITATIVE
In a perfect world, female athletic trainers would be judged solely on their knowledge and skills, and gain the confidence of players and coaches simply by doing their jobs well. While that may be the case in some programs, women often have to go above and beyond the call of duty to earn respect in the male-dominated football environment.

One key is to quickly and firmly establish rules and boundaries. This is something athletic trainers of any gender need to focus on, but is especially important for women working with football.

"Establishing those boundaries is more important for female athletic trainers because it establishes your sense of professionalism--that you're there as a healthcare provider and nothing else," says Kelli Pugh, MS, ATC, LMT, CES, Associate Athletic Trainer at the University of Virginia, who covers football. "Coaches have to see that you can be attentive to the athletes' needs without being a pushover--that you're firm and consistent in your expectations of the athletes and enforcement of sports medicine department rules and team rules. Demonstrating every day that you're there as a healthcare provider who's consistent and firm is probably the best way to win over your coaches."

Establishing rules, though, means little if you don't enforce them when a player or coach starts to cross the line. "Sometimes that means reminding an athlete that a specific joke or certain language is not appropriate for the athletic training room," Pugh says. "In my experience most athletes have been very respective to that type of direct feedback, and it doesn't happen again."

One stereotype that often exists is the concern that a female athletic trainer will "baby" players and not work them as hard in rehab as a male athletic trainer would. To combat that notion, Stanley-Green made sure to exhibit her tough side.

"I worked very hard at being tough," she says. "I'd kick the players in the butt a lot during rehab so they learned not to mess with me. They knew they had to be there on time and do what they were supposed to do. On the practice field, I went toe to toe with any of the assistant coaches and grabbed players by their facemasks. I felt like I had to do those things so I wouldn't be labeled a pushover."

Melissa Harrington, MEd, LAT, ATC, Head Athletic Trainer at Cedar Ridge High School in Round Rock, Texas, agrees. "I'm strict with my male athletes," she says. "They have to know that they can't walk all over me and pressure me just because I'm a woman. They have to understand that what I say goes."

If a player doesn't listen, Harrington works hard to make sure it's a one-time offense. "If they don't take care of their responsibilities, they are in trouble," she says. "I'll make them do pushups or something similar, so they view me as more of an authoritative figure."

TAKING IT IN STRIDE
While being clear about your expectations and exhibiting toughness certainly have their place, it's also important to know when to let things go and not sweat the small stuff. For Stanley-Green, fitting into the football world came down to recognizing that she made a choice to work in a male-dominated environment and would have to accept some of the things that came with it.

"I felt I was entering their space," she says. "If I was going to be shocked or offended, then I had made the wrong choice to be there. The athletes and coaches were always respectful of me, but I heard a lot of things. Nothing was offensive--it was just talk. You have to go in and be somewhat entertained by it.

"I made the choice to work football, so I don't expect the players or coaches to totally clean up and do things differently than they would if I was a guy," Stanley-Green continues. "I always expected them to not sexually harass me, but I wouldn't expect them to curb what they were talking about just because I'm a woman."

Iso agrees. Asking players or coaches to change their behavior too much may result in them being less enthusiastic about having a female on the athletic training staff.

"Sometimes if I'm standing right next to a coach and they yell at a player, they'll kind of apologize to me afterwards for using that type of language," Iso says. "But I usually say I don't care and I don't take that personally. My advice is to not react. Don't make it a big deal. I don't want them to change because I'm standing on the field."

For all football athletic trainers, occasional disagreements with the coach are just part of the relationship. Maybe you think the players need a water break, but the coach doesn't. Or you refuse to clear an athlete to return to play, and the coach isn't happy about it.

Whatever the source of contention, Harrington has found a difference in the way male coaches perceive disagreements with male athletic trainers versus female athletic trainers. She's discovered that she needs to make it a point to assure the coach the difference of opinion won't be a long-term problem.

"If I'm upset with a coach, they may think that I'm going to hold a grudge against them the way their sister or wife might," Harrington says. "If there is a disagreement, I have to let things go quickly and joke around with the coach so he knows that it's over.

"When I'm telling a coach one of his athletes can't play, I'm telling him what he can and cannot do," she continues. "I think sometimes they don't like hearing that from a woman. Some men don't really know how to accept that a female challenged them."

SPORT SMARTS
Since few female athletic trainers have played football themselves, it may be assumed they don't know much about the sport. But you can show the players and coaches otherwise.

"Knowing the sport does help earn credibility," says Pugh. "We have to be able to talk to players and coaches in their unique language. It's also hard to lead someone through functional rehabilitation if you don't understand the position requirements of a linebacker versus a defensive end."

Mary Tovornik, MA, ATC, Associate Athletic Trainer at Stony Brook University, agrees. "I've been around football a long time and I've always tried to learn about it as much as I can," she says. "The way you express things to the coaches and players, such as your understanding of the differences between positions and your knowledge about how to modify a practice based on a certain injury is key."

Stanley-Green suggests sitting in on as many coaches' meetings as you can to build up your football knowledge and vocabulary. "That's a huge part of gaining respect," she says. "You have to understand the demands of the sport. As much as anything else, that really helped me work with the assistant coaches. I was pretty good at watching the quarterbacks, for example, and seeing when they were dropping their arm a little bit. Once you can notice things like that, coaches realize you're really watching and that helps gain their respect."

In addition to positions and practice demands, it's also important to know the rules. "If I didn't know things like first down, timeout, and when to be where on the field, I think I would be mocked for a long time," Harrington says. "It would be hard to overcome that as well as the general gender issues. I also make sure I know what's going on in college and professional football. I can get into the players' conversations and show that I'm a football fan and I know the sport."

CREATING CONNECTIONS
Above all else, being successful as a female athletic trainer in a male-dominated sport comes down to building relationships with the people you're working with. If a coach or player knows you have their best interests in mind and has confidence that they will be treated properly, many problems can be avoided.

"The biggest thing is finding a way to connect with each person," Tovornik says. "Once they see that you're there because you like what you do and you're giving 100-percent effort, you can gain their trust. And when they see that in action, there won't be as many barriers."

Last season, the football team at Cedar Ridge featured upwards of 200 players. Harrington did her best to develop a connection with each of them.

"I really focus on building relationships with the players, to make sure they understand when they come to me I'm going to treat them like a man and not a little kid," she says. "To create that comfort level, I try to make them laugh. I feel like if I can make a player laugh even when they're hurting, they'll be more comfortable during a time of crisis. Once they're relaxed with me, then they can see my knowledge.

"I like to banter back and forth so they know I'm a human," Harrington continues. "If I can do that, they understand there's a person here who really cares about their life and what happens to them."

Building the right relationships takes on even more importance if you're in your first season working with a team or are a young athletic trainer just breaking into the field or working as a student. "I get discouraged when I see a female student who isn't acting professionally all the time. It feeds into the stereotype that women can never work with a male sport," says Tovornik. "If a female student's mind is on the wrong track or she's not there for the right reasons, it affects how she's being perceived by others."

Stanley-Green speaks with young female students about existing stereotypes early and often. She emphasizes that displaying confidence in yourself will inspire confidence from others.

"I go absolutely crazy when some of the smaller women look at the big guys and say things like, 'Oh, his leg is so heavy, I don't know if I can lift it,'" Stanley-Green says. "You never say you can't do something. You have to find a way. There's no one I've ever worked with who's too big to stretch or tape or evaluate. There's always a way."

Perhaps one of the most common stereotypes facing female athletic trainers working with male athletes is that they are there looking to meet men. While that's almost never the case, females have to do everything possible to protect against that perception.

"I'm a very strong supporter of female athletic trainers, but I'm also a believer that women are sometimes their own worst enemies," Stanley-Green says. "Those athletic trainers who go into the athletic training room and end up sleeping with the players send us a step back."

Having appropriate relationships means never crossing that line. "Women have to be above being there to pick up guys and using the athletic training room as their own personal Match.com," she continues. "In my 15 years at Kentucky, I always felt like my job could be taken away from me at any time. I was very protective of the females who were in our program as grad assistants, other assistants, or students. I always felt that if they crossed that line in some way, the athletic department could just declare that no more females could work football."

Tovornik also warns that feeding into other stereotypes can be harmful, even if the conduct itself appears innocent. When she senses a problem developing, especially involving one of her athletic training students, Tovornik is very direct in stopping it.

"An athletic trainer's primary reason for working with football players can't be to socialize or make friends for the weekend," she says. "The primary reason is to learn more about athletic training. Sure, you'll get to know these players because you're with them more than you're with anyone else, but you can never let it cross that line."

MOVING FORWARD
Although there are more female athletic trainers working with male teams at the high school and college levels now than ever before, there is still a lot of room for growth. Iso, who in 2002 became the first full-time female athletic trainer in the NFL when she began working with the Steelers, offers some advice for those interested in following the path she paved.

"You need to ask yourself why you want to do this," she says. "Some people just want to be a rare female in a male environment. But I think that's the wrong approach. You should want to be a good athletic trainer regardless of gender or the sports you work with. I never planned to specifically work in the NFL. It just happened that way."

For females who are interested in working with football, she suggests working toward that goal from the get-go. "If you want to work with professional football, you should apply for football experience at any level or professional experience in another sport," Iso says. "When someone is looking at a resume, they look at experience with the sport or at that particular level."

As this trend continues, there should be more opportunities in the future. "The culture and stereotypes are certainly dissipating, as the football players who've worked with female athletic trainers are becoming coaches and athletic administrators," Pugh says. "The attitude of players is also changing as more and more high schools have female athletic trainers, so when guys get to college, I'm not the first female athletic trainer they've worked with."


Sidebar: MOM AND DAD
Talk about a dynamic pairing. When Sue Stanley-Green, MS, LAT, ATC, worked as an athletic trainer with the football team at the University of Kentucky, her husband was the school's head athletic trainer.

"Our experience was that I had my players and he had his, and then there were some who bounced back and forth between the two of us," says Stanley-Green, who now directs the Athletic Training Education Program and is an Associate Professor of Athletic Training at Florida Southern College, where her husband serves as Associate Athletic Director and Head Athletic Trainer. "It was almost a mom and dad sort of thing."

Stanley-Green found that the players who gravitated toward her were most often the ones who were raised by a strong female figure, such as their mother or grandmother, and might not have had a father around. Meanwhile, the athletes who grew up with a strong father in the family were most comfortable with her husband.

"It was an advantage for some guys to have a female athletic trainer because they felt more comfortable with me," Stanley-Green says. "My husband and I really developed the attitude that athletes should have access to both a male and a female athletic trainer, because they tend to be more comfortable with one or the other."


Sidebar: COMFORT ZONE
One area where any female athletic trainer working with a male team may need to take extra precaution is in the locker room. For Mary Tovornik, MA, ATC, Associate Athletic Trainer at Stony Brook University, keeping players comfortable with a female in the locker room is all about focusing on the task at hand.

"I have to do my job, so there are times I have to go into the locker room," she says. "I just keep my head down and find the player who needs my attention. There are times I'll send a male assistant or student in. If I don't need to put myself in that situation, I won't. But if there's a medical need, I'm going in."

It's also important to put the male athlete at ease if his injury is in a sensitive area. "If something needs to be looked at in the high groin region, I'll make sure I have a male with me, usually an assistant athletic trainer or student," Tovornik says. "I not only have to protect myself, but also make the athlete more comfortable."

At the high school level, discussing an injury to a sensitive area can be easier for the athlete if the athletic trainer leads the conversation. "It's usually pretty obvious what's wrong once you've seen that look on a kid's face a few times," says Melissa Harrington, MEd, LAT, ATC, Head Athletic Trainer at Cedar Ridge High School in Round Rock, Texas. "So instead of forcing them to tell me what's wrong, I ask if this or that hurts. They're more likely to answer a yes or no question than to come out and tell me what the problem is themselves. Sometimes they're embarrassed, so it works much better if you can lead them through it."

Above all else, take the athletes' concerns seriously. "It's important to make sure you respect people's boundaries and establish their comfort zone for evaluation," says Kelli Pugh, MS, ATC, LMT, CES, Associate Athletic Trainer at the University of Virginia. "Most of our evaluations happen in an open athletic training room with lots of people around. It's not a closed door, one-on-one situation. But it's still important to tell them or show them what you'd like to check and ask permission before starting the evaluation."



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