With athletic trainers in short supply, Mass General Brigham program comes to the aid of high schools

Athletic trainer Jonathan Raskow (left) examines the status of a recent injury suffered by Tri-County student Emmaline Lafleur.Jim Davis/Globe Staff

FRANKLIN — Jonathan Raskow doesn’t watch sports like a spectator.

When the Tri-County Regional athletic trainer is perched on the sideline of a high school game, he’s often focusing on specific players, and their knees, ankles, or other areas susceptible to injury, instead of the ball or the play.

“A lot of times, I don’t know if we caught the ball,” Raskow said. “A lot of times, I don’t know if we scored. My eyes are on something else.”

Raskow is in his second school year as the athletic trainer at Tri-County, which contracted through Mass General Brigham’s department of athletic training and sports medicine outreach.

The program supplies 35 school districts (approximately 50 high schools) with nearly 100 full-time, part-time, and per-diem athletic trainers. It helps schools in need of certified athletic trainers meet the high demand and secure qualified professionals. Mass General Brigham even offered free physicals to more than 70 Boston Public Schools student-athletes last August.

Mass General Brigham’s outreach program works from its associated hospitals, which extend from Boston, to Cooley Dickinson in Northampton, up to Wentworth-Douglass in Dover, N.H., and down to Spaulding Rehabilitation in East Sandwich. The hospital reaches an agreement with an interested school to contract out an athletic trainer, but the intent is to help cultivate a long-lasting partnership.

“As we develop relationships with our schools, we look to make sure that the school feels as if the athletic trainer is a member of their staff,” said Mike Belanger, director of athletic training and sports medicine outreach.

Until recently, Tri-County only had a CPR-certified aid on call, not a licensed athletic trainer. The school is in the fourth year of its partnership with Mass General Brigham.

Raskow’s typical work day starts around 10 a.m., when he logs on to Mass General Brigham department meetings and works on hospital initiatives. He then heads to Tri-County in the mid-afternoon to be on-site for home competitions and practices.

Last Monday, a lighter day of athletics, Raskow kept an eye on the Cougars’ varsity and JV girls’ basketball games, as well as a wrestling practice in the school’s practice room next to the gym. He advised student-athletes who came to him with minor aches and pains and checked in with a few others on their injury recoveries.

Other days and seasons can be more intense. It’s not unusual for a student to see Raskow sprinting across the school from one practice to another if he hears of a player suffering a serious injury.

“It is a thing — they’ll swing the corner and they’re usually saying, ‘John!’ before they get around the corner, so I have a sense of what’s going on,” he said.

Raskow, a Salem, N.H., native, has spent 15-plus years in Massachusetts as part of various athletic trainer outreach programs, with a brief stint in New Jersey as a hospital-based athletic trainer. He’s seen the full spectrum of injuries during his career, including players losing consciousness, temporary blindness from head injuries, neck and spinal injuries, and compound fractures.

When the worst happens, Raskow and the school are prepared with an Emergency Action Plan. Tri-County’s EAP is a 20-page, step-by-step guide for who to call, where to go, and what to do in emergency situations. Every school in the state creates a unique EAP.

Raskow’s game-day cart includes bandages, gauzes, slings, and larger instruments, including an automated external defibrillator and devices for removing football players’ facemasks to access their airways. One of his most important tools, however, is his calm demeanor, which proves valuable when athletes are at their most vulnerable.

“Calmness is contagious,” Raskow said. “So when I go out there, I’m very calm. And if you have the rapport with the athletes and the staff that you should as an athletic trainer, it gets easier when you get out there and they can breathe a sigh of relief.”

Tri-Country athletic director Sara Martin appreciates that rapport. She’s been the Cougars’ AD for five years after coaching soccer, basketball, and track.

“Jonathan takes care of everything,” Martin said. “Communication with parents, communication with doctors — he really is our health center hub down here. I don’t know how you do it if you don’t have someone every day on staff.”

Not every school has such a luxury. The MIAA handbook says members schools should employ an athletic trainer, but it is not an absolute requirement (though football games are required to have at least one athletic trainer present). Teams still host competitions without athletic trainers and sometimes suffer the risks. Tri-County recently had a girls’ basketball player dislocate her shoulder at an away game with no athletic trainer present; the best thing the player could immediately receive was a bag of ice.

Senior Hannah Clarke tore her anterior cruciate ligament in a soccer collision this past fall at an away game with ice on hand, but no athletic trainer.

“My coach and one of my teammates had to help me off the field,” Clarke said. “And then the assistant coach helped me to my mom’s car, and we decided to go to the doctor because I’d never felt this pain before.”

The broader problem remains that the demand for athletic trainers far exceeds the supply — hence the specific wording in the MIAA’s handbook.

Athletic trainers work long, unconventional hours, and independent employees are often underpaid. Martin recently saw two athletic trainers take on an entire 10-hour, 20-team wrestling tournament at Bellingham.

“If you have a young family, how do you balance all of those things?” she asked. “I think people get into it for love of sport and love of medicine, but then just the demands I think, really, are difficult for a lot of people.”

Belanger, a former 11-year athletic trainer at Walpole, recognizes those challenges. He adds that entry-level education standards for athletic trainers have increased to a master’s degree requirement, meaning a higher barrier to enter the field and more student loan debt along the way.

“And from a demand perspective, I think COVID also showed the value of the athletic trainer and health care provider to athletic programs,” he added. “And I think that helped increase the demand for athletic trainers on the other side of athletics opening back up again.”

Buffalo Bills safety Damar Hamlin’s recent collapse and hospitalization shone a spotlight on the life-saving importance of athletic trainers. Martin wants to reinforce their vital status.

“I think that people still don’t understand all of that what they do,” Martin said. “They just look at them as, ‘Oh, [Raskow] just stands on the sideline, and if a kid gets hurt, he helps him or her.’ That’s only a small portion of what he does on a daily basis.”

“I think that people still don’t understand all of that what they do,” said Tri-County Regional AD Sara Martin of athletic trainers, including Jonathan Raskow (above, center, working a junior varsity girls' basketball game). “They just look at them as, ‘Oh, [Raskow] just stands on the sideline, and if a kid gets hurt, he helps him or her.’ That’s only a small portion of what he does on a daily basis.”Jim Davis/Globe Staff

Jonathan Raskow has a collection of depressors taped on the wall of his office, and when he leaves he attaches the appropriate location on his office door (below).Jim Davis/Globe Staff

“Calmness is contagious,” said Tri-County athletic trainer Jonathan Raskow. “So when I go out there, I’m very calm. And if you have the rapport with the athletes and the staff that you should as an athletic trainer, it gets easier when you get out there and they can breathe a sigh of relief.”Jim Davis/Globe Staff