When Buffalo Bills safety Damar Hamlin collapsed following a hit in a game against the Cincinnati Bengals on Jan. 2, a spotlight was cast on the need for certified athletic trainers at all levels — from high school to the pros.

Shortly after Hamlin’s close call, Denver 9News reported that most Colorado high schools don’t have a certified athletic trainer — or CAT — on-site at sporting events, typically claiming a lack of funding for these services.

Fortunately for Moffat County, the school district offers a depth of athletic training services to its student athletes, according to local CAT Matt Hertz.

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Hertz provides CAT services for Moffat County School District under a contract with Memorial Regional Health, which receives a small reimbursement of $1,000 per sports season for the athletic training services.

In the offseason, Hertz fills other needs for sports medicine at MRH.

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According to Hertz, a key part of his athletic training work is to remain “calm in the storm,” and not only respond calmly to injuries and emergencies, but to try to keep the parents and coaches calm, too. 

The condition that caused Hamlin to go into cardiac arrest on Jan. 2 is called commotio cordis, which means he took a hit at the precise moment in his cardiac rhythm that caused his heart to stop. Hertz said that the condition can happen to any athlete playing a contact sport — the impact just has to occur at the exact moment.

“I imagine when (Hamlin) recovers, he will bring more awareness to that particular injury and problem,” Hertz said. 

On Jan. 2, the assistant athletic trainer immediately delivered CPR and used an automated external defibrillator on Hamlin, an action that medical experts credit for saving the 24-year-old athlete’s life. 

Depending on the extent of the damage that was done to Hamlin’s body for the minutes he was without oxygen, Hertz said he can see Hamlin making a full recovery and being cleared to return to the field. 

“I think the problem with him coming back is going to be more of a mental barrier for him than physical,” Hertz said. “That happens with any significant injury, there’s a mental side of the care that a lot of people don’t realize we have to check.” 

Many athletes who recover from anterior cruciate ligament, or ACL, injuries, experience the same thing, Hertz said. Getting back on the field, athletes have a fear of getting hurt again and often have to relearn to trust their body after the injury. 

“If you play scared, you’re going to get hurt,” Hertz said. “If you play scared, you’re going to play tense, and you’re not going to play well.” 

Looking out for the athletes, above the sport

Hertz, who studied athletic training at New Mexico State University, has been the trainer for MRH and Moffat County schools for four years. Prior to coming to Craig, Hertz worked as a trainer in the Denver area and at Columbine High School in Littleton. 

“I don’t take my job lightly,” said Hertz, who is the trainer for the middle school and high school sports teams including baseball, soccer, volleyball, basketball, track, wrestling and football. 

Hertz attends all of the Moffat County home games, and he travels with the high school football team on away games. There is a risk for injury in any sport, but football has the highest number of players and is the most full-contact sport. 

When he’s working games, Hertz tries to blend in on the sidelines, watching players on both sides as he keeps an eye out for any kind of medical needs.

As a trainer, Hertz said he acts as a buffer, focusing on the medical knowledge, which takes stress off coaches so they can focus on the game. That’s another reason why Hertz travels with the Bulldogs football team, to take that same pressure off coaches from other schools that might not have certified medical trainers. 

While Colorado High School Activities Association requires high school teams to have an emergency action plan for each sports venue, schools are not required to have CAT services at games or during sports seasons. 

CHSAA requires that all coaches be trained to deliver CPR, use an automated external defibrillator machine and deliver first aid. And the emergency plan should include a CPR guide, locations of AEDs machines and instructions for how to get ambulances in and out of the venue.

Emergency plans should also identify a lead person to carry out the plan, but it doesn’t require that person to be an athletic trainer. 

Most athletic trainers are contracted by outside entities, which helps ease the cost for schools and provides appropriate support for trainers to be effective working with athletes. Trainers also need an institution to serve as medical oversight.

Aside from the MRH contract with the school district, Hertz works with club sports such as the local hockey league and the Rising Star Gymnastic Center, both sports that tend to see a good number of injuries. 

Hertz can also have to make tough calls about taking athletes out of games when they are injured, which can sometimes go against the wishes of the coaches, parents or the athletes. 

“A lot of times, I have to be the one to say, ‘It’s just a game,’” Hertz said, adding that his priority is to keep athletes safe. 

In addition to being the first response for injuries, Hertz continues to work with athletes through recovery, and helps determine when they are ready to start playing again.

Being on staff at the hospital allows Hertz easy access to resources and referrals for athletes on matters outside of his scope of practice, and he can help athletes and their families navigate higher levels of medical care. 

Return to Play

Hertz serves on the local concussion group, which meets monthly to review individual concussion cases and determine when the students can return to different activities. 

“It’s not just for athletes; it’s for students who get a concussion in or outside of school,” Hertz said. “We’re another set of eyes on the students to determine how they should return back to activities.” 

Among medical professionals, concussions still have so many variables that treatment takes an individualized approach, but there is still a standard protocol to follow whether the concussion is major or minor. Hertz said concussions on a developing brain come with additional concerns, so the cases are monitored closely.

Hertz said the best way to prevent injuries is to ensure athletes are trained for their sports. For football, that can mean training in proper hitting and falling techniques, and making sure players have the proper equipment. However, concussion prevention is still not an exact science. 

CHSAA has mandated fewer hours of impact plays during football practice, under the theory that fewer hours will produce fewer incidents. But Hertz said some coaches argue that athletes need more practice on how to hit properly to prevent injuries during games. 

Hertz said he can be the objective “bad guy” in concussion cases, often advocating to keep athletes out for an adequate amount of time to prevent additional injuries. 

“I am always looking five years down the road, to what the long-term effects are going to be,” Hertz said. “Young people don’t think in that kind of time frame.”