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Athletic trainers have come a long way

Modern position is now much more sophisticated

By Nick Cafardo
Globe Staff / March 27, 2011

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They didn’t have HIPAA, or laser treatments, or medical plans back in the old days. It was simply tape up the ankle, rub down the arm, and get out there and play. Oh, how things have changed.

“It’s definitely more sophisticated even from the time I started in the early 1970s,’’ said longtime Yankees head trainer Gene Monahan. “There’s been a lot of new innovations with technology that have helped in treating the players, but we still incorporate some of the old-fashioned methods as well.’’

The athletic trainer in baseball has become more educated, requiring more qualifications and certifications. Training staffs have grown into monstrosities, including physical therapists, masseuses, psychologists, and strength and conditioning coaches. There’s more paperwork to be done, more information available on treatments for what ails you. There’s more direct contact with team physicians and specialists and the trainer often has to carry out the rehab plan for a player returning from injury.

Gone are the days when, as one former player put it, “the trainer used to have a big jar of greenies and he’d say ‘Take a few of these, they’ll make you feel better to play.’ ’’ In the late 1980s and into the ’90s, trainers were dealing with players who were suddenly bigger and stronger.

“Because trainers were so close to the players from a physical point of view, I’m sure they knew of steroid use, but looked the other way,’’ said one former player of that era.

All medical dealings are documented now. Trainers must pore over records and daily reports. Their days often start before noon for a night game and don’t end until well after midnight. They still do the mundane stuff like wrapping ankles, rubbing out knots in muscles, and massaging joints. There’s a great respect for the profession. Commissioner Bud Selig has taken a personal interest in trainers and medical staffs, holding meetings twice a year to discuss any issues they may have.

Red Sox head trainer Mike Reinold, a Boston area native who holds a doctorate in physical therapy, is one of the more modernistic trainers in the game and is constantly upgrading his portfolio.

“Constantly, every day. That’s actually a big, big theme that we have in our medical department: continuing education and professional development,’’ Reinold said. “We challenge each other, minor league trainers on up. We have e-mail chains to check out different websites. We’re always taking classes or going to seminars. We try to get to at least one a year and usually it’s two or three. We try and bring in prestigious guests in their fields to do presentations for us. You want to get a lot of perspectives.

“The one thing we know is we don’t know everything. We’re always striving to get better.’’

Monahan started with the Yankees in 1973 and is their only current employee to have started with George Steinbrenner. He is a legend in his field. He has transitioned from the old days to the modern days without a hitch. In 2010, Monahan and longtime assistant Steve Donohue were named trainers of the year by the Professional Baseball Athletic Trainers Society.

Yankee players love and respect Monahan. He’s so ingrained as a Yankee that Joe Torre asked him to give an inspirational talk to the team right before Game 7 of the 2001 World Series against the Arizona Diamondbacks. He’s more than just a trainer.

“He’s part of the family,’’ said Derek Jeter. “I can’t imagine walking in here and not seeing Geno.’’

For a while, Monahan was absent while he underwent treatment for throat and neck cancer. He missed Opening Day last season, the first one he’s missed in 48 years dating to when he was a Yankee bat boy.

“The players are bigger and stronger now,’’ Monahan said. “Our staff is bigger. We now have therapists and massage people. The doctors are more involved with the trainers than they used to be. We work hand-in-hand now. Things are much more complex now. Players are smarter about their bodies and what they need from a trainer than in the old days. You now need a college degree and you have to be certified. Those weren’t requirements years ago.’’

Monahan said he still incorporates some of the “old stuff’’ in with the new.

“I make sure the players know that way back in the day so-and-so used to do this after he threw, and once in a while a player will want to try something like that,’’ he said. “Sometimes players didn’t like to ice their arms after they threw so I’d give them an alcohol splash and a baby-oil rub. It worked for Whitey Ford and Luis Arroyo. That’s what they used to do. Few guys do that now, but I make it available for anyone who wants to try it.’’

Red Sox minor league pitching consultant Tony Cloninger, a 24-game winner for the Milwaukee Braves in 1965, remembers after pitching having an “Atomic Balm’’ — a substance that would create intense heat on the shoulder.

“I know that did the trick for me,’’ Cloninger said. “I never iced, maybe my elbow once in a while, but we did very basic things to make us feel better and get us out on the field. Now it’s pretty sophisticated.’’

The biggest changes have come in equipment. One American League trainer estimates that there are three times more MRIs and CT scans administered than “15 years ago’’ because “there’s so much more at stake. The players are making so much money that they’re a huge investment.’’

Medical staffs now have a centralized database where they can access medical data of any player in baseball. The database was pushed for many years by Dodgers trainer Stan Conte.

Trainers must constantly update medical records, record every treatment they administer. There’s always a plan for treating a specific injury, usually mapped out by the team physician but normally executed by the training staff. Years ago, you got treated and you went back out on the field.

“When I came up to the big leagues we had a trainer with these big, huge hands and you almost didn’t want to go to him because he hurt so much,’’ said legendary Red Sox third baseman Frank Malzone. “Most of it back then was rubdowns to relieve stiffness or soreness. There wasn’t anything too complicated like today.’’

In the old days there was no HIPAA Act — which protects health information from being leaked to the public — to worry about. Trainers were free then to discuss player injuries publicly and they spent a lot of time with the media. The HIPAA Act has just about put a muzzle on trainers. Medical information has to be handled with privacy and care.

The biggest change for trainers has come in injury prevention.

“In the old days you showed up and got in shape in spring training,’’ said Monahan. “Now you’re in shape when you get here. The training staff has a program for rest after the season, conditioning in the offseason, and then a conditioning and maintenance program during the season. It’s different. Very different.’’

Nick Cafardo can be reached at cafardo@globe.com. Follow him on Twitter @nickcafardo.

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