You are here

CSMAS recommendation empowers medical staffs

Recommendation would give athletic trainers, physicians unchallengeable authority

The NCAA’s committee responsible for student-athlete health and safety took steps at its summer meeting to better establish medical personnel as authoritative decision-makers in college sports.

During its meeting June 15-17 in Dallas, the Committee on Competitive Safeguards and Medical Aspects of Sports approved a series of recommendations that build on legislation passed by the NCAA’s five autonomy conferences earlier this year and would establish athletic trainers and team physicians as unchallengeable decision-makers for medical management and return-to-play decisions related to student-athletes. The recommendations would also create a new designated position on campuses – an athletics healthcare administrator – which would ensure campuses are following established best practices for medical care.

“Over the last three years, the committee has consistently worked to empower primary athletics health care providers and championed organizational structures that ensure independent medical care for student-athletes,” said CSMAS chair Forrest Karr, athletics director at Northern Michigan University. “These recommendations are another step in the process. We envision a future where each member institution, in all three divisions, will designate an athletics healthcare administrator responsible for ensuring that their school’s policies and procedures follow inter-association consensus recommendations and comply with all NCAA health and safety legislation.”

The committee crafted its recommendations by working from legislation that was passed by the five autonomy conferences in Division I at the 2016 NCAA Convention. That legislation will take effect Aug. 1 and provides unchallengeable autonomous authority to team physicians and athletic trainers at schools in those conferences to determine medical management and return-to-play decisions related to student-athletes. The remaining conferences in Division I currently have the option of applying that legislation.

The CSMAS recommendations aim to shape the intent of that legislation into a consistent standard across college sports. To get there, CSMAS made three recommendations:

  • One recommendation encourages leagues outside the autonomy conferences in Division I to apply the autonomous legislation passed in January. The recommendation asks that those conferences opt in to the legislation by Aug. 1, 2017.
  • A second legislative recommendation asks the Division I autonomous conferences to clarify the bylaw passed in January by changing the name of its oversight position – called a director of medical services in that legislation – to athletics healthcare administrator. The name change was requested out of concern that the position could be confused with the title of “medical director,” which is established elsewhere in NCAA bylaws.
  • A third recommendation asks Divisions II and III to sponsor legislation similar to that passed by the Division I autonomous conferences to establish the athletics health care administrator position and provide team physicians and athletic trainers with unchallengeable autonomous authority to determine medical management and return-to-play decisions related to student-athletes. The committee stressed that the health care administrator role may be given to an existing staff member rather than create an additional administrative position.

CSMAS recommendations follow those from other organizations in recent years which called for physicians and athletic trainers to have the ability to make medical decisions without fear of interference from coaches or other athletics personnel.

In 2014, the Journal of Athletic Training published interassociation best practices – of which the NCAA’s Sport Science Institute was included as an endorsing organization – which included giving physicians and athletic trainers authority to make medical decisions for student-athletes. That document was published at a time when a national survey conducted by the Chronicle of Higher Education documented that athletic trainers, in particular, function under the heavy influence of the coaching staffs: Thirty-two percent of respondents indicated the head coach influences their hiring; 42 percent reported feeling pressured to return a concussed athlete to play early; and 52 percent reported feeling pressured to return injured athletes early.


CSMAS recommended to the Women’s Lacrosse Rules Committee a language change in the women’s lacrosse rule book that would require any protective headgear worn in competition to meet a new women’s lacrosse headgear standard adopted by the American Society for Testing and Materials. The change was recommended by U.S. Lacrosse, which worked to develop the standard and later petitioned the CSMAS to recommend the change. The final decision on any recommended changes will be made by the Women’s Lacrosse Committee and by the Playing Rule Oversight Panel.

No headgear now on the market meets the required ASTM standard, but the committee was told by U.S. Lacrosse that equipment manufacturers anticipate having acceptable headgear available sometime in 2017. Women’s lacrosse now allows any soft headgear to be worn with no standard requirement.


CSMAS approved a change in its championships drug-testing protocol to allow teams whose games finish after 10 p.m. to defer their drug tests until the next morning at the arena testing site as long as the tests start by noon. The protocol previously required tests to start by 10 a.m.

The decision was made after the committee considered a request from the Division I Men’s Basketball Committee. The committee felt it was important to update championship drug testing protocol to provide more flexibility for schools and to allow additional rest for student-athletes.

In other decisions:

  • The committee recommended that the NCAA Sport Science Institute review all championships manuals and identify health and safety concerns it believes need to be addressed. The committee asked the Sport Science Institute to bring its report to the committee at its December meeting.
  • CSMAS recommended making an editorial revision in all three divisions to rename the “street drugs” class on the list of banned substances to “illicit drugs” because the committee felt the longstanding name was outdated and cast inappropriate perceptions of those drugs’ users. The revised drug class will include marijuana, synthetic cannabis and heroin, and other related drugs of abuse.
  • The committee supported a legislative recommendation that Division II establish a single person as a campus expert on nutritional supplements and banned drugs guidelines. That expert would educate staff that interact with student-athletes about the presence of the NCAA’s list of banned substances and the affect that taking supplements can have on their eligibility.