Written by Joshua Berg, LAT, ATC
The profession of athletic training has evolved significantly from its early beginnings in ancient civilizations to the highly specialized healthcare field it is today. Sports Medicine began with the Greek and Roman physicians who treated athletes and soldiers. Athletic Training formally emerged in the late 19th and early 20th centuries as organized sports gained popularity. Over time, advancements in medical knowledge, injury prevention, and rehabilitation techniques have transformed athletic trainers into essential healthcare professionals. To understand this rapidly evolving profession, it is essential to explore its origins. In 1869, Rutger’s and Princeton Universities introduced football to the United States. After 18 deaths and 159 serious injuries, President Theodore Roosevelt threatened to ban football as an intercollegiate sport in 1905. In response, universities sought to improve care and injury prevention for the rapidly growing sport by hiring individuals to take on the role of athletic trainer.
The Early Roots and Evolution of Athletic Training
Samuel E. Bilik is considered a pioneer in reshaping perceptions of the ATs responsibilities. In 1917, he published The Trainer’s Bible, widely regarded as the first book on athletic training. It would be impossible to discuss the early years of the profession without mentioning the contributions of the Cramer brothers, Charles (“Chuck”) and Frank. After traveling with the U.S. Olympic team in 1932, they launched The First Aider, a newsletter that covered topics ranging from the state of the profession and emerging trends to injury treatment and prevention in athletics.
From the outset, it was understood that for the profession to advance and gain national recognition, ATs needed to collaborate on a national level to establish minimum standards of practice and provide a platform for idea exchange. The first attempt to organize occurred at the Drake Relays in Des Moines, Iowa, during the spring of 1938. However, as the development of the first NATA was gaining steam, World War II had begun, disrupting efforts to establish a national governing body. The initial attempt to develop a national organization slowly dissolved, and by the war’s end, discussions had faded. Despite this setback, efforts to organize reemerged at the regional level, gradually gaining momentum. Eventually, 101 ATs from regional conferences gathered in Kansas City, Missouri, officially forming the NATA.
Modern Advancements and the Future of Athletic Training
Under the leadership of William E. “Pinky” Newell, NATA’s executive secretary in 1956, the foundation of the modern athletic training profession was set. Key milestones followed, including the establishment of a scholarly research journal in 1956, the adoption of a code of ethics in 1957, and the approval of an athletic training curriculum in 1959. These efforts culminated in 1967 when the American Medical Association (AMA) recognized athletic training as a professional organization. It wasn’t until 1990, however, that the AMA would formally recognize athletic training as an allied healthcare profession.
By 1970, four schools had submitted their curricula for evaluation and approval by the NATA. As the profession continued to evolve, a national certifying exam was introduced in 1971. Many ATs at the time, particularly those who were trade-trained, opposed this move toward professionalization, as they witnessed the profession undergoing drastic changes. However, visionary leaders responsible for shaping the profession saw it as the only path to achieving a respected credential comparable to other allied healthcare fields. The certification examination and ATC credential were managed by the NATA until 1989, when the independent, nonprofit Board of Certification (BOC) assumed responsibility. The BOC was better equipped to assure the public that ATs met and maintained the minimum competency requirements through continuing education— a practice that remains in place today.
According to the BOC in 2023, there were nearly 60,000 certified athletic trainers (ATC), with an NATA global membership of 30,000. This number has likely grown since the last report. The U.S. Bureau of Labor Statistics projects a 17% job growth over the next decade, largely due to ATs versatility and highly transferable skill set.
Currently, ATs work in over 40 settings both nationally and internationally, with athletics having the highest concentration at 45%. Other sectors, such as occupational health and the armed forces, continue to gain interest. The profession’s growth potential is limitless, especially as employers increasingly recognize an athletic trainer's ability to prevent injuries, manage risk, and rehabilitate injuries.
The evolution of the athletic training profession has seen significant advancements in medical knowledge, education, and recognition as an essential component of sports and healthcare. From its early roots in ancient athletic competitions to its formalization in the 20th century and continued growth in modern medicine, athletic trainers have played a crucial role in injury prevention, treatment, and rehabilitation. Today, they are highly trained professionals who work alongside physicians, coaches, and athletes to ensure their health and safety. As the field continues to expand with new research and technology, the impact of athletic trainers will only grow, further solidifying their place in the landscape of sports medicine and healthcare.
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References
Haig. “The National Athletic Trainers’ Association Explained.” Go4.io, July 3, 2020. Read here.
National Athletic Trainers’ Association. “NATA Archives.” NATA.org. Access here.
National Athletic Trainers’ Association. “NATA History.” NATA.org. Read here.
Peterson, Connie L. “Athletic Training.” Principles of Athletic Training: A Competency-Based Approach, edited by William E. Prentice, 13th ed., Jones and Bartlett Learning, 2005. Read here.
Sitzler, Beth. “The Diamond Legacy: Timeline Explores the Last 75 Years of NATA History.” NATA News, Jan. 2025.
Sitzler, Beth. “The State of Employment in Athletic Training.” NATA Now, National Athletic Trainers’ Association, March 2023. Read here.
TCU Harris College. “Athletic Training: 50 Years of Impact.” Harris College of Nursing & Health Sciences, 2022. Read here.