Career of an Independent Athletic Trainer
Level 1: Amateur
Welcome Players! There are many available opportunities to succeed both professionally and personally as an Athletic Trainer. So what’s the problem? Most newly-certified ATC’s have no idea they exist! This post is guest-written by a Certified Athletic Trainer who saw the plight that the traditional setting for Athletic Trainers offered and decided that he would seek out better opportunities on his own. He recounts his journey of discovering a passion for musculoskeletal healthcare, the financially-scarce lifestyle he considered in traditional settings, and the validation and abundance that came once he established his independent business.
Please welcome Harrison Kheun to the writer’s circle!
Coaches note: This article is written entirely by Harrison. It has been lightly edited for clarity to the reader by me. All emphasis (bold, italics, etc.) has been added by me. Comments included by me have been delineated with the quotation box in green, such as this paragraph.
Discovery of Athletic Training
AT in PT Clinic
Independent Athletic Trainer
Life as an Entrepreneur
State of Athletic Training
Message to You
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Discovery of Athletic Training
Sometimes, when something “bad” happens to you and it seems like it’s the worst day of your life, it can turn out to be one of the best things that ever happened to you.
I remember that moment for me like it was yesterday.
Cold winter day in the San Francisco Bay Area (so yeah, not THAT cold), sitting in my dad’s truck in the hospital parking lot, tears flowing down my face.
Fractured wrist, left scaphoid, full arm cast.
I was devastated, my basketball season just ended abruptly, and my baseball season was undoubtedly a lost cause. Was this going to be the reason I didn’t get to play college baseball? Am I still even a part of the team? If I’m not a part of the team, will my teammates and friends even want to hang out with me? How long will it be before I can play again? And what the hell am I going to do until then?
If you’ve ever been an injured athlete, you know how quickly the mind can start circling the drain, and how important sports/competition/camaraderie/physical activity is to your daily life, your identity, your psyche.
I should have considered myself lucky. I would have bet my life savings (couple hundred dollars maybe? Give me a break I was 14) that I broke both wrists, but they assured me the right wrist was just a sprain.
Turns out the right one was broken too. When they finally took an x-ray of it after 6 weeks and no improvement…
“Oh yeah, that’s a clean fracture of the scaphoid”
“Yeah, thanks a lot Doc!”
One cast turned into two casts, and I was effectively about as physically capable as C3P0.
Don’t worry, it gets worse.
When I finally got my casts off, I was so excited to start physical therapy. I was going to attack it like I did practice or the weight room, give it everything I had, I was ready to be pushed again and get back to action ASAP.
They called my name and I walked with the PT down the hall to the gym, a gigantic state-of-the-art facility with all the bells and whistles you can imagine. But we didn’t go in there. We went to a tiny room, smaller than your typical doctor’s office.
“So, what did you break again?”
*PT spins around in her chair and looks through a folder organizer*
“Ok, wrist. Here you go!”
She handed me a pamphlet with diagrams to show theraband-resisted wrist flexion and extension, then cut me a green theraband.
“Ok, so do this at home when you can. And if you have any questions, feel free to reach back out!”
That was it? A pamphlet? Wrist flexion and extension with a green theraband? Are you kidding me?
How is that supposed to help me swing a baseball bat as hard as I can and connect with a 90 mile-an-hour-fastball without my wrists exploding into a thousand pieces? Or snap my wrist hard in a basketball game for a deep three pointer?
That’s all the physical therapy I ever got for my injury.
When you ask most people why they got into PT, AT, Chiro, etc. they usually say something like “I had an injury and I got better because I had an awesome AT that helped me recover!”
My story is the opposite.
The care I received was a joke, from missed fractures to lazy and unimaginative therapy.
I saw a lack of competency and proper care for people that really wanted it and needed it.
I saw an opportunity to help people that wanted to be helped, and weren’t going to get it unless someone (rather, a lot of people) stepped up.
Lucky for me, the public high school I went to had a wonderful Athletic Trainer, who has probably been on staff since the early 2000s.
He ran the school’s sports medicine program, an elective class for upperclassmen that had clinical rotations in addition to the coursework, much like what I would later experience in colllege.
Only this high school program was much harder didactically than anything I had to do in college.
We had blindfolded anatomy practicals in front of the class where they would put your finger on a part of the skeleton and ask questions like “Name all of the actions of every muscle that has an articulation at this landmark…”
They would also hold mock-triage certifications; you’d walk into a room and have seven older students acting out some medical issue: concussion, shock, choking, etc. and quickly decide which order to treat each person while another three older students question your every move, pretending to be a parent or coach.
I had been put through the wringer and was hungry to continue this journey in my college studies.
I went directly to community college (to save some money and have a little fun) at Santa Barbara City College in Southern California for two years, then transferred to The Ohio State University.
Ohio State’s program was an excellent three-year experience. I got everything out that I put into it and it provided me with the knowledge and experience that I needed to have a successful career.
But what next?
Did I want to continue my journey as an Athletic Trainer?
Well let’s see, what would that look like…
First, get a graduate assistantship, working for a school for a small stipend of roughly $15K (probably putting myself into further debt) while I get a masters degree.
And after the master’s degree - I’ll be set up with a great job with great pay, right?
Let’s say after I get my master’s degree, I’m lucky enough to get hired on to a great university like Ohio State as an intern to get my foot in the door. What did that pay? $17K.
So let me get this straight… I’m doing the full time job of an Athletic Trainer for three more years before I can attempt to make a living?
Well is the money great after those three years at least? A full-time AT staff member makes $45K at most universities.
So I would have gone to school for five years, with an additional three years of experience (that’s eight years now) to make $45K… Talk about a bad ROI (return on investment).
Harrison does not exaggerate here. This is the unfortunate reality for thousands of qualified healthcare professionals in Athletic Training. Expensive & time-consuming education, limited job opportunities, and compensation packages that don’t support even basic costs of living.
My preceptors at Ohio State were brilliant. Excellent AT’s with great clinical, social, organizational, and leadership skills. I couldn’t believe it when I found out how much they made.
On top of that, there were very few AT’s at Ohio State that I knew of that had significant others or families. Additionally, it appeared to me that many of them seemed honestly kind of unhappy most of the time.
When you think you want something, you should be looking at what the other people who have reached that goal look like.
For me, things I asked myself were:
“Do they seem genuinely excited and happy coming to work each day?”
“Do they have a rich and fulfilling life outside of work?”
“Do they make enough money to achieve their financial goals?”
Those are the things that I personally value most when it comes to my career.
I thought Physical Therapy would check a lot of those boxes for me, especially because I have always loved the clinical rehab aspect of Athletic Training more than any other.
I met with a financial advisor and we ran a cost-benefit analysis to see if/when becoming a PT would be financially “worth it”.
I would highly recommend doing this yourself, no matter what form of higher education you are planning on investing in. You can clearly see your future earning potential in front of your eyes, and see how the debt you will have to take on will influence it.
Not enough people do this before making a huge life decision. In order to do this, ask your family members or a mentor in your life if they can recommend a great financial advisor/Certified Financial Planner and make an introduction. You can also just find a local company on google, I prefer smaller companies. If you’re interested reach out and I’d be happy to refer you to my financial advisor.
Creating a relationship with someone who can help you navigate these tough decisions and explain the financial implications is so important and helpful. Like anything else in life, if you want it to go well, you should make a plan and take steps each day to accomplish your goal.
For me, the results of the cost-benefit analysis said I would be 47 years old before the decision to become a PT would allow me to out-earn my AT salary trajectory.
This is an excellent recommendation, re: utilizing financial services to gauge the feasibility and benefit of pursuing higher-education. I think many young professionals regret getting a master’s degree when they realize that the addition to their resume was not worth the hundreds of thousands of dollars (+ interest) it cost to acquire. Harrison’s approach displays enormous maturity and foresight to understand the cost-benefit of the decision to pursue, or not to pursue, a master’s degree that many young students can and should emulate today.
AT in PT Clinic
So I decided to create my own path.
After a year of post-grad experience in the high school setting, I found an Athletic Trainer who was working out of a PT clinic running their “Sports Performance program”, a cash-pay service. I was able to get some incredible mentorship from my manager (ATC) and the other PT’s there.
I worked there for about two years and loved it.
I finally got to work one-on-one with somebody and have them consistently show up to get better and improve their body and life. I also got the opportunity to learn from a lot of different PTs with a myriad of experiences and clinical strengths.
My day-to-day consisted of hour-long sessions with clients, some of whom had already received some PT for their injuries (this is where my rehab background was best served) and some of whom had completed PT years ago and were seeking more of a training program and sports performance.
So for me as an ATC it felt much different than my usual role, I felt more like a personal trainer at moments for the first time in my life. This included scheduling and booking clients, making “sales calls”, community engagement, keeping accurate billing/package records - all things that were foreign to me, but I really enjoyed learning those new skills and the lifestyle they created for me.
That job gave me the confidence that my skills as an ATC were indeed monetizable, people would actually pay me more for being more awesome at my job (than the competition).
I was so happy to be going to work each day to do only my favorite parts of the job. To be honest, that was enough for me, and I was happy to stay and keep doing that for a long time.
There was only one problem with that life - I was in love. My girlfriend of three-and-a-half years was living in Los Angeles, and after years of debate, with a pretty big push amidst a global pandemic, I decided I would move in with her in LA.
When I told my bosses at the PT Clinic they made the decision to shut down the Sports Performance side of the business following my departure and gave me full permission to continue working with any of the clients that wanted to continue with me.
This was a total shock and opened up an opportunity that I hadn’t even considered.
I had about 16 clients who were interested in continuing working with me and many of those wanted to train more than once per week. Most of these clients I had been working with for at least a year, and almost none of them were still experiencing pain from an active injury; they just wanted more of a maintenance program.
They wanted to train with someone who knew their injury history and what exercises or movements they should and should not do based on that, their goals, their biomechanical deficiencies, etc. and most importantly, someone who they had built trust and rapport with.
I estimated about 25 client-facing hours a week, and that schedule would basically make it impossible for me to get another job once I moved.
Independent Athletic Trainer
Next thing I knew, I was getting ready to move down to LA, setting up my LLC, investing in some business coaching, and starting my own business.
Why business coaching? Let’s face it, our AT education taught us absolutely nothing about business or sales. For me, at least, it was very clear that I was supposed to be an AT in the traditional setting after graduating.
Ironically enough, the day I decided I would start my own business I saw an instagram ad from a PT (who I had been following for about a year or so) who helps cash-pay practices grow from day one to large scale.
The program was expensive - around $5000.
For me, it was absolutely worth it. I would rather learn the right way first than bang my head against the wall and have to figure it out the hard way. Also, I have lifetime access to zoom Q&A sessions that occur twice a week, so as my business changes, I can have direct access to pertinent information.
We spend tons of money on improving our clinical skills with courses, certifications, etc, so why wouldn’t you feel comfortable or expect to do the same on your business skills?
It’s a wise investment because it will not only save you time and money, but actually help you grow faster and earn more money.
The knee-jerk reaction to business coaching is often disbelief; “It’s a scam. It won’t really help. It’s not necessary. I can figure it out on my own.” But as with all things, there are good ones and there are bad ones. If you are able to find the right coach who understands you and your business, then as Harrison said it can SIGNIFICANTLY improve the efficiency at which you operate while helping you avoid common mistakes that new business owners make. In retrospect, the many years I spent making my own mistakes in business could have been avoided with a competent business coach. Should you think the investment is right for you - spend the time and effort to fully vet who you’re working with. Make sure they understand you and your business goals, and do not, DO NOT, take the leap without being 100% committed to follow their process and put the effort in on your side in order to succeed.
With a coach at my side, I went to work establishing a place to do business.
After scoping out and dropping in on classes at roughly 15 different gyms, yoga/pilates studios, and multidisciplinary clinics; I doubled down on a local boutique gym that I thought did a great job with exercise programming and instruction as well as building a fun & friendly community.
After being a paying client for about five months or so, I started a professional relationship with the gym renting space for them and providing care to their clientele many of whom had lingering injuries.
A quick note on California: It’s the only state without licensure or any form of state practice act. This affects my business greatly. Mostly I’d say it’s for the better. I think licensure would probably just mean annual fees and more rules and legal specifics for me to follow.
I have considered moving to other states for the financial benefits, but in addition to California being beautiful and awesome, the lack of licensure is actually a bit of a draw for me to stay here.
Life as an Entrepreneur
The first year of business was honestly pretty difficult. I felt out of my comfort zone, and in a world that was still reeling from COVID, I wasn’t sure how I was going to build referral sources and grow my business in a community that was still basically on lockdown.
During that first year I was almost entirely virtual, seeing clients only through Zoom as I waited for the right opportunity for me to establish myself in the community.
I wish I could say that I knew I was going to “make it”, but when it’s your first time doing something, it’s hard to have full confidence. At one point, I even considered letting my business die to pursue a full time job at a Golf Performance company.
I made it through five rounds of interviews before understanding that it would have probably taken me at least five years of working at that company just to make what I was already making in my own business at the time.
So I started to do the math: if I can’t make my business work, what is it really costing me? It costs me the huge dip in salary I’d have to take, and a huge increase in hours I’ll have to work to make that crappier salary.
In other words: Would I rather work more and make less with less schedule flexibility? Or work less, make more and have infinite schedule flexibility?
When I put it that way, it was a no-brainer.
Yes it was hard.
Yes I was disappointed, frustrated, confused, and concerned, most of the time during that first year.
You will probably feel the same way at times, and that’s OK. I think most business owners do in any field, especially the early years. My dad owned and operated a seafood market and he didn’t feel like he had any financial or time freedom until 25 years in.
But if you can be courageous enough to just keep going, and continue betting on yourself, the beauty and happiness of success - whatever that means to you - lies on the other side of that constant faith and hard work.
If you choose this path, I promise you it won’t be easy, but it will absolutely be worth it.
I can echo these sentiments 100%. Being a business owner is hard. It is not the easy way out. It’s not glorious and most certainly isn’t lavish. As entrepreneurs we battle self-doubt and imposter syndrome more frequently than we’d like to admit. But there’s only one trait that defines a successful entrepreneur: They didn’t give up. If you can do that, then it is not a matter of if, but when.
Today, I have a wonderful balance of virtual and in-person clients that I see, it’s about a 50/50 split. Personally, I love the flexibility that it provides me.
It does make everything more challenging: camera setup, equipment availability, can’t palpate, provide manual therapy, MMT, or tactile cue, etc., but you adapt by improving your ability to connect with the client, demonstrate movements, verbally cue, set up camera angles, and ask better questions to get feedback from the client.
It wasn’t an easy transition, but like anything else, the more I do it, the better I get at it.
All in all, I love having a hybrid model. I’ll always love the in-person experience and what it allows me to do, as well as the experience of being in the community, inside of a gym with other clients and trainers - the music, the energy, it’s so much fun.
I also love that I can be traveling somewhere and still work with clients virtually in the morning before exploring a new city or seeing friends and family. I love to travel and I spend most weekends not at home, so having that mobility and access to my clients from anywhere is something I value greatly.
When you have your own company, there’s no such thing as PTO, so every day that you decide to “take off” hurts a little more than before.
The pro’s of independence: You can make money whenever you want to work.
The con’s of independence: You only make money when you work.
It still blows my mind that I am performing sessions virtually to clients and they continue to love and value the service. I never thought that would be possible prior to COVID. Even after the shelter-in-place began, and I had been seeing other clinicians working with zoom successfully, I was still highly skeptical.
But if there’s one thing that life has taught me thus far, it’s that change is the only constant. Those that rolled with the punches and saw & seized the opportunities that COVID created came out of the pandemic successfully, some even growing more than ever. Adapt or die, that’s the name of the game in business.
From a day-to-day point of view, I typically see about 5-6 clients each day. Sessions with me are 55 minutes in duration, which I like because it gives me plenty of time to provide the service I want to provide, and gives me a five minute window to drink water, use the restroom, review notes, or just take a breath.
At the end of the day, I spend about an hour in my home office for:
Documenting and writing notes of what I did with each client, making sure I am keeping up with their billing/packages.
If I had an initial evaluation, I will usually send videos (HEP) to that client and make sure they know exactly what they need to do before I see them next.
Reach out to clients to schedule that aren’t firmly on my calendar.
Check emails and respond to any inquiries, setting up meetings for discovery calls with prospective clients.
The weekly tasks look more like this:
Financial reviews and money management - I have a system for how much money I pay myself, how much I allocate to operating expenses, how much I set aside for taxes, etc.
Accounting (I know, yuck, but if you do it weekly it doesn’t suck quite as much) - I use quickbooks and it links to all my cards and accounts so I can keep easy categorized records of business expenses, sales, and mileage.
Networking - very important for me to grow and find organic word-of mouth referrals. I still haven’t spent a single dollar in ad spend since I started. I have lunch/coffee/a phone call once a week and go to local business owner networking events once a month.
Big Picture Thinking about what I want my business to look like. This includes goal setting, starting new projects, planning and executing seminars for personal trainers, etc.
Continuing Education - I’m always learning. Period. I invest a lot of time and money into being as good at my craft as I can be.
Other random things that take my time (social media posts, updating my google business page and reaching out to clients for reviews, stuff like that)
Yes, it looks like a lot, and sometimes it is, but it’s not pointless busy work.
Every single task is moving the needle forward for my business, getting me more organized, more outreach/exposure, more client sessions, better client experiences, and subsequently, a better experience for me as the business owner.
State of Athletic Training
Throughout my journey, my perception of Athletic Training has honestly changed a lot.
My high school AT made me promise him I wouldn’t become an AT. “Anything else” he’d say, “Nurse Practitioner, Physician Assistant, Physical Therapist, whatever - just not an Athletic Trainer”. Hearing this should have stopped me, but it didn’t, but I was at least prepared for how disappointing the profession would be.
In community college I started to drink the Kool-Aid again because the lifestyle seemed so laid back and fun and accessible, and at Ohio State I was so impressed with all of my preceptors, they were so smart and professional and good at their craft, which really attracted me to the profession, but I just didn’t think that life would make me happy.
I have the utmost respect for Athletic Trainers, probably more than any other health care profession. Most AT’s I know are incredibly smart, personable, cool under pressure; absolute grinders. Schools and athletes all over the world need us now more than ever.
However, I continue to be disappointed by the NATA and how unimpressive the representation has been. People still have no idea what an AT is or what they do. It hasn’t changed and it doesn’t seem to be any time soon.
The continuing education options that are supported often fall short of my lofty expectations. I am proud to be an AT, but I think the profession has a LOT of work to do if they are going to continue to attract and develop rockstar professionals.
The salaries in most positions are still so incredibly low it’s an insult. Especially now that all degrees are entry-level masters programs. To ask someone to spend six years of higher education, just to come out making what is being offered, simply does not make any sense to me. Why would anyone do that? Especially when there are other professions that have similar requirements for years of education but have much more competitive salaries and work/life balance.
So for now, it seems Athletic Training will continue to prey on the passionate: young people who want to be an AT so badly that they don’t care what it costs, what they’ll make in return, and what their work/life balance will be.
I don’t typically refer to myself as an AT. If someone asks me what I do, I tell them something like “I help people recover from physical pain and get back to doing what they love to do.”
Nobody cares what you are, they care what you do and how good you are at it. I don’t tell people I’m an AT because most people don’t know what that is, and they’re usually going to assume that I “train athletes” (we’ve all experienced this, right?) and get the wrong impression about me immediately.
I view myself as many things, a biomechanist, a healer, a body educator, a physical body guide - to be honest I don’t really “call” myself anything in particular, I leave that up to the clients to decide what I mean to them.
I always knew I would combine a lot of different ideas and skills into my practice, and I always knew I would find a way to get myself into a position where I could treat patients however I felt was above industry standard.
I didn’t know it would look exactly like this.
Message to You
All in all, this life is better than whatever I had imagined for myself prior to the pandemic. I am working much less than before, and making much more money than before. I live a much healthier life, I cook for almost every meal and rarely get takeout, I have time throughout my day to exercise or go for a walk, I have less financial and workplace stress, and I have deeper relationships with my friends, family, and clients.
For me, running my own business has been less about becoming as rich as possible (which, let’s be honest, if that was my goal, I picked the wrong field), though I do make much more than I would be able to make working for almost any other clinic/gym.
Rather, it’s been all about me using my clinical, business, and interpersonal skills to create a sustainable life that does the most important thing of all: makes me happy. With that being said, it doesn’t hurt that from a financial outlook, I can work as much as I want and charge whatever I want to make as much money as I want.
So in your journey, my advice would be to create the life you want to live. Manifest it.
Literally dream about what you want and tell yourself it’s not only possible but that it is going to happen.
Believe it and it will be.
Whether that means being an ATC at the highest levels of professional sport, or branching off and starting your own business, you can do whatever you want (after all, ATCs have an incredibly versatile skillset), and life is much too short to spend too much time not living your best life.
Take a chance on yourself. If you fail, so what? At least you won’t have any regrets.
You only get one life, don’t play small.
Harrison can be contacted via email at firstname.lastname@example.org. He’s also on instagram @hk_athletictraining. Please reference Train Like a Pro should you choose to reach out.
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Please give Harrison a big thank you for guest-writing this Train Like a Pro article!