Monson: A dirty little secret vexes high school sports in Utah: Athletic trainers aren’t required for practices and games, so many schools go without. It needs to be addressed.

(Trent Nelson | The Salt Lake Tribune) Pleasant Grove's Dayne Christiansen (20) is tackled by East's Sione Angilau (11) as East hosts Pleasant Grove in the first round of the 6A high school football playoffs, Friday Oct. 26, 2018.

There’s a dirty little secret plaguing high school sports in Utah. The fact that the plague might not be as bad here as it is in some other states shouldn’t bring much comfort.

Here’s what would bring comfort: More full-time athletic trainers hired and utilized at Utah schools.

At a conference on safety in prep sports held on Thursday in a suite at Rice-Eccles Stadium, David Perrin, Dean of the College of Health at the University of Utah, asked a significant question: “Don’t high school athletes deserve the same care as college and professional athletes in the treating and prevention of injuries?”

Anybody who answers that question with a big old negatory never pulled on the pads or laced up a hightop or a soccer or baseball cleat, or had a kid in his or her family who did so. And to those who claim that schools can’t afford it, Perrin says they should count the number of remunerated coaches on the sidelines: “They can afford it, if they will. It has to be a priority.”

Right now, it is not.

Lisa Walker, a veteran athletic trainer at Springville High School who has been on the state’s Sports Medicine Advisory Council, as well as national committees for her profession and who addressed Thursday’s conference, estimates that just more than half the high schools in Utah have “access” to an athletic trainer, but that schools that have athletic trainers on site during school days, at practices and games are “significantly fewer.”

“There is no requirement in Utah for an athletic trainer or medical personnel to be on hand,” she says. “Schools that make it a requirement should be commended. But there is no [statewide] mandate. To me, it’s disturbing.”

Doug Casa, a professor at UConn, the CEO of the Korey Stringer Institute, a national expert on exertional heat stroke, and a speaker also featured at the conference, says the problem reaches far beyond Utah: “We contacted all 21,000 high schools in America and found that only 40 percent of them had full-time athletic trainers on campus. Some schools had two or three, some had none. A third had no access to an athletic trainer, at all.”

Casa’s organization, KSI, is in the middle of a four-year outreach to enlighten and educate administrators at schools around the country about the importance of proper preparation and planning for health emergencies among student-athletes. With national and local concerns growing about concussions and heat strokes and heart events among athletes, awareness about preventing and treating such issues is on the rise.

“In the past three to five years, we’ve made more progress than the last 25 years combined,” Casa says. “We need to expand education for coaches in proper tackling techniques and in other areas and in other sports. We’re going to see good news in that space, but education needs to be mandatory for all sports.”

He adds that deaths in high school sports occur 15-20 times annually, but that lasting effects from improperly treated conditions, such as in cases of heat exhaustion and head-and-neck injuries, affect hundreds of student-athletes.

“We’re fighting to have the right protocols in place.” he says.

In 70 percent of the cases where prep athletes died over the past year, there was no athletic trainer present.

Walker, Perrin and Casa are all trying to limit, prevent those tragedies.

One of the keys to change, attendant with pushing for additional athletic trainers at schools, is changing the over-the-top macho culture that persists in some athletic programs, including coaches who not only neglect to call for appropriate treatment for distressed players, but who ridicule those who struggle in training and conditioning.

“At any time, an athlete can have head, heart or heat issues,” Walker says. “It’s not just in June or July. Education is so important — for athletes, parents, coaches and administrators. Most coaches aren’t looking to do harm, but they might not know. That’s why it’s so important to have licensed athletic trainers on hand.”

She pauses.

“It always comes down to money. I’m sensitive to that. But you would never go wrong to have an athletic trainer at each school protecting the lives of the kids. Prevention is better than having to deal with a tragedy.”

Walker concurs with Casa that progress in policy-making is rising — for instance, a 14-day-heat-acclimation period is now required for prep sports in Utah, eliminating so-called hell weeks, in which back-to-back-to-back-to-back two-a-day practices are implemented.

“Some would say, ‘Ah, you’re making the kids weak,’” Walker says. “My response is, ‘No, we’re preserving their health for today and the future.’”

A state law on concussions requires a plan and protocol for treating a high school athlete suspected of suffering one, approved by a parent.

“Any athlete thought to have had a concussion must be evaluated by a health-care professional specifically trained in concussion in the last three years,” she says. “That suspicion can come from a coach, a parent, a player.”

It should come from an athletic trainer, paid to be present at the school.

“We encourage schools to provide the best medical care they can for their students and their school community,” says Jon Oglesby, assistant director of the UHSAA. ”We have trainers at our championships.”

But making athletic trainers comprehensively mandatory would have to come from the State Legislature.

In Utah, all coaches must be current in first-aid and CPR, among other certifications, and some schools have physicians who volunteer their services at games, but that’s not enough. Immediate treatment should be available on campus throughout the day — at practices, games, even for P.E. classes.

That’s a conclusion that everyone — those at Thursday’s conference, coaches, parents and especially the athletes themselves — should agree with and find comfort in.

GORDON MONSON hosts “The Big Show” with Jake Scott weekdays from 3-7 p.m. on 97.5 FM and 1280 AM The Zone.