Monica Nickoli, Norwalk & Western Reserve
• EDUCATION: Bachelor of Science, sports medicine, Marietta College, 1999
• YEARS EXPERIENCE: 11
• WHY SHE WANTED TO BECOME A TRAINER: Nickoli was an athlete who couldn't return to sports after an injury. "It was a great avenue to keep going with that."
Monica Nickoli is one of the few female athletic trainers in the area.
"When I started I was the only (female trainer) around," she said. "Now when Norwalk has a football game, half the other teams have female trainers. It's nice to see women in the field and moving up the ranks."
What she and other athletic trainers do can be encapsulated by injuries, but the scope of the job is far more extensive.
"We're somebody who specializes in injuries," Nickoli said. "It frees coaches to coach, and we handle the injuries, the taping, the icing and prep work."
Responding to and assessing injuries is a portion of what athletic trainers do; They also work with athletes to prevent injuries, and obviously to rehabilitate injuries.
"A lot of this is prevention," Nickoli said. "We see lots of ankle injuries and overuse injuries... so we focus on core strengthening, and lower body stretching and strengthening."
One of the best ways to prevent injuries to knees and ankles is to strengthen the muscles near them. So to reduce risk to knee injuries, athletes can strengthen their calf, hamstring and quadriceps muscles.
And as a female trainer, she has started programs designed to teach female athletes proper techniques when landing because of increased risk for knee injuries.
"They're not always trained on jump stops and landings, so when they you get knees knocking (together)," Nickoli said.
Because female hip-bones are wider than male hips, the femur, the long bone in the upper part of the leg, slants inward to the knees. So when female athletes jump and land, their knees tend to come inward together and have a higher risk for knee injury.
"We're working on programs that teach women how to jump and land to avoid those injuries," Nickoli said.
Nickoli, who is from Tiffin, is one of three athletic trainers at Fisher Titus, which serves seven schools in its immediate area -- Norwalk, St. Paul, Edison, Monroeville, Western Reserve, New London and South Central. Each trainer is assigned to two schools -- Nickoli oversees Norwalk and Western Reserve -- and the level of services vary because each school selects its level of coverage.
Mornings are spent at the hospital on paperwork and reports, Nickoli said, calling doctors, parents and coaches to keep communication open on the status of injuries. She's at Western and Norwalk high school for practices in the afternoons. Days are between six hours to 13 hours depending on the season.
The work has its rewards in "seeing athletes who have injuries, especially season-ending injuries, return for the end of one season or return for another season," Nickoli said.
It's also rewarding when her athletes at Western Reserve -- one of the two schools at which Nickoli is the trainer -- finish with a 10-0 regular season in football and host the first playoff game in 26 years.
Nickoli is certified by the National Athletic Trainers Association. To receive that certification, a trainer must complete the following criteria:
• Earn a bachelor of science from an NATA accredited school
• A six-hour certification exam
• A state licensing exam
She is also certified by the OHSAA for weight assessment, a program that certifies wrestlers to compete in the proper weight class for their body type.
As far as serious injuries beyond the common sore body parts, Nickoli said if trainers stay in the business long enough, they'll see it. She's treated dislocated hips and a broken fibia.
"You've got to stay calm and keep your wits about you," Nickoli said on handling more serious injuries. "Your heart sinks for that kid, but you've got to keep your cool to keep the athlete calm and get the situation under control."
When an injury occurs during a game, Nickoli gets out to the athlete and checks if they are alert and conscious.
"From there, I'll ask them what hurts, try to keep them calm, and if they can get up and walk off on their own I'll have them do that," Nickoli said. "If we suspect a neck injury, we'll get the ambulance and transport them."
Nickoli described an analogy to describe the seriousness of concussions to athletes.
"The brain is like an egg, and it's got its separate parts, and when you get a concussion, it's like shaking the egg and scrambling it against the inside of the shell," she said. "You want to wait for everything inside to separate and then get back."
Concussions at the high school level are not always disclosed because athletes may not admit they're feeling the effects.
"You may have a kid who wants to go out there and thought it was a headache," Nickoli said. The danger of concussions is a second impact to the brain before its fully healed, which could result in permanent brain damage.
Fisher Titus uses baseline testing for head injuries in contact sports. In a baseline test, athletes answer questions that evaluate recognition and cognitive skills before the season. If a brain injury occurs or is suspected, the athlete retakes the test and trainers can compare the new scores to past results and identify any deficiencies.