Objectives In addition to colleges and schools, certified athletic trainers (ATs) are now found in hospitals, clinics and other settings including industry. We describe ATs musculoskeletal symptoms, and work exposures and conditions in different settings.

Methods We administered online surveys to a random sample of 10,000 US ATs. Participants (n = 1826) estimated the frequency they performed selected work tasks and rated task-related stress [scale 0 (no problem) to 10 (major problem)]. Musculoskeletal symptoms (MS) that interfered or prevented work in the last year was reported by body region as well as frequency with which ten protective strategies were used to reduce work-related physical strain [scale 1 (never) to 5 (always)].

Results ATs commonly worked in schools (67%) and clinics or hospitals (20%). Prevalence of MS that interfered/prevented work was 27.2% (95% CI: 25.1%, 29.3%); prevalence was highest in the low back (13.7%) and wrist/hand (7.0%). Back pain was higher in schools (14.7%) and other (12.9%) settings compared to clinics/hospitals (9.7%). ATs in schools more frequently performed taping/wrapping, used treatment modalities, handled/moved equipment, cared for multiple patients at once, worked under time constraints, awkward positions or sustained positions, and inclement weather conditions. School ATs rated physical stress of handling/moving equipment (mean = 4.9), working in same position (4.8), inclement weather conditions (4.0), being short staffed (5.0) and work scheduling issues (5.4) higher than clinic/hospital ATs. Mental stress due to understaffing (mean = 4.9), increased workload (5.0), irregular schedules (5.1), and long work weeks (5.8) were also rated higher by school ATs. School ATs reported always or almost always getting help with patient transfers, asking others to perform physically stressful tasks, and using electrotherapy instead of manual techniques to avoid injury aggravation.

Conclusions Work tasks, physical and mental stressors, and use of protective strategies varied by work setting. Preventive measures need to consider variability across work settings.