By Gene Galin
Pittsboro, NC – The public face of high school sports is easy to recognize: the Friday night crowd, the scoreboard, the championship chase and the athletes whose names fill the box score. The work that makes those moments possible is quieter and far less visible. It happens in pregame parent meetings, hurried evaluations after school, weather checks before practice, conversations with worried families and the difficult decision to tell a competitor that one game is less important than long-term health.
That largely unseen operation was the subject of the Sept. 20 episode of “AD Huddle”, where Northwood High School athletic director Cameron Vernon and Southeast Alamance High School athletic director BJ Condron spoke with Northwood athletic trainer and sports medicine teacher Jackie Pennucci. For almost an hour, the conversation moved from concussions and heat illness to staffing, scheduling, rehabilitation and the day-to-day demands placed on the person responsible for helping protect hundreds of student-athletes.
Pennucci’s central message was straightforward: Safe high school athletics depend on preparation, trust and communication long before an injury occurs. The profession requires clinical knowledge, but it also demands judgment, patience, logistical planning and the credibility to make an unpopular call when a student’s health is at stake.
“The days are long, but it’ll be worth it,” Pennucci said when asked what she would tell the young professional who arrived at Northwood in 2013.
A career shaped by equal care
Pennucci’s path into athletic training began at Downingtown West High School outside Philadelphia. She played several sports and dealt with the ordinary injuries and discomforts that accompany athletic participation. Her high school athletic trainer, Joe Iezzi, showed her what the profession could be.
There was no single dramatic episode that redirected her future. Instead, Pennucci remembered a pattern of everyday care. Iezzi treated the star and the reserve with the same attention, she said, establishing a standard that stayed with her.
“No matter if you were the star player or the benchwarmer or somewhere in between, he was going to provide really good care,” Pennucci said. “That really stuck with me.”
Only later did she understand that the trainer her school took for granted was highly regarded nationally. The larger lesson was not about prestige, however. It was that students remember whether an adult took them seriously.
Pennucci studied athletic training at Ithaca College and continued her education in exercise science at the University of North Carolina at Chapel Hill. During graduate school, she worked in college athletics with women’s soccer, softball and football. The football assignment exposed her to long hours, seven-day workweeks and the intense pace of a major college program. Sundays could include injury checks after Saturday games; practices, rehabilitation and other responsibilities consumed much of the rest of the week.
That experience developed stamina and clinical confidence. It also helped Pennucci decide that a high school was where she could make the kind of impact she wanted.
At the college level, she said, layers of staff and decision-making limited her autonomy. The money, politics, and around-the-clock expectations also made burnout seem likely. A high school offered something different: the chance to know students over time, make consequential decisions and connect health care with education.
“I felt like it wasn’t allowing me to really use my true gifts,” she said of the collegiate setting. At a high school, she believed she could “make a bigger impact and help a lot of kids.”
Building a program from almost nothing
Northwood had never employed a full-time athletic trainer when Pennucci arrived in 2013. Cameron said former principal Chris Bliss has described her as the most important hire of his tenure. Longtime football coach Bill Hall had advocated for the position, and that support mattered as Pennucci began creating a program without an established template.
She had come from a college environment where nearly every resource was available. At Northwood, she had to determine the essentials, build systems and make the operation work in a setting with fewer supplies and only one full-time trainer.
The experience taught her that an effective program does not begin with an elaborate room or an unlimited budget. It begins with emergency equipment, the supplies needed for routine care, an appropriate workspace, a supervising physician and a practical plan for reaching athletes spread across a campus.
“I don’t need a lot to be a good athletic trainer,” Pennucci said. “All you really need is to care about what you’re doing, to have your basic lifesaving supplies, and the rest you can kind of figure out from there.”
The location of the training room was one early lesson. Pennucci’s original classroom and treatment area sat on the opposite side of the school from the athletic fields. The arrangement was changed after the first year so that she could work closer to the activity she covered. Transportation mattered, too. A utility vehicle can allow a trainer to move quickly between venues and carry equipment to an injured athlete. In the episode’s lighter rapid-fire segment, Pennucci decisively chose a Gator over a golf cart because it can climb hills and cross curbs more reliably.
Those details may sound mundane, but in an emergency, distance and access become medical issues. The North Carolina High School Athletic Association’s current health-and-safety guidance describes licensed athletic trainers as health professionals who work with physicians to provide injury prevention, emergency care, clinical evaluation, treatment and rehabilitation. The association also calls for venue-specific emergency action planning and establishes medical-coverage requirements for activities including football and wrestling.
For a school adding its first trainer, Pennucci’s advice was to settle the foundational questions early: Where will the trainer work? What emergency equipment is available? How will the trainer travel across campus? Which physician will provide supervision? Can a hospital, university or sports medicine organization provide supplemental coverage?
Northwood later developed a relationship with UNC Health that supplies additional help. That partnership is valuable, but the episode made clear that the school-based trainer remains the daily point of connection among athletes, parents, coaches, administrators and outside medical providers.
Trust is built before the difficult decision
Clinical knowledge alone does not give an athletic trainer authority in a crowded stadium or tense sideline. Trust must be developed with coaches, athletes and parents, Pennucci said, and it grows through consistency.
When she arrived, she was a young professional entering a sports culture that included experienced coaches and some traditional attitudes about toughness. Hall’s support helped. He had pushed for Northwood to hire a trainer and made it clear that the position should be respected.
Pennucci said the school’s coaches and families were generally receptive. Still, conflict is inevitable when a medical decision removes an athlete from competition or delays a return. The trainer may be focused on a student’s health over months or years while the player, parent or coach is focused on the next series, match or game.
The best answer, Pennucci said, is early, frequent communication. That was an adjustment after college, where most athletes could make their own medical decisions. In high school, parents are part of the process.
“Let them know why you’re making these decisions and that you’re keeping the best interest of their child at heart,” she said. “We’re making decisions based on their season and life, not just on this one moment.”
Vernon and Pennucci also described their own working relationship as a partnership rather than a hierarchy. An athletic trainer needs accurate schedules, timely notice of changes and administrative support during challenging conversations. An athletic director, in turn, needs a trainer who will work hard, adapt when plans shift and contribute to the larger operation.
That exchange produced one of the livestream’s most revealing jokes. Asked what a trainer needs most from an athletic director, Pennucci immediately answered, “Up-to-date schedules.” The laughter that followed underscored a serious point: A canceled practice, rescheduled contest or venue change affects medical coverage. If the trainer is the last to learn about it, the school may create an avoidable safety gap.
The job also includes countless “other duties as assigned.” A visible, helpful staff member may be asked to unlock a gate, locate a trash can or solve a facility problem. Pennucci said a successful trainer must be willing to pitch in without losing focus on the primary responsibility of athlete care.
The training room as classroom and clinic
Pennucci’s position differs from an outreach model in which a clinician arrives shortly before practices and games. She teaches sports medicine during the school day and then shifts into after-school care and event coverage.
The arrangement is demanding – she described teaching as essentially a second job – but it creates connections that would be difficult to build through game coverage alone. Students see her as an educator as well as a medical professional. She sees athletes in class, learns how they respond outside competition and has opportunities to explain the science behind her decisions.
Her classes also reach students who do not play sports. Some enroll because they are considering careers in athletic training, physical therapy, medicine or another health field. Others land in the course because it fits their schedule and discover an unexpected interest.
That educational role has produced a legacy beyond the athletes Pennucci has treated. Former students have entered college sports medicine programs, and she said two were pursuing master’s degrees in athletic training at UNC Charlotte and UNC Greensboro at the time of the episode.
“Seeing the students that once worked with me on the sideline at football and games throughout the year, and now they are off becoming certified athletic trainers on their own, is pretty special,” she said.
The model can also improve trust. Students who learn what an athletic trainer is qualified to do are more likely to understand that a restriction is based on clinical judgment rather than an attempt to keep them out of competition. They also gain practical knowledge about stretching, rehabilitation, first aid and injury prevention.
Chatham County Schools highlighted that combination of instruction and sports medicine in a 2025 feature about Pennucci’s Northwood program. During the “AD Huddle” discussion, Vernon also noted that Pennucci received statewide recognition in 2024 as the NCHSAA’s Elton Hawley Athletic Trainer of the Year, after receiving a regional secondary-school athletic trainer honor in 2016.
Awards were not the accomplishment Pennucci emphasized. She spoke instead about former students entering the profession and the hope that athletes remember being cared for.
Concussions: Progress in culture and protocol
The livestream turned repeatedly to the tension between competitive urgency and medical patience. Concussions were the clearest example.
Pennucci said attitudes have changed markedly during her years at Northwood. Early in her tenure, she sometimes expected resistance after identifying a possible concussion. Parents or coaches might argue that previous generations played through similar symptoms. Now, she said, families more often accept that the athlete must stop, be evaluated and complete the required process.
That change reflects better education and clearer procedures. NCHSAA materials provide concussion forms and return-to-play resources, while annual concussion education is part of the association’s requirements for coaches. The objective is not to make sports risk-free – an impossible standard – but to identify injuries promptly and prevent a premature return.
Pennucci tells families before the season that a concussion recovery is not instantaneous. Even after a health care provider clears an athlete to begin progressing, the student must still complete gradual steps before full competition. Explaining that process in advance reduces the surprise and frustration that can arise when an athlete feels better but is not yet ready for a game.
Her message was reassuring without minimizing the injury. Concussions can be serious, she said, but proper management gives athletes the best opportunity to recover and return safely.
Football remains central to the public discussion, but concussions occur across sports. Vernon said some of the more severe cases he has observed were outside football. Pennucci also described changes in football instruction: less full-contact tackling to the ground during practice, greater use of tackling dummies and wheels, and more emphasis on techniques that avoid leading with the head.
Pennucci rejected the notion that reducing unnecessary practice collisions makes players less tough. Athletes still need to learn how to tackle and absorb contact, she said, but programs can reserve more of the unavoidable collision load for competition.
“We have to evolve with the science and what we’re learning about these injuries,” she said. Making football safer, in her view, is part of preserving the sport rather than weakening it.
Heat can threaten every athlete outside
If concussions are the injury most commonly associated with athletic trainers, Pennucci said heat illness may be an even broader argument for their presence. On a hot, humid North Carolina afternoon, the risk is not confined to one player or one sport. Everyone practicing outside is exposed.
Pennucci explained that schools do not simply guess whether conditions are safe. They measure wet-bulb globe temperature, an index that accounts for multiple environmental factors, and follow activity-modification guidelines. Depending on the reading, practices may require additional breaks, reduced equipment, shorter duration or cancellation.
The statewide concern is substantial. In an NCHSAA-posted memorandum on heat acclimatization, the National Federation of State High School Associations cited 20 heat-stroke deaths among high school athletes during the 10 school years from 2011-12 through 2020-21. Fourteen occurred in July or August and 17 involved football, but the guidance stressed that heat illness can affect participants in any outdoor sport, along with cheerleaders, marching-band members and athletes working in hot indoor spaces.
At Northwood, monitoring is only one part of prevention. Hydration must begin before a student arrives at practice, Pennucci said. One bottle of water during the school day is rarely enough preparation for strenuous activity in the heat. Athletes need to drink before, during and after practices and games.
Just as important, they need permission to speak up. Pennucci urged parents to tell students that reporting dizziness, weakness or other distress is responsible behavior, not a failure of toughness. Teammates and coaches should watch one another because heat illness can develop quickly.
“It’s OK to take a break,” she said. “It’s OK to tell your coach you need to sit down and get a water break.”
Hurt, injured and the judgment between them
Not every visit to the training room involves an emergency. Many begin with a question familiar to anyone who has played sports: Is this ordinary soreness, or is something wrong?
Pennucci said the distinction requires listening because athletes have different pain thresholds, histories and levels of experience. A first-year player may be alarmed by the bilateral muscle soreness that follows a hard workout. A veteran may understate a problem in an effort to stay on the field.
One basic clue is symmetry. If the same muscle group hurts on both sides, soreness may be more likely than an acute injury to both limbs. But the trainer still must evaluate the student, consider the mechanism and monitor how symptoms respond to movement.
Pennucci often asks an athlete with no obvious injury to warm up and reassess. If the discomfort improves, the student may continue, perhaps with modified repetitions or limited drills. If it worsens, the athlete returns for another evaluation. The goal is neither to force participation nor to shut down every student who is sore. It is to keep athletes as safely active as their condition allows.
That approach includes teaching students to manage routine needs. Pennucci demonstrates stretching, foam rolling and other mobility work so athletes can help themselves at home and before practice. She wants them to recognize normal training discomfort, respond appropriately and report warning signs rather than hide them.
The same patience applies to major rehabilitation. Asked about anterior cruciate ligament injuries, Pennucci warned that athletes can begin feeling capable before the reconstructed graft has fully healed. Running may resume months before unrestricted sport participation. A complete return can take close to a year, depending on the athlete and medical guidance.
“ACL is one that you definitely cannot rush back from,” she said. The trainer’s role includes reinforcing the physician’s and physical therapist’s plan when competitive pressure makes patience difficult.
Triage when one person serves an entire program
The volume of high school sports becomes visible in Northwood’s training room after the final bell. By the middle of a season, Pennucci may find a room full of students seeking evaluations, treatment, taping or rehabilitation at nearly the same time.
There is only one of her.
She manages the crowd through a practical triage system. Athletes leaving soon for an away contest receive priority, followed by those whose practices begin first. Pennucci explains the order so students know they have not been forgotten.
While they wait, students begin safe tasks they have learned to perform independently. Diagrams on the wall show foam-rolling and stretching techniques for different muscle groups. Experienced students may help prepare ice bags or assist teammates with basic, supervised tasks. Pennucci reserves evaluations and other clinical decisions for herself, but she uses education to keep the room moving.
The system does more than relieve congestion. It teaches athletes to take responsibility for routine care and to help teammates. It also creates a small community inside the athletics program.
When Pennucci reaches a student who has waited, she tries to give that athlete her full attention. “I really appreciate you being patient,” she tells them. The students, she said, generally understand how busy the room is.
That scene captures the staffing challenge at the heart of the episode. High school athletics may offer multiple practices and contests at overlapping times on different parts of a campus. Weather can move events without much warning. One injury can require sustained attention while other athletes still need care. A trainer’s effectiveness therefore depends partly on the systems surrounding the position – communication, facilities, transportation, backup coverage and students who know how to seek help.
Weather, lightning and the unglamorous essentials
The rapid-fire portion of the show added humor without straying far from the realities of the job. Pennucci identified lightning as her least favorite weather problem, not because she works through it, but because a lightning delay leaves schools with little control beyond following safety rules and waiting.
Northwood uses a county-provided weather service to detect nearby lightning and maintain the required countdown, along with other apps to check strike distance and radar. That redundancy illustrates the operational side of risk management. A school needs a dependable source of information, a person empowered to act on it and a communication plan for coaches, officials, spectators and visiting teams.
Other answers were equally practical. The most-used item in Pennucci’s bag is standard athletic tape. Football is the busiest sport to cover, though also one of her favorites. One item every athletic director should provide, she said, is a genuinely waterproof rain suit. Her preferred concession-stand snack is a bag of Famous Amos cookies.
The humor reflected a working relationship built over years. It also made a larger point: Running school sports safely depends on ordinary items and habits that seldom receive public attention. A functioning ice machine, a charged communication device, an accessible gate, a rain jacket and an accurate schedule can matter more on a difficult night than anything visible on the scoreboard.
Care as the lasting measure
Near the end of the livestream, Pennucci was asked what she hopes Northwood athletes say about her after her career is over.
Her answer was four words: “I hope they say that she cared about me.”
That aspiration connected every part of the conversation. Equal treatment inspired her career. A high school setting offered closer contact with students. Classroom teaching extended her influence beyond injured athletes. Communication helped families understand difficult decisions. Rehabilitation required patience. Triage demanded that even a student who waited knew that the trainer was listening.
I personally recalled seeing that influence after a serious football injury left one of Pennucci’s student assistants visibly shaken. Pennucci later explained what had happened and how the medical response unfolded. Rather than driving the student away from sports medicine, the experience strengthened her interest in the field.
Pennucci said helping students process those frightening moments is part of the job. Her hope is that athletes and student assistants will look back on the sports medicine program as a positive part of high school, even when their contact with it came through pain or uncertainty.
“I hope that I can help people through those challenging times, help them keep a level head and a positive attitude,” she said, “and hopefully they can look back and say that I helped make a difference in that scary moment of their life.”
The takeaway for schools and families
The “hard truth” about running high school sports is not that the games have become impossible to manage. It is that a safe, credible program rests on far more labor than spectators usually see. The athletic trainer must be clinician, educator, communicator, planner and steady presence. The athletic director must provide reliable information, appropriate resources and institutional backing. Coaches must accept medical boundaries. Parents must reinforce hydration, honest symptom reporting and patience during recovery. Students must learn that toughness includes asking for help.
Pennucci’s experience also offers a blueprint for schools evaluating their own coverage. Begin with emergency equipment and venue plans. Put the trainer where athletes can reach them. Establish physician oversight and outside partnerships. Communicate schedule changes immediately. Explain concussion and heat procedures before the season. Give the medical professional authority to make health decisions without competitive interference. When possible, integrate sports medicine into the school day so students see the trainer not only as the person who removes them from a game, but as a teacher who helps them return.
For families, the next step is equally concrete: Learn who provides medical coverage at the school, attend preseason meetings, review the school’s emergency and concussion procedures, and ask how heat and lightning decisions are made. The NCHSAA maintains parent, student and school resources on its health-and-safety page, including concussion forms, emergency-action-plan guidance and return-to-play materials.
Games will continue to be decided by touchdowns, goals, aces and finishing kicks. But whether athletes reach those moments safely often depends on the work performed out of view – by someone watching the weather, answering a parent, checking a symptom, updating a plan or telling a teenager that protecting tomorrow matters more than playing tonight.