Burnout, a state of physical or emotional exhaustion, is a concern within athletic training, as between 17 and 40% of athletic trainers (ATs) report high levels of burnout. Adverse childhood experiences (ACEs) are linked with higher levels of burnout in other health professions.


To compare burnout to ACEs in athletic trainers.


Cross-sectional study.


Web-based survey.


1000 ATs were selected at random to participate in the study. 78 ATs started the survey, with 75 ATs completing the survey.

Main Outcome Measures

Burnout as measured by the Copenhagen Burnout Index (CBI) overall and subscale scores were compared across groups based on number of adverse experiences as measures by the ACES survey. Multiple ANOVAs were used to determine the association between ACE score and overall, personal, work, and patient-related burnout. Bonferroni post hoc corrections were used, and the a priori alpha level was p≤.05. The study protocol was approved by the IRB.


At least one adverse experience was reported in 37 (49.33%) participants. Those with 4 or more ACEs had higher odds of reporting overall, personal and work-related burnout than those with 0–3 ACEs. Moderate burnout (CBI≥50.00) was reported in 27 (36%; overall), 44 (58.67%, personal), 34 (45.3% work-related), and 15 (20.00%, patient-related) ATs. Participants with 4 ACEs had significantly higher overall burnout (67.11±19.89; ANOVA F6, 68=2.59, p=.03) than those with 0 (40.53 ±17.12, p=.04), 1 (38.42±20.99, p=.04), and 7 (19.08±12.09, p=.03) ACEs. The same pattern existed with personal burnout as participants with 4 ACES (76.67 ±17.33) had significantly higher scores (ANOVA F6, 68=3.40 p=.00) than those with 0 (46.60 ±17.49, p=.02), 1 (42.78±21.48, p=.01), and 7 (27.08±20.62, p=.03) ACEs. No other significant differences existed.


Between 20.00% and 58.67% of ATs surveyed reported some form of burnout. Higher levels of overall and personal burnout were found in those with 4 ACEs. While it was expected to see lower levels of burnout in those with lower ACEs, it was surprising to see that those with 7 reported some of the lowest CBI scores. It might be beneficial for ATs with childhood trauma to engage in self-regulation exercises to reduce limit triggers and burnout. Additionally, employers should explore becoming trauma-informed workplaces to better support employees.