An Overview
Whether you’re a newly minted personal trainer just getting their feet wet in the industry or an experienced fitness professional boasting years in the trenches, you should always be aware of possibly facing litigation one day. Fitness professionals are too often engrossed in generating revenue streams such as attracting new clients and then there’s the growing trend of trying to create passive income through publications, products, and delivering seminars. So what usually gets neglected? The legal stuff and those types of things. You know like court and insurance and all that fun stuff. The same stuff that personal trainers barely give any attention yet could easily end their careers. But there are some things you can do to safeguard yourself long before the possibility of litigation surfaces.
Education
In 2001, Susan Guthrie, a 42-year-old Atlanta woman, signed up for personal training sessions, with the hopes of getting back into shape so she could resume playing tennis, as she did when she was younger. The manager of the gym paired her with Ray Crouser, a tennis instructor, and according to Crouser, held a personal training certification through the International Sports Sciences Association (ISSA). According to an article published by (Crouser, 2006) on protraineronline.com, Crouser admittedly had no formal education; however, he was considering pursuing it in the future. Why does his certification and/or education or lack thereof serve relevance? Well, if he had more, Susan Guthrie wouldn’t have spent the time following her first two workouts with Crouser, clinging on for her life. Guthrie was on life support and received dialysis treatments for a week due to exertional rhabdomyolysis (“Woman Says Personal Trainer Put Her in Hospital,†2007), a condition characterized by the breakdown of muscle tissue in the blood (Patel, Gyamfi, & Torres, 2009). The blood binding protein, Myoglobin, enters the kidneys, which attempt to filter the clumps of muscle tissue, or protein, but often times become so overloaded they shut down. Susan Guthrie had suffered acute renal failure.
Could this have been avoided? Absolutely. But, Crouser, a novice personal trainer, prescribed the same workouts he had used for his advanced clients, exclaiming that he uses the same routine for everyone (“Woman Says Personal Trainer Put Her in Hospital,†2007). Susan Guthrie was a novice trainee, who had no business performing a high-volume, intense, ass-beating of sorts with seemingly little rhyme or reason. Not only were these two workouts counterproductive, they were, in Guthrie’s case, deleterious to health – she almost died! Had Crouser been more versed in exercise physiology, the concepts of proper loading, rest to work ratios, and the individualization of programming would likely have been employed, therefore, decreasing the chances of Guthrie sustaining any injury or illness as a result of her workouts with Crouser.
According to the Business of Personal Training, a book published by exercise physiologist Scott Roberts, “personal trainers should have earned at least a bachelor’s degree in exercise physiology, nutrition, physical education, or [in] a related field†(Roberts, 1999, p. 17). Education doesn’t necessarily guarantee that a person will be a better trainer, but they’ll likely be more attuned to things such as exercise prescription and the resulting acute and chronic adaptations, whether they be good, or as in Guthrie’s case: bad. Alternatively, a prospective fitness professional who lacks a college education or who holds an unrelated degree, should consider obtaining a certification through a reputable organization, which will be discussed later.
Certifications
In lieu of a formal education, or preferably in addition to one, certification is essential. Certifications that are recognized by the National Commission for Certifying Agency, or NCCA (http://credentialingexcellence.org), hold the most legitimacy in the eyes of employers, clients, and make obtaining liability insurance much easier. Holding a certification that is recognized by the NCCA makes you more legally defensible, due to the rigorous requirements that must be met in order to be eligible to take the exam and subsequently maintain the certification. Among the most reputable and recognized certifying organizations are the American College of Sports Medicine (ACSM), American Council on Exercise (ACE), National Academy of Sports Medicine (NASM), and the National Strength and Conditioning Association (NSCA). In order to sit for each of their personal training exams, the candidate must be at least 18 years old and hold a valid CPR and AED certification. Again, these requirements represent the bare minimums for eligibility to take the exams – what isn’t included is the lengthy preparation that each certification test entails. Put it this way, none of these exams can be taken cold with the expectation of passing them. They are often considered challenging for someone with an exercise science background! Each of the organizations offer higher level certifications, which require a bachelor’s and/or master’s degree in a health or exercise related field, such as the Health and Fitness Specialist (HFS), offered through the ACSM. The ACSM also offers two certifications that require documented practicum hours in a clinical setting, such as the Clinical Exercise Specialist (CES) and the Registered Clinical Exercise Physiologist (RCEP) (http://www.acsm.org). The ACSM and ACE (http://www.acefitness.org) offer specialty certifications for those fitness professionals working or intending to work with the elderly and diseased populations. Certifications offered through NASM (http://www.nasm.org), such as the Corrective Exercise Specialist (CES) and Performance Enhancement Specialist (PES) and the NSCA (http://nsca-lift.org), such as the Certified Strength and Conditioning Specialist (CSCS), are more geared towards training athletic populations and emphasize functional anatomy, exercise technique, and the concept of periodization within their teachings.
Does holding any of the aforementioned certifications make you a better trainer? The answer is “noâ€. However, in order to maintain the certifications mentioned above, you must report continuing education hours within a specified reporting period. Continuing education usually includes attending workshops, seminars, taking exercise science or health related college coursework, and regularly completing online assessments and practice quizzes. Additionally, your CPR/AED certification must stay current otherwise your certification will lapse.
Experience
This is a critical component which is overlooked by many health club managers and clients. Most trainers out there lack extensive experience working with people, as in the case of Ray Crouser, who had only been working as a personal trainer for one year when his workouts nearly killed Ms. Guthrie. According to (Roberts, 1999, p.17), “aspiring personal trainers should seek out local fitness facilities that are willing to let you observe their classes, or even train you. “
You really have to work from the ground up. Intern, volunteer, attend conferences, pick the brain of more experienced trainers and see if they’ll mentor you. There is nothing more problematic in this industry than someone who passes a certification test and hits the ground running the next day – you have to remember that your knowledge is really still in its infancy. You only passed a test! Remember, knowledge is the product of education AND experience.
Liability Insurance
You’re a fool without it. If you’re an independent contractor, getting liability insurance should be a no-brainer. Even if you’re an employee of the health club or gym that you train clients in, you should seriously consider it, because you still may not be fully covered, if at all! According to Sean Riley, a lawyer and personal trainer, “employees of health clubs are only covered under their employer’s general liability insurance†(Riley, 2005, para. 2). This type of insurance typically covers the premises and all equipment and the claims which include losses due to slippery showers, faulty exercise equipment, worn flooring surfaces, [and bacterial infections contracted due to unsanitary conditions] (Riley, 2005, para. 2). General liability insurance deals with the working environment, not the scope of employment. Unless you’re a gym owner, or manager, you have no control over the working environment (Riley, 2005, para. 4), but as a personal trainer you have control over what you were hopefully certified and educated to do: prescribe exercise, demonstrate exercises, and design training programs. This is where the need for professional liability insurance comes into play. Professional liability insurance is similar to malpractice insurance for physicians and attorneys (Riley, 2005, para. 5), essentially protecting you from conduct known as professional negligence (Riley, 2005, para. 5), which the court found Ray Crouser of doing. As a result of the judgement, Crouser had to pay the defendant money for damages (Guthrie v. Crouser, 2003). Claims can originate from improper warm-ups, equipment failure and its improper maintenance, [equipment misuse], slip and fall accidents, even if they were caused by one member bumping into another (Riley, 2005, para. 8), and in Crouser’s case, causing injury or illness. This can include preexisting injuries or illnesses that may be known or unknown to the trainer, citing the eggshell plaintiff theory (Renka, 2007).
Professional liability insurance is relatively easy to obtain. Organizations such as ACSM, ACE, and the NSCA, offer its certified professionals and members the resources to apply for and purchase liability insurance. Additionally, discounts are extended to the members of the organizations. You may purchase insurance through a private insurance company. Rates and premiums depend upon the amount that you’re covered for.
There are some exclusions however. Professional liability insurance usually does not cover claims such as criminal acts, misconduct, and misrepresentation (Riley, 2005, para. 5). In (Guthrie v. Crouser, 2003) the defendant represented himself as a certified personal trainer, however, his certification at the time of Guthrie’s injuries had lapsed, meaning if he had professional liability insurance then, it likely would’ve not covered Crouser’s professional negligence. Riley also stated that insurance policies are primarily limited to negligence cases, which are based on carelessness, not deliberate intention.
Common Sense
Something that momentarily lapses or was never possessed by some people to begin with, is a little thing called common sense. Unless you’re on a Reality TV show, you can’t get away without common sense. Getting inebriated and triggering a fracas at the local tavern or standing firm to your belief that Chicken of the Sea is from “sea chickensâ€, not tuna are things that we as TV viewers get a kick out of. Clients who paid loads of cash, entrusting you with their fitness and health goals, won’t appreciate you making a Reality TV-caliber gaffe with what’s essentially their lives.
Fitness professionals need to practice within their professional scope. We hear all too often about personal trainers providing nutritional counseling. You don’t know how many times I’ve heard “my trainer said you should eat this…â€. Okay, is your personal trainer also a registered dietician? If not, they should not be doling off recommendations, especially if they’re not qualified to do so. Recommendations can sometimes prove harmful, even fatal, and if you’re operating outside of your professional scope, you’ll be on the hook for any judgments against you that may result. Courts found an employee and the commercial health club that employed them, responsible for the death of one of their clients. Anne Marie Capati, 37, and a sufferer of high blood pressure was instructed to ingest a list of nutritional supplements suggested by her trainer to combat fatigue and accelerate her weight loss efforts (Pristin, 1999, para. 2). Among the supplements, was a product called, Thermadrene, which contained 20mg of ephedra and 80 mg of caffeine per serving (Reents, 2007, para. 7). Literature suggests that those suffering from high blood pressure should abstain from ergogenic aids, such as ephedrine and caffeine (Magkos & Kavouras, 2004). The result? Ms. Capati died from a brain hemorrhage (Reents, 2007, para. 7) and the health club had $320 million lawsuit levied against it (Capati v. Crunch Fitness International, 1999).
Though fitness professionals are commonly asked questions regarding nutrition, they should not design diets and suggest nutritional supplements; instead, they should refer their client to their physician or a registered dietician for advice and perhaps a full assessment. Personal trainers are also asked questions regarding injury treatment and prevention. Though personal trainers may knowingly or unknowingly utilize modalities used by physical therapists, they are not licensed to practice physical therapy. A competent personal trainer will know when to refer to a physical therapist and may eventually bridge the gap between rehabilitating injury and training for fitness and/or improved performance.
Closing thoughts
In response to the flurry of litigation in recent years, states such as Georgia, Maryland, and New Jersey have made a push for uniform licensure of personal trainers (National Board of Fitness Examiners, 2008). Requiring licensure atop formal education and accredited certifications, will weed out a lot of the riffraff that’s in our profession. Long gone will be the online certifications, which only require a credit card number and an address to mail it to. Lawsuits will dwindle and our profession will actually have some legitimacy! Just think, if licensure is required for us to practice as fitness professionals, we may get a piece of healthcare pie, as we may be able to bill for our services, similar to ancillary professions such as athletic training and holistic services (i.e. acupuncture and massage therapy). Until then, I’ll just do what I can and I suggest other fitness professionals do to stay ahead: pursue more education, gain as much experience as you can, and keep active liability insurance!
References
Capati v. Crunch Fitness Int’l, No. 113218, N.Y. Sup. Ct. filed 1999
Crouser, R. (2000). Get busy living. Pro Trainer Online.
               Retrieved from http://www.protraineronline.com/past/nov16/living.cfm
Guthrie v. Crouser, WL No. 5600703, G.A. St. Ct. of Cobb County filed 2003
Magkos, F., Kavouras, S.A. (2004). Caffeine and ephedrine: physiological, metabolic, and performance-Â Â
               enhancing effects. Sports Medicine, 34(13), 871 – 889.
National Board of Fitness Examiners. (2008). State licensing of personal trainers, update DecemberÂ
 2008. Retrieved from http://www.nbfe.org/news/press_releases/stateLicensing_122008.cfm
Patel, D.R., Gyamfi, R., Torres, A. (2009). Exertional rhabdomyolysis and acute kidney injury. The
              Physician and Sports Medicine, 37(1), 71 – 79.
Pristin, T. (1999, June 29). Health club and trainer are sued in a death. The New York Times.
              Retrieved from http://nytimes.com/
Reents, S. (2007). Personal trainers should not offer nutritional advice. Athlete in Me.
               Retrieved from  http://www.athleteinme.com/ArticleView.aspx?id=264
Renka, C.E. (2007). The presumed eggshell plaintiff rule: Determining liability when mental harm
               accompanies physical injury. Thomas Jefferson Law Review, 29(1), 289 – 312.
               Retrieved from http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1023495
Riley, S. (2005). Liability insurance. IDEA Trainer Success, 2(2).
               Retrieved from http://www.ideafit.com/idea-trainer-success/2005/april
Roberts, S. (1996). The business of personal training. Champaign, IL: Human Kinetics
Woman says personal trainer put her in hospital. (2007, February 20). WSBTV ABC Atlanta.
              Retrieved from http://www.wsbtv.com
Joe Giandonato, MS, CSCS, is a Philadelphia-area healthcare support professional and personal trainer, he holds an M.S. in Exercise Science and has nearly a decade of personal training experience. Presently, he is employed as a Fitness Specialist with the University of Pennsylvania, Department of Recreation and also trains clients Broad Street Fitness in Philadelphia, PA. He is also pursuing a MBA with a concentration in Healthcare Administration, is a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association and a Performance Enhancement Specialist (PES) through the National Academy of Sports Medicine. More of his articles can be found on elitefts.com, joshstrength.com, beyondstrengthperformance.com, and personaltrainersunited.com.