Fitness professionals and personal trainers must follow a number of legal and professional guidelines when training clients in any capacity. This includes knowing the scope of practice, obtaining proper certifications, following proper standards of care, obtaining necessary paperwork from clients, and ensuring a clean and safe facility.
Introduction to the Healthcare Continuum
Healthcare professionals include most individuals credentialed through licenses, certifications, and registrations in a field relevant to human health. Each of these professionals provides services which identify, prevent, and treat injuries and diseases.
When an individual needs treatment, they visit with their primary care physician. When that physician encounters a situation outside of their scope of practice, they refer their patient to another healthcare professional who can provide specific services (such as a registered dietician to provide nutritional information or an orthopedist to treat a bone-related issue).
While other professionals may provide general guidelines for physical activity, it is the certified personal trainer (CPT) that develops exercise programs for healthy individuals to help improve and maintain their fitness goals. Certified personal trainers are often the bridge between the medical community and those who exercise. Physicians are often called on to recommend physical activity to their patients, but only 30% of patients report hearing this advice from their doctor.4
All personal trainers should stay within the scope of practice equivalent to their training and experience, following the recommendations of other healthcare professionals. When a client is referred by a physician, it is necessary to get permission from the client to communicate with their doctor in order to keep the doctor abreast on how the client is doing and to see what recommendations the doctor may have.
Physicianโs orders take precedence over the fitness professional, since they will have a more complete understanding of the clientโs health and medical history. The trainer must remain cognizant of their own role in order to avoid any legal problems and provide the right types of services for which they are qualified. This will also help develop relationships with the other medical professionals who are linked to this client as well and create good cohesion, and the trust to refer more clients to the trainer.
The Trainer Academy CPT Scope of Practice
The Trainer Academy CPT scope of practice encompasses working with apparently healthy individuals or people with health conditions who have been cleared to exercise by an appropriate healthcare professional.
Scope of Practice for Trainer Academy Certified Personal Trainers:
- Training apparently healthy individuals to improve aerobic and muscular fitness
- Training individuals with medical conditions who are cleared by physician for exercise
- Training 1-on-1 or in small groups
- Coaching clients on developing realistic fitness goals
- Designing appropriate fitness training programs for specific goals
- Instructing safe exercise technique
- Supervising exercise equipment use
- Conducting preparticipation health screenings
- Conducting physiological measurements (heart rate, blood pressure, weight)
- Assessing cardiovascular fitness
- Assessing muscle strength and endurance
- Assessing flexibility
- Providing basic general nutrition information
The Trainer Academy CPT scope of practice prohibits:
- Diagnosing or treating any illness or injury
- Prescribing medications or supplements
- Making specific meal plans or dietary recommendations
- Monitoring medical conditions
- Rehabilitating or providing counseling for any conditions
Liability Guidelines for Personal Trainers
The trainer should understand areas of liability associated with the delivery of their service and how to minimize these risks by following standards and guidelines established by professional organizations.
Along with a comprehension of how to develop safe and effective exercise programs, personal trainers must obtain liability waivers from all clients prior to bringing them into the equipment area.
Proper Certification
Although there is no one governing body over exercise and no specific qualifications as far as education or certification, the primary purpose of each certification is to protect the public from harm. Becoming certified is the first step prospective trainers must take to minimize the risk for the client and liability for themselves.
With a certification from a National Commission for Certifying Agencies (NCCA) accredited organization, fitness professionals prove that they have met minimal competencies and that they possess the knowledge, skills, and abilities to develop safe and effective exercise programs.
Certification and adherence to industry recognized standards will serve to maintain professionalism, reduce liability, and give guidance to the client as far as the trainerโs credentials.
Numerous professional organizations recommend hiring trainers who have an NCCA accredited certification. Certifications will require that trainers achieve continuing education units to maintain certification.
The Trainer Academy CPT is among the NCCA accredited certifications, and has thus gone through the rigorous process to ensure the information and guidelines provided match the best practices in the industry.
The Trainer Academy CPT has a continuing education requirement of 20 credit hours every 2 years from a wide range of continuing education providers.
Standard of Care
Personal trainers must act as any reasonable and prudent professional would with the same level of training. If a lawsuit is brought against them, another professional may testify as to what they would have done in the same situation. Also, the position statements of prominent exercise organizations may be consulted to see if they conformed to these standards.
Confidentiality and Record Keeping
Since CPTs collect various health forms, personal information, records of training sessions, and payments made or due, the clientโs confidentiality will have to be protected. And in case of any litigation, trainers may need to reproduce documentation to prove that they performed appropriately. It is important for trainers to hold on to and maintain accurate client records for a minimum of four years.
Facilities and Equipment
Facilities that trainers may work in include commercial fitness centers, private studios, outside locations, or in a clientโs home. Regardless of location, trainers have a responsibility to make sure that they took all reasonable precautions to eliminate any hazards. If training in a gym, CPTs should make sure the floor is clean and equipment is put in its proper location. They should check local laws when training outdoors and inform clients of any potential risks.
Ensuring that clients are wearing appropriate clothing and footwear for the workout is another area of concern that the CPT should be aware of. All precautions that are undertaken should be documented and kept up to date in case they need to be produced.
Trainers use various apparatuses during workouts. It is important to use equipment from reputable manufacturers. CPTs should inspect equipment to make sure it is not damaged, it is clean, and it is safe to use.
Procedures should be in place to document that the equipment receives inspections, maintenance, and repairs. CPTs must make sure they are knowledgeable about the intended use of the equipment so that they will use it effectively and appropriately. Using equipment for unintended use will open the trainer up to liability.
Personal trainers should make sure that the client has been familiarized with the apparatus and has the physical aptitude to safely use a piece of equipment. They should make sure to have the appropriate pieces of equipment for the number of people they will be training so nobody is fighting over it and know how to substitute one piece of equipment for another in case something is not available when they go to train a client.
Emergency Response
In the event of an emergency, certified personal trainers should follow the facility procedures. Since Trainer Academy Certified Personal Trainers are required to maintain a valid CPR/AED certification, trainers should always respond as trained individuals in those certifications when responding to potential cardiovascular risks.
Risk Management
Proper risk management involves having policies and procedures in place as well as following industry standards and guidelines to show that CPTs took all possible precautions to ensure safety, minimize risk, and are prepared to handle any foreseeable emergencies.
Risk management plans should be multi-tiered. Written documentation showing that the facility and equipment is being surveilled for damage, maintenance, and repair should be kept on file, informed consent and waivers for all participants should be signed and up to date, and liability insurance should be procured by the CPT. The CPT should uphold all copyright laws as well.1, 3
Liability insurance will help to protect trainers from claims due to such things as accidents or negligence. When acquiring insurance, the CPT should make sure to check that the insurance provides proper coverage for the services they will be delivering and the settings that they will be working in and the amount appropriate to the level of risk.
Though CPTs will take every precaution to minimize any liability, accidents happen. Carrying liability insurance along with the practice of other risk management strategies are the best ways for personal trainers to protect themselves and their assets from possible litigation.
Summary
In conclusion, the CPT has many professional responsibilities. They need to understand their place alongside other healthcare professionals and how their services interact with them.
The CPT must adhere to their scope of practice and refer to the appropriate professionals when clientโs present with conditions that fall outside the Trainer Academy Scope of Practice.
The CPT must also respond appropriately to emergencies, keep detailed records of all client waivers and incidents, and take steps to protect themselves against potential liability.
References
- IDEA Health and Fitness Association. IDEA Opinion Statement: Benefits of a working relationship between medical and allied health practitioners and personal fitness trainers. IDEA Personal Trainer. 2001; 13 (6): 26-31.
- US Bureau of Labor Statistics. Occupational Outlook Handbook, Fitness Trainers, and Instructors. Fitness Trainers and Instructors : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics (bls.gov). Accessed 1 July. 2022.
- Archer-Eichenberger S. Reward Carries Risk: A Liability Update. Idea Personal Trainer. 2004; 15 (4): 30-4.
- Pojednic R, Bantham A, Arnstein F, Kennedy MA, Phillips E. Bridging the gap between clinicians and fitness professionals: a challenge to implementing exercise as medicine. BMJ Open Sport Exerc Med. 2018 Oct 16;4(1):e000369. doi: 10.1136/bmjsem-2018-000369. PMID: 30364472; PMCID: PMC6196940. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196940/