Website design By BotEap.comA big problem in the fitness industry in general is personal trainers going outside of their scope of practice. These days, functional training has taken over the personal training industry as the evidence-based best practice. However, this has led many trainers to cross the line in their qualifications. Many gyms and personal training studios have their trainers perform things like postural assessments and functional movement screens to diagnose potential problems with normal daily activities. How many trainers are really qualified to do this? For example, I have seen x-rays of people who appear to have exaggerated postures when looking at their skin, but the x-ray shows nothing abnormal. In this context, if we tried to correct the situation, we could actually be doing more damage. The question that needs to be answered is: are we really qualified to diagnose anything?

Website design By BotEap.comMany “functional” trainers walk the fine line between physical therapist and personal trainer by diagnosing problems (muscle imbalances, joint pain, etc.) and attempting corrective exercises to fix the problem. Is this really within the scope of practice of a personal trainer? Let’s take a closer look at some scope of practice definitions from the American Council on Exercise (ACE), the American College of Sports Medicine (ACSM), and the National Strength and Conditioning Association (NSCA). These are three very well recognized and established personal training certifications within the fitness industry. The NSCA developed a definition of a professional for its primary certification, the Certified Strength and Conditioning Specialist (CSCS), which states that the CSCS is a professional who “practically applies basic knowledge to assess, motivate, educate, and train athletes with the primary goal of improving sports performance. It further states that it is the job of a CSCS to consult and refer athletes to medical, dietary, athletic training, and sports training professionals when appropriate. ACE is silent in its definition of a personal trainer’s scope of practice about diagnosing abnormalities. He mentions that trainers can develop and implement programs for people who are apparently healthy (what does “apparently healthy” really mean? Is it a matter of judgment?) or have medical clearance.

Website design By BotEap.comSimilar to the CSCS definition of professional, it specifically says that a trainer’s job is to “recognize what is within the scope of practice and always refer clients to other health professionals when appropriate.” The ACSM states that “The ACSM Certified Personal Trainer is a fitness professional involved in the development and implementation of an individualized approach to exercise leadership in healthy populations and/or those medically cleared to exercise.” There is nothing in their scope of practice statement that says a trainer must be able to diagnose and/or treat any ailment. Eickhoff-Shemek and Deja (2002) echo these claims in their article “Four Steps to Minimize Legal Liability in Exercise Programs.” Sean Riley, a licensed attorney and exercise physiologist, warns us that a trainer can only legally design and implement training programs (Riley, 2005). He further states that to act outside this scope is to practice medicine illegally (Riley, 2005). Trainers can be convicted of a crime if they “practice or attempt to practice, or…advertise or represent themselves as practicing, any system or mode of treating the sick or afflicted…or that diagnoses, treats, or operates for or prescribes for any ailment, blemish, disorder, injury, or other physical or mental condition…without being authorized to perform such an act…” (Herbert & Herbert, 2002). This was specifically written for California, but many states have similar statutes. As with the aforementioned scope of practice statements from the NSCA, ACE, and ACSM, Riley notes that “…it’s up to you to turn down clients whose needs exceed your skills and knowledge.” This opens up a whole new can of worms, as most trainers are paid on commission, making it difficult to turn clients away.

Website design By BotEap.comIT IS appropriate that we, as exercise professionals, notice limitations in our clients. This could range from limitations in ROM, strength, coordination, and even mental ability. From here, unless you’re a qualified professional, it’s our job to fix these issues while keeping our clients active and healthy and not make the problem worse. Bottom line: Personal trainers need to monitor themselves and know when their job ends and someone else’s begins.

Website design By BotEap.comEickhoff-Shemek, J. and Deja, K. (2002). Four steps to minimize legal liability in exercise programs. ACMS Journal of Health and Fitness, 4(4), 13-18.

Website design By BotEap.comHerbert, D. & Herbert, W. (2002). Legal aspects of preventive, rehabilitative and recreational exercise programs. (4th ed.). Canton, OH. Publications of the People’s Republic of China.

Website design By BotEap.comRiley, S. (2005). Respecting your limits. IDEA Trainer Success, 2(4), retrieved from http://www.ideafit.com/fitness-articles/personal-training/personal-training-ethics-scope-of-practice