Health and Fitness Standards: Use Them to Provide Appropriate Client Care and to Avoid Claim & Suit

Written standards of practice, sometimes referred to as parameters of practice or even guidelines, are important to provide acceptable levels of care to various service recipients, be they patients of physicians or clients of fitness professionals.  Starting in the 1970s the medical profession began a substantial effort to reduce malpractice claims and suits through a number of means including the development of practice guidelines and standards.  While some physicians criticized the development of these statements as “cookbook-type recipes” which restricted the delivery of individualized health care, the effort continues to this day.  The thought was to develop such guidelines or standards to guide and support the care provided by physicians following the practice recommendations contained within such standards which were developed by numerous and authoritative practitioners.  The provision of care in accordance with such standards was then thought to be above reproach if a bad result should occur to a patient whose provider adhered to the standards documents.  However, even though these standards can be used to support the delivery of service by professionals, they can also sometimes be used to attack the care that is rendered if providers don’t adhere to such standards.

The health and fitness industry came under rather close media scrutiny in the late 1990s and early 2000s as a result of a number of injuries and even deaths to personal trainer clients engaged in fitness activities while under the supervision of such fitness service providers.  As a result, in 2006 the International Health, Racquet and Sportsclub Association (IHRSA), one of the world’s largest fitness trade organizations, developed a final and formal corporate resolution which recommended that its member health clubs employ only those personal trainers who were certified by a certification organization accredited by the National Commission for Certifying Agencies (NCCA) or one recognized by the United States Department of Education (USDE) and/or the Council for Higher Education Accreditation (CHEA).  In accordance with IHRSA’s resolution,  the  later  recognized  organization  became  the  Distance  Education  and  Training Council (DETC), now known as the Distance Education Accrediting Commission (DEAC).  As a consequence of IHRSA’s corporate recommendation, the qualifications and service delivery routines of many personal trainers began to improve.  At about the same time, the health and fitness industry also turned to the development of standards and guidelines produced through various consensus processes to establish acceptable guidelines and standards for the delivery of appropriate fitness services to clients.

In this regard, health and fitness guidelines and standards of practice were developed by a number of well-known fitness organizations, including IHRSA, the American College of Sports Medicine (ACSM), the Aerobics and Fitness Association of America (AFAA), the National Strength and Conditioning Association (NSCA), the Medical Fitness Association (MFA) and even the YMCAs of the United States.   Since the development of these standards statements, new editions of such standards have been developed by, among others, the ACSM and the NSCA.  Another similar effort was also instituted some years ago in a partnership arrangement of sorts between the ACSM and NSF International (NSF) which resulted in the initial development of an American National Standard (ANS) sanctioned by the American National Standards Institute (ANSI).  It was expected that this standard would ultimately improve the delivery of fitness services in the United States.  However, once it was brought to ANSI’s attention that the effort left out a substantial segment of the fitness industry in the development of the standard, the ANSI sanction provided to the standard as an American National Standard was withdrawn and the standard was thereafter withdrawn by NSF as an American National Standard on August 8, 2014.   Despite the NSF setback to industry standards, standards when properly written from an entire industry perspective should improve the delivery of fitness services in this country.

All health and fitness professionals providing services to clients must appreciate, understand and apply the industry’s applicable standards statements in their delivery of service to clients.  While the use of such statements has been limited in some litigations due to certain qualification statements contained within some of these statements, it seems rather clear that these standards set the bar for appropriate care for fitness clients and are established to protect not only the consumers of fitness services but in turn, those fitness professionals following these standards from claim and suit.

Standards statements cover the intake process for fitness clients, screening, testing, prescription/recommendation   of   exercise,   supervision,   selection/set-up/use/maintenance   of fitness equipment, on-going service provision, emergency response and even such issues as informed consent, the use of releases and waivers, insurance and other subject matters. It appears rather clear that such statements establish the bar to which all fitness professionals, including personal trainers, must strive to meet to avoid the delivery of less than acceptable care leading to injury to fitness clients as well as potential claim and suit to fitness professionals.  The standards statements developed by prominent fitness associations include those of IHRSA1, ACSM2, AFAA3, and NSCA4, among others.  We shall begin to look at these standards in our upcoming articles to alert fitness professionals to important service delivery issues designed to protect clients and professionals alike.

1 IHRSA Club Membership Standards.   In: IHRSA’s Guide to Club Membership & Conduct.   3rd  ed. Boston: International Health, Racquet & Sportsclub Association (IHRSA); 2005.

2  Tharrett SJ, Peterson JA, eds. ACSM’s Health/Fitness Facility Standards and Guidelines. 5th ed. Champaign, Ill; Human Kinetics; 2012.

3   AFAA  Exercise  Standards  and  Guidelines  Reference  Manual,  Sherman  Oaks,  Calif;  Aerobics  and  Fitness

Association of America (AFAA); 2010.

4  NSCA Strength & Conditioning Professional Standards and Guidelines. Approved July 8, 2009, updated from

2001  NSCA  Standards  and  Guidelines.  Available  at:  www.nsca.com/WorkArea/DownloadAsset.aspx?id=638. Colorado Springs: National Strength & Conditioning Association (NSCA) Accessed October 1, 2015.

This publication is written and published to provide accurate and authoritative information relevant to the subject matter presented.  It is published with the understanding that the author and publisher are not engaged in rendering legal, medical or other professional services by reason of the authorship or publication of this work.  If legal, medical or other expert assistance is required, the services of such competent professional  persons  should  be  sought.   Moreover,  in  the  field  of  personal  fitness training, the services of such competent professionals must be obtained.

Adapted  from  a  Declaration  of  Principles  of  the  American  Bar  Association  and Committee of Publishers and Associations


David Herbert

David Herbert

David L. Herbert, Attorney at Law, David L. Herbert & Associates, LLC, Attorneys & Counselors at Law, Canton, Ohio 44718; http://www.herblaw.com/ Editor, The Exercise, Sports and Sports Medicine Standards & Malpractice Reporter PRC Publishing, Inc., Canton, Ohio 44735; http://www.prcpublishing.com/ David L. Herbert, JD is an Ohio lawyer and Editor of The Exercise, Sports and Sports Medicine Standards & Malpractice Reporter now in current form, in its 27th year of publication. He has helped write and/or served as legal counsel for published standards and guidelines developed for the health and fitness industry by ACSM, NSCA, NSF and AFAA. David has worked in law-related fields associated with these and other matters for over 35 years and has provided services to ACSM, NSCA, ACE, AFAA, ISSA, NBFE and numerous other similar organizations. He has made presentations to various audiences for ACSM, AHA, NSCA, NATA, IHRSA, NIRSA, AACVPR, HeartWatchers International, the Cleveland Clinic, as well as many other hospitals, professional organizations and educational facilities. He is the author or co-author of 47 books and book chapters and over a 1,000 articles in the field, including a new fictional book entitled The Personal Trainer; A Tale of Pain, Gain, Greed & Lust, a legal thriller that focuses on the fitness industry’s interaction with the legal system, see, www.thepersonaltraineronline.com.

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