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Here is an article from mens health, it will be in the next issue I believe. I've been harping back and forth with some guys on here about this forever. Especially the ones that suggest getting help from a guy in the gym or their buddiys. It's a long read, but if you are serious about fitness, and considering using a personal trainer, you should read this. Caveat Emptor.
After his third session with a "really nice" personal trainer, David Carr found himself in a hospital with one of his arms in a splint and blasted muscle proteins in his urine.
"Wow!" exclaimed the doctor when he saw Carr's arms, which were swollen so badly that they could barely bend and wouldn't respond to prescription muscle relaxers. "You're a hair away from compartment syndrome, which means we'd have to open your arms and release the pressure."
Carr had torn his biceps and triceps, and suffered such diffuse muscle damage that protein was flooding his kidneys. His right arm was the worst; he'd have to have it in a 90-degree splint for nearly 2 weeks. He'd also have to miss work till the swelling subsided and he was able to bend his elbows enough to steer a car.
"Now, how did you do this again?" the doctor asked.
Carr was embarrassed to tell him it was just from an "easy" intro workout. He couldn't help thinking he should have been tougher, or more focused, or at least savvy enough about lifting to know to pull back. "Those sessions were supposed to teach me a basic routine, not break me," he says. "But I didn't know my limits--and the trainer who was supposed to tell me didn't."
Carr didn't return to the gym for 8 months, and when he did, the trainer who'd savaged his arm was still there. Carr saw him, and did exactly what so many other guys have done in the same situation.
Not a damn thing.
Right now, there are roughly 182,000 fitness trainers at work in the United States, according to the Bureau of Labor Statistics. Every day, they perform what are essentially medical functions--they strain clients' cardiovascular, muscular, and nervous systems; jack up heart rates and blood pressure; strain joints and ligaments; and recommend diets, drinks, and supplements.
But unlike other health professionals, fitness trainers, a.k.a. personal trainers, aren't required to have a license, or training, or even experience. They don't have to know CPR, or how to find a pulse, or the difference between healthy exhaustion and a diabetic blood-sugar stupor. In fact, they're not required by law to know anything. To become a personal trainer, all you need to do is . . . wait, let's go through the whole process ourselves.
Ready?
Step 1: In a clear, confident voice, say, "I am now a personal trainer."
Step 2: Congratulations--you passed! See you at the class reunion.
Not so bad, was it? That's because presently, there are no federal or state requirements for personal trainers. There isn't even an industry benchmark: Every gym decides, independently, who's qualified to work on its floor. The screening is even worse for freelance trainers who visit clients in their homes and offices: Most gyms at least require references and some kind of certification, but all you need to go into business for yourself is a Swiss ball and a smile.
So if you're one of the 5 million Americans who have personal trainers, consider this: You may be putting your life in the hands of someone with less training--and certainly less legal oversight--than the shampoo girl at Supercuts. To become a barber, real-estate agent, or nail technician anywhere in the United States, you need formal training, a passing grade on a written exam, and a state license--which means someone who trims your hair, sells your condo, or polishes your girlfriend's fingernails has been far better vetted by the government than the guy who's rehabbing your knee postsurgery and checking your heart-rate monitor.
"When you sign up for personal instruction, you really are in a buyer-beware situation--so the buyers better be aware," says Steven Loy, Ph.D., a professor of kinesiology at California State University and former executive director of the Southwest region of the American College of Sports Medicine. "Gyms may require trainers to have some kind of certification, but they may not be rigorous about discriminating between worthwhile certifications and worthless ones."
Some trainers in the trenches say the problem is even worse than Loy describes. "You see a lot of people who go to a gym, and see a flyer advertising 'We Hire Fitness Trainers,' and the next week, they're on the floor with a clipboard and a polo shirt with 'Fitness Trainer' on it," says Carlos Sumulong, a California-based trainer who holds the respected C.S.C.S., meaning Certified Strength and Conditioning Specialist, from the National Strength and Conditioning Association. He routinely takes on clients injured by other trainers. "They're just learning, so everyone is their guinea pig. I just hope they don't hurt somebody."
Sumulong inherited one client whose back had been wrecked by his previous trainer. "The trainer put 1,000 pounds on the leg press, just to see if the client could do it," Sumulong recalls. "He thought it looked cool to have the machine fully stacked with 45-pound plates. The client got it halfway up, and then, blam! there was a big mess." The man suffered a compressed disk and has spent 4 years trying to rebuild his strength to where it was before. "Truth is, he's still not there," Sumulong says.
No gain, plenty of pain
Last year, a 37-year-old TV editor named Fred Widland sued a well-known New York City gym, claiming that an incompetent trainer nearly worked him to death. Widland was overweight and out of shape and had just given up smoking, he says, but instead of a gradual buildup, he got a boot-camp beat-down. During his initial session, Widland claims, the trainer pushed him to failure with very little rest in between a punishing weight circuit and walking lunges across the yoga room. Soon after, Widland was diagnosed with exertional rhabdomyolysis, a breakdown of muscle fiber from severe exertion, a condition that can be toxic to the kidneys.
It's actually "quite common" for trainers to drive their clients into this disorder, says Priscilla Clarkson, Ph.D., associate dean of Public Health and Health Sciences at the University of Massachusetts and coauthor of a recent study that examined cases of trainer-induced rhabdomyolysis. "They may think they're just providing the motivation to work hard and giving someone a 'good workout.' "
Still, compared with Anne Marie Capati, Widland was lucky. Capati was also 37, and had gone to the same NYC gym to lose weight. Six months into her workouts with a trainer, Capati suffered a brain hemorrhage doing light squats and later died as a result. The trainer, it turns out, had put her on a dietary plan that included ephedra, even though Capati had told him she was on high-blood-pressure medication, which should never be mixed with ephedra. The trainer's credentials could not be verified, and the case was settled for an undisclosed amount.
"Nobody really knows how many injuries are out there," says Marc Rabinoff, Ed.D., chairman of the human-performance-and-sport department at Metropolitan State College of Denver and a forensic specialist who has been consulted in 70 cases of training negligence or incompetence. "Most cases are settled quickly and quietly and never make their way into a newspaper or a courtroom."
And all those victims who've kept quiet are contributing to the problem, Rabinoff points out. "The industry has been getting away with it for years because of this macho attitude about not complaining," he says. "A trainer can mess up, break a guy's nose, and the guy's supposed to say, 'Aw, heck with it.' "
Teutonic hard-guy and perpetual locker-room poster boy Friedrich Nietzsche isn't helping either: "So many people buy into that old 'What doesn't kill you makes you stronger' mentality," says Kyle Battis, C.S.C.S., a personal trainer in Concord, New Hampshire, who has been outspoken about abuses in his profession. "The truth is, what doesn't kill you will ruin your training, or put you in a hospital, or drive you out of the gym. And a good trainer should know that. Too many don't, and neither do their clients. So when a guy gets hurt, he thinks it's normal--just a down payment on the 'No Pain, No Gain' system."
Take Murray Cran: He was 23 years old, and because he liked competing in martial arts and hockey, he wanted to add a few pounds of muscle to his 5'10", 160-pound frame. The gym he chose in downtown Calgary was busy and popular, and staffed by gigantic trainers. One of them had a "3- or 4-minute" conversation with Cran about his goals, then plunked him down on the incline bench for some dumbbell presses.
"I was using too heavy a weight, so he was pushing my arms up, and he must have pushed too hard, because one of the weights flipped over and crashed down on my face, breaking my tooth," Cran says. There was blood everywhere, but the trainer didn't apologize. "It was more like, 'Too bad,' " Cran says. He had his tooth fixed and returned a few days later, but didn't make a stink. "Those guys kind of intimidated me," he admits.
So Cran, just like Carr, kept his injuries to himself. But if Carr had walked out of a bar instead of a gym looking the way he did after his session with a "really nice" trainer, someone would have been arrested for assault. That's why it's helpful to do a CSI of Carr's experience and see all the fiery red flares that were blazing right in front of him.
At 27, Carr still looked good in clothes. He was 6'1" and 215 pounds, and his job as an E.R. nurse in Roseville, California, kept his shoulders broad and his arms reasonably beefy. But Carr knew that once his shirt came off, there'd be little trace of the 170-pound wrestler he'd been in high school.
He and his wife were going on a cruise last spring, so he figured the time had come to torch some fat off his belly and chisel a few cut lines into his chest. That was the extent of his athletic goals: He didn't care if he did free weights or machines, circuits or straight sets, as long as he looked good on the lido deck.
He had heard that a big health club was offering new members five free sessions with a fitness trainer, which sounded perfect. The gym assigned him to someone they claimed was a certified trainer and who definitely knew a lot about fitness--at least, it looked that way to Carr. The guy shaved his arms and looked pretty strong--those are good signs, right?
For their first session, the trainer had Carr fill out a standard questionnaire, with questions like "What are your goals?" and "What's your athletic experience?" Carr duly noted that he'd wrestled 10 years before, but had no weight-training experience. The trainer glanced over the questionnaire, then printed out a workout. "It looked like a standard thing--a diet and a series of exercises," Carr says. "He did it so fast, I had the feeling that everyone got the same thing." And that was it for day 1. No strength testing or flexibility testing, no demonstration of a proper warmup, no technique handouts.
On day 2, the trainer worked Carr's abs and legs so hard, Carr had trouble walking the next day. "I worked in an E.R., so that made it uncomfortable, but I figured it was normal," he says. Then came day 3: arms and chest.
"I was doing dumbbell benches, dumbbell shoulder presses, dumbbell flies," Carr recalls. "I don't remember what kind of weight I was lifting, but I remember thinking, I don't think it's supposed to hurt this much." The trainer kept pushing him, though, so Carr kept struggling.
That night, his arms blew up. He tried "tons" of ibuprofen and even some old prescription muscle relaxers, but nothing worked: His arms ached so much, he couldn't sleep. When he dragged himself to the toilet the next morning, he was startled to see the bowl filling with brown urine. He could barely drive but got himself to a doctor, who immediately set Carr's right arm in a splint and a tight bandage to arrest the swelling.
"He said my muscles were so torn up, the fiber so ruptured, I was pissing protein," Carr says. "The swelling was so bad, fresh blood couldn't flow through, so my muscles were basically starving." It took Carr a few days before he could go back to work on light duty. One of his more gym-savvy colleagues took a look at Carr's splint and shook his head. "Nah, that just ain't right," he said.
It was more than half a year before Carr ventured back to the gym. By that point, he'd ballooned to nearly 230 pounds. He never said a word to the trainer or the gym management, which baffles him. "I guess I was embarrassed," he says. "It's weird--I go to a hotel and get bad service, I complain right away. But this--I must've felt this was sort of my fault."
"Oh boy," sighs Lorenzo Gonzalez, D.P.T., when he hears about Carr's case. Gonzalez was an instructor in the department of physical therapy at the University of Miami and now runs a private physical-therapy practice in Manhattan, where he spends a good amount of time correcting trainers' mistakes. "That was kind of a disaster, wasn't it?"
The first thing that should have made Carr cautious was the very thing that brought him through the door. "Be wary of the free deal," Gonzalez says. In these promotional offers, he says, the trainer's job is to process bodies double-time; even a trainer with the best experience and intentions may not have the time--or even the authority--to customize a truly thoughtful workout plan. "You say you want strength and flexibility, and they spit out a standard routine," Gonzalez says. "They're putting a square peg into a round hole."
Second, the trainer didn't do any baseline assessment. "That's a big warning sign right there," Gonzalez says. "Simple rule: If you're not tested, walk away." It's basic diagnostics, he points out: How can a trainer gauge a new client's strength, balance, flexibility, or cardiovascular fitness without a walk-through? "How does he even know where to put the pin in the stack?" Gonzalez asks. "He's just guessing, like pin the tail on the donkey."
Third, the client isn't supposed to be diagnosing strengths and weaknesses. "It's kind of surreal," Gonzalez says. "You go to a trainer because you don't know, and his starting point is to take information from a guy who's already said he doesn't know! If you went to a doctor and said, 'My stomach hurts--I think it's appendicitis,' he wouldn't say, 'Right, then. Let's schedule you for surgery at once.'"
And finally, "That first legs-abs workout, that was a big red flag," says Gonzalez. "You should feel worked, but not have difficulty walking. That's a sign of injury." The stiffness sets off a destructive spiral, he says. The pain makes you avoid using that part of the body, which means the muscle isn't getting stretched, and it becomes shorter and tighter as it heals. And the tighter the muscle, the more prone it is to an imbalance injury.
"One of the biggest faults I find is that a lot of trainers exacerbate imbalances," Gonzalez adds. "I see a lot of CEOs, and when they come to me with neck pain and shoulder pain, it's because they've exacerbated a prior condition."
One client had been having nagging lower-back pain for years. He was a corporate executive in his early 40s and a highly motivated runner. "Type A, all the way," Gonzalez recalls. "You tell him 10, he bangs out 100." The problem was, the 10 his trainer gave him were all wrong. "The trainer had him doing lots of flexions--toe touches, quad work, every kind of crunch, but they made the problem worse." What the runner needed to do was the exact opposite: Instead of constantly bending forward, he would have gotten relief from working backward--doing bridges and Swiss-ball stretches, loosening his glutes and hamstrings.
"For a year, the very guy who's supposed to help him is increasing his pain," says Gonzalez. "Usually, I try to work with a trainer and show him how to make corrections. But I told this client, 'You'd better get rid of that guy.'"
Many trainers, of course, have advanced degrees and tremendously sophisticated knowledge of nutrition, anatomy, and kinesiology. There are legions of people out there who are top pros and give you smart, expert guidance. So when you hire a trainer, how do you tell if you're in the hands of a Yoda or a yo-yo? Physique and experience, unfortunately, are no help. If you think the man benching the biggest stack knows enough to give you training advice, you'd better pay attention to what UCLA's exercise physiology research laboratory discovered in a 2002 study of health-and-fitness professionals: Trainers who had 5 years of experience but no college degree did terribly on a test of their fitness knowledge, scoring an average of only 44 percent.
"Extensive training experience in the health and fitness profession," the researchers found, "does not necessarily translate into a knowledgeable and capable professional."
The test wasn't extremely hard, either. It was multiple choice, so the answers were on the page, and typical questions were "What intensity of exercise is most appropriate to develop a cardiovascular benefit in an apparently healthy individual?" and "Which of the following exercise prescriptions would you recommend to a nonâ “insulin-dependent diabetes mellitus client?" Basic, crucial information, in other words--the kind of information that could have saved Capati's life.
Only one group of trainers did reasonably well on the test: those with a bachelor's degree in kinesiology and certification by either the American College of Sports Medicine (ACSM) or National Strength and Conditioning Association (NSCA), two organizations that are considered the gold standard of fitness training.
"Thus, education may be more important than personal-training experience in personal trainers," the study concludes. That makes sense: If trainers have no oversight and their managers aren't fielding complaints from in-jured clients, then there's nothing stopping them from continuing the same ill-informed and potentially dangerous practices.
Determining whether your trainer has the education he needs can be difficult. There are nearly 300 different certifications available, all identified by a confusing jumble of acronyms that sound similar. Wouldn't you be impressed by a degree from American Fitness Professionals & Associates? Turns out, it comes from a P.O. box in Ship Bottom, New Jersey, and can be had for $315.
Through its online certification process, American Fitness Professionals & Associates claims to have produced "over 57,000 Certified Personal Trainers & Fitness Professionals worldwide." That's not surprising, since the only requirements are 18 years on the planet, a GED, and "basic familiarity" with anatomy and resistance-training equipment. You don't need to know CPR, but you do have to score 90 percent on their test. If you fail, no worries: They'll mail you the questions you answered wrong and give you 2 weeks to get them right.
ExpertRating.com makes it even easier: "All you have to do is buy the ExpertRating Personal Trainer certification for $49.99," its Web site states. ExpertRating will then send you its personal-trainer courseware and give you an online certification exam. Get half the questions right and you're in.
Not surprisingly, neither American Fitness Professionals & Associates nor ExpertRating responded to our inquiries.
Perhaps the most shocking fact about outfits like ExpertRating is that people employ their graduates. Why would a gym risk losing customers and fighting a lawsuit by hiring a $49.99 trainer? Two reasons: (1) They desperately need personnel, and (2) they've figured out a seemingly foolproof way to dodge liability.
Because of the boom in personal training over the past 15 years, gyms have been scrambling to hire more staff. Nationwide, fitness training is projected to be one of the strongest-growing occupations, at least through 2012. When the trainers are qualified, that's great--it means more people are being taught and motivated.
But when they're not, the gyms have a way to deny responsibility. "The gyms hide behind two degrees of separation," says Rabinoff. "First, they get you to sign a waiver." If you belong to a gym, you've almost certainly signed that clause yourself, the one that states "You agree that if you engage in any physical exercise or activity or use any club facility on the premises, you do so at your own risk."
"On top of that," Rabinoff continues, "they set it up so trainers are subcontractors. In some cases, I've found outrageous negligence, but because the trainer is categorized as 'independent,' the gym has slipped out of liability." The injured client can always sue the trainer, of course, but if the trainer isn't insured, there's little hope of winning compensation. "If people are foolish enough to hire someone who owns only a van and a jump rope, you can have the best case and no lawyer is going to take it," Rabinoff says. "You'd have to garnishee the trainer's salary for 100 years to make back what you lost in medical bills."
It's little wonder, then, that an estimated 50 percent of all health-club members have sustained minor injuries, says David L. Herbert, an attorney and health-fitness specialist in Canton, Ohio. "As long as the injured parties didn't complain . . . what's the incentive to make sure that everyone is qualified?" Herbert asks.
But Herbert has noticed some encouraging signs lately, from both the legal and fitness communities. Some courts are no longer accepting the exculpatory waivers at face value and are holding gyms accountable; basically, they're allowing experts, like Rabinoff, to testify as to what a realistically safe level of supervision should be. Herbert notes that in 1996, a New York appellate court threw out a lawsuit by a man whose shoulder was injured by an inept trainer, but 3 years later, that same court accepted a nearly identical case.
"The courts are starting to understand the fitness industry, and that's going to put more pressure on the clubs to shape up," Herbert says. And, he's pleased to report, they are. "I'm one of the trustees of the National Board of Fitness Examiners, and we're in the process of developing a single, unifying examination for all personal fitness organizations," he says. "More than 2,000 trainers have already shown individual interest in taking the exam, which is a good sign--they're making the move on their own, without being coerced."
Plus, the fitness industry is now casting an even harder eye on trainer certifications, says Shirley Archer, a lawyer who has served as a consultant to fitness-company insurers. "Health-club owners are interested in more standardized qualifications to ensure consistency among the trainers they hire."
Until trainers become better regulated, you'll need to be as scrupulous about who takes care of your body as you are about who takes care of your car. "Don't blindly trust anyone," Archer advises. "Look around and watch the trainers at work. If you see someone who's attentive, encouraging, and really engaged with his client, you're ready to ask questions." Question number one, she says, is about credentials: Has the trainer earned an certification from either the ACSM or the NSCA?
But before approaching the trainer, talk to his client--and don't waste your time with touchy-feely nonsense about whether the trainer is "nice" or "a good guy." Trainers, after all, are in sales. "You never met a used-car salesman who was a jerk to your face, did you?" asks Steve Grisanti, author of Industry of Illusions: Health and Fitness Industry Scams, Frauds, Fakes and Personal Trainers Exposed. Instead, he recommends, ask the client about the only three criteria that matter: "Are you happy with your progress? Does the trainer provide smart, innovative, and constantly updated workout plans? Is he teaching you technique and whole-body fitness, or just counting reps?"
And once you've found a trainer who makes your heart beat faster, take one last step before falling in love. Get on the phone and check more references: Make sure his--or her--clients are still in one piece.
http://www.menshealth.com/cda/article.do?site=MensHealth&channel=fitness&category=muscle.building&topic=total.body&conitem=6c7825f21a0a5010VgnVCM200000cee793cd____&page=1
After his third session with a "really nice" personal trainer, David Carr found himself in a hospital with one of his arms in a splint and blasted muscle proteins in his urine.
"Wow!" exclaimed the doctor when he saw Carr's arms, which were swollen so badly that they could barely bend and wouldn't respond to prescription muscle relaxers. "You're a hair away from compartment syndrome, which means we'd have to open your arms and release the pressure."
Carr had torn his biceps and triceps, and suffered such diffuse muscle damage that protein was flooding his kidneys. His right arm was the worst; he'd have to have it in a 90-degree splint for nearly 2 weeks. He'd also have to miss work till the swelling subsided and he was able to bend his elbows enough to steer a car.
"Now, how did you do this again?" the doctor asked.
Carr was embarrassed to tell him it was just from an "easy" intro workout. He couldn't help thinking he should have been tougher, or more focused, or at least savvy enough about lifting to know to pull back. "Those sessions were supposed to teach me a basic routine, not break me," he says. "But I didn't know my limits--and the trainer who was supposed to tell me didn't."
Carr didn't return to the gym for 8 months, and when he did, the trainer who'd savaged his arm was still there. Carr saw him, and did exactly what so many other guys have done in the same situation.
Not a damn thing.
Right now, there are roughly 182,000 fitness trainers at work in the United States, according to the Bureau of Labor Statistics. Every day, they perform what are essentially medical functions--they strain clients' cardiovascular, muscular, and nervous systems; jack up heart rates and blood pressure; strain joints and ligaments; and recommend diets, drinks, and supplements.
But unlike other health professionals, fitness trainers, a.k.a. personal trainers, aren't required to have a license, or training, or even experience. They don't have to know CPR, or how to find a pulse, or the difference between healthy exhaustion and a diabetic blood-sugar stupor. In fact, they're not required by law to know anything. To become a personal trainer, all you need to do is . . . wait, let's go through the whole process ourselves.
Ready?
Step 1: In a clear, confident voice, say, "I am now a personal trainer."
Step 2: Congratulations--you passed! See you at the class reunion.
Not so bad, was it? That's because presently, there are no federal or state requirements for personal trainers. There isn't even an industry benchmark: Every gym decides, independently, who's qualified to work on its floor. The screening is even worse for freelance trainers who visit clients in their homes and offices: Most gyms at least require references and some kind of certification, but all you need to go into business for yourself is a Swiss ball and a smile.
So if you're one of the 5 million Americans who have personal trainers, consider this: You may be putting your life in the hands of someone with less training--and certainly less legal oversight--than the shampoo girl at Supercuts. To become a barber, real-estate agent, or nail technician anywhere in the United States, you need formal training, a passing grade on a written exam, and a state license--which means someone who trims your hair, sells your condo, or polishes your girlfriend's fingernails has been far better vetted by the government than the guy who's rehabbing your knee postsurgery and checking your heart-rate monitor.
"When you sign up for personal instruction, you really are in a buyer-beware situation--so the buyers better be aware," says Steven Loy, Ph.D., a professor of kinesiology at California State University and former executive director of the Southwest region of the American College of Sports Medicine. "Gyms may require trainers to have some kind of certification, but they may not be rigorous about discriminating between worthwhile certifications and worthless ones."
Some trainers in the trenches say the problem is even worse than Loy describes. "You see a lot of people who go to a gym, and see a flyer advertising 'We Hire Fitness Trainers,' and the next week, they're on the floor with a clipboard and a polo shirt with 'Fitness Trainer' on it," says Carlos Sumulong, a California-based trainer who holds the respected C.S.C.S., meaning Certified Strength and Conditioning Specialist, from the National Strength and Conditioning Association. He routinely takes on clients injured by other trainers. "They're just learning, so everyone is their guinea pig. I just hope they don't hurt somebody."
Sumulong inherited one client whose back had been wrecked by his previous trainer. "The trainer put 1,000 pounds on the leg press, just to see if the client could do it," Sumulong recalls. "He thought it looked cool to have the machine fully stacked with 45-pound plates. The client got it halfway up, and then, blam! there was a big mess." The man suffered a compressed disk and has spent 4 years trying to rebuild his strength to where it was before. "Truth is, he's still not there," Sumulong says.
No gain, plenty of pain
Last year, a 37-year-old TV editor named Fred Widland sued a well-known New York City gym, claiming that an incompetent trainer nearly worked him to death. Widland was overweight and out of shape and had just given up smoking, he says, but instead of a gradual buildup, he got a boot-camp beat-down. During his initial session, Widland claims, the trainer pushed him to failure with very little rest in between a punishing weight circuit and walking lunges across the yoga room. Soon after, Widland was diagnosed with exertional rhabdomyolysis, a breakdown of muscle fiber from severe exertion, a condition that can be toxic to the kidneys.
It's actually "quite common" for trainers to drive their clients into this disorder, says Priscilla Clarkson, Ph.D., associate dean of Public Health and Health Sciences at the University of Massachusetts and coauthor of a recent study that examined cases of trainer-induced rhabdomyolysis. "They may think they're just providing the motivation to work hard and giving someone a 'good workout.' "
Still, compared with Anne Marie Capati, Widland was lucky. Capati was also 37, and had gone to the same NYC gym to lose weight. Six months into her workouts with a trainer, Capati suffered a brain hemorrhage doing light squats and later died as a result. The trainer, it turns out, had put her on a dietary plan that included ephedra, even though Capati had told him she was on high-blood-pressure medication, which should never be mixed with ephedra. The trainer's credentials could not be verified, and the case was settled for an undisclosed amount.
"Nobody really knows how many injuries are out there," says Marc Rabinoff, Ed.D., chairman of the human-performance-and-sport department at Metropolitan State College of Denver and a forensic specialist who has been consulted in 70 cases of training negligence or incompetence. "Most cases are settled quickly and quietly and never make their way into a newspaper or a courtroom."
And all those victims who've kept quiet are contributing to the problem, Rabinoff points out. "The industry has been getting away with it for years because of this macho attitude about not complaining," he says. "A trainer can mess up, break a guy's nose, and the guy's supposed to say, 'Aw, heck with it.' "
Teutonic hard-guy and perpetual locker-room poster boy Friedrich Nietzsche isn't helping either: "So many people buy into that old 'What doesn't kill you makes you stronger' mentality," says Kyle Battis, C.S.C.S., a personal trainer in Concord, New Hampshire, who has been outspoken about abuses in his profession. "The truth is, what doesn't kill you will ruin your training, or put you in a hospital, or drive you out of the gym. And a good trainer should know that. Too many don't, and neither do their clients. So when a guy gets hurt, he thinks it's normal--just a down payment on the 'No Pain, No Gain' system."
Take Murray Cran: He was 23 years old, and because he liked competing in martial arts and hockey, he wanted to add a few pounds of muscle to his 5'10", 160-pound frame. The gym he chose in downtown Calgary was busy and popular, and staffed by gigantic trainers. One of them had a "3- or 4-minute" conversation with Cran about his goals, then plunked him down on the incline bench for some dumbbell presses.
"I was using too heavy a weight, so he was pushing my arms up, and he must have pushed too hard, because one of the weights flipped over and crashed down on my face, breaking my tooth," Cran says. There was blood everywhere, but the trainer didn't apologize. "It was more like, 'Too bad,' " Cran says. He had his tooth fixed and returned a few days later, but didn't make a stink. "Those guys kind of intimidated me," he admits.
So Cran, just like Carr, kept his injuries to himself. But if Carr had walked out of a bar instead of a gym looking the way he did after his session with a "really nice" trainer, someone would have been arrested for assault. That's why it's helpful to do a CSI of Carr's experience and see all the fiery red flares that were blazing right in front of him.
At 27, Carr still looked good in clothes. He was 6'1" and 215 pounds, and his job as an E.R. nurse in Roseville, California, kept his shoulders broad and his arms reasonably beefy. But Carr knew that once his shirt came off, there'd be little trace of the 170-pound wrestler he'd been in high school.
He and his wife were going on a cruise last spring, so he figured the time had come to torch some fat off his belly and chisel a few cut lines into his chest. That was the extent of his athletic goals: He didn't care if he did free weights or machines, circuits or straight sets, as long as he looked good on the lido deck.
He had heard that a big health club was offering new members five free sessions with a fitness trainer, which sounded perfect. The gym assigned him to someone they claimed was a certified trainer and who definitely knew a lot about fitness--at least, it looked that way to Carr. The guy shaved his arms and looked pretty strong--those are good signs, right?
For their first session, the trainer had Carr fill out a standard questionnaire, with questions like "What are your goals?" and "What's your athletic experience?" Carr duly noted that he'd wrestled 10 years before, but had no weight-training experience. The trainer glanced over the questionnaire, then printed out a workout. "It looked like a standard thing--a diet and a series of exercises," Carr says. "He did it so fast, I had the feeling that everyone got the same thing." And that was it for day 1. No strength testing or flexibility testing, no demonstration of a proper warmup, no technique handouts.
On day 2, the trainer worked Carr's abs and legs so hard, Carr had trouble walking the next day. "I worked in an E.R., so that made it uncomfortable, but I figured it was normal," he says. Then came day 3: arms and chest.
"I was doing dumbbell benches, dumbbell shoulder presses, dumbbell flies," Carr recalls. "I don't remember what kind of weight I was lifting, but I remember thinking, I don't think it's supposed to hurt this much." The trainer kept pushing him, though, so Carr kept struggling.
That night, his arms blew up. He tried "tons" of ibuprofen and even some old prescription muscle relaxers, but nothing worked: His arms ached so much, he couldn't sleep. When he dragged himself to the toilet the next morning, he was startled to see the bowl filling with brown urine. He could barely drive but got himself to a doctor, who immediately set Carr's right arm in a splint and a tight bandage to arrest the swelling.
"He said my muscles were so torn up, the fiber so ruptured, I was pissing protein," Carr says. "The swelling was so bad, fresh blood couldn't flow through, so my muscles were basically starving." It took Carr a few days before he could go back to work on light duty. One of his more gym-savvy colleagues took a look at Carr's splint and shook his head. "Nah, that just ain't right," he said.
It was more than half a year before Carr ventured back to the gym. By that point, he'd ballooned to nearly 230 pounds. He never said a word to the trainer or the gym management, which baffles him. "I guess I was embarrassed," he says. "It's weird--I go to a hotel and get bad service, I complain right away. But this--I must've felt this was sort of my fault."
"Oh boy," sighs Lorenzo Gonzalez, D.P.T., when he hears about Carr's case. Gonzalez was an instructor in the department of physical therapy at the University of Miami and now runs a private physical-therapy practice in Manhattan, where he spends a good amount of time correcting trainers' mistakes. "That was kind of a disaster, wasn't it?"
The first thing that should have made Carr cautious was the very thing that brought him through the door. "Be wary of the free deal," Gonzalez says. In these promotional offers, he says, the trainer's job is to process bodies double-time; even a trainer with the best experience and intentions may not have the time--or even the authority--to customize a truly thoughtful workout plan. "You say you want strength and flexibility, and they spit out a standard routine," Gonzalez says. "They're putting a square peg into a round hole."
Second, the trainer didn't do any baseline assessment. "That's a big warning sign right there," Gonzalez says. "Simple rule: If you're not tested, walk away." It's basic diagnostics, he points out: How can a trainer gauge a new client's strength, balance, flexibility, or cardiovascular fitness without a walk-through? "How does he even know where to put the pin in the stack?" Gonzalez asks. "He's just guessing, like pin the tail on the donkey."
Third, the client isn't supposed to be diagnosing strengths and weaknesses. "It's kind of surreal," Gonzalez says. "You go to a trainer because you don't know, and his starting point is to take information from a guy who's already said he doesn't know! If you went to a doctor and said, 'My stomach hurts--I think it's appendicitis,' he wouldn't say, 'Right, then. Let's schedule you for surgery at once.'"
And finally, "That first legs-abs workout, that was a big red flag," says Gonzalez. "You should feel worked, but not have difficulty walking. That's a sign of injury." The stiffness sets off a destructive spiral, he says. The pain makes you avoid using that part of the body, which means the muscle isn't getting stretched, and it becomes shorter and tighter as it heals. And the tighter the muscle, the more prone it is to an imbalance injury.
"One of the biggest faults I find is that a lot of trainers exacerbate imbalances," Gonzalez adds. "I see a lot of CEOs, and when they come to me with neck pain and shoulder pain, it's because they've exacerbated a prior condition."
One client had been having nagging lower-back pain for years. He was a corporate executive in his early 40s and a highly motivated runner. "Type A, all the way," Gonzalez recalls. "You tell him 10, he bangs out 100." The problem was, the 10 his trainer gave him were all wrong. "The trainer had him doing lots of flexions--toe touches, quad work, every kind of crunch, but they made the problem worse." What the runner needed to do was the exact opposite: Instead of constantly bending forward, he would have gotten relief from working backward--doing bridges and Swiss-ball stretches, loosening his glutes and hamstrings.
"For a year, the very guy who's supposed to help him is increasing his pain," says Gonzalez. "Usually, I try to work with a trainer and show him how to make corrections. But I told this client, 'You'd better get rid of that guy.'"
Many trainers, of course, have advanced degrees and tremendously sophisticated knowledge of nutrition, anatomy, and kinesiology. There are legions of people out there who are top pros and give you smart, expert guidance. So when you hire a trainer, how do you tell if you're in the hands of a Yoda or a yo-yo? Physique and experience, unfortunately, are no help. If you think the man benching the biggest stack knows enough to give you training advice, you'd better pay attention to what UCLA's exercise physiology research laboratory discovered in a 2002 study of health-and-fitness professionals: Trainers who had 5 years of experience but no college degree did terribly on a test of their fitness knowledge, scoring an average of only 44 percent.
"Extensive training experience in the health and fitness profession," the researchers found, "does not necessarily translate into a knowledgeable and capable professional."
The test wasn't extremely hard, either. It was multiple choice, so the answers were on the page, and typical questions were "What intensity of exercise is most appropriate to develop a cardiovascular benefit in an apparently healthy individual?" and "Which of the following exercise prescriptions would you recommend to a nonâ “insulin-dependent diabetes mellitus client?" Basic, crucial information, in other words--the kind of information that could have saved Capati's life.
Only one group of trainers did reasonably well on the test: those with a bachelor's degree in kinesiology and certification by either the American College of Sports Medicine (ACSM) or National Strength and Conditioning Association (NSCA), two organizations that are considered the gold standard of fitness training.
"Thus, education may be more important than personal-training experience in personal trainers," the study concludes. That makes sense: If trainers have no oversight and their managers aren't fielding complaints from in-jured clients, then there's nothing stopping them from continuing the same ill-informed and potentially dangerous practices.
Determining whether your trainer has the education he needs can be difficult. There are nearly 300 different certifications available, all identified by a confusing jumble of acronyms that sound similar. Wouldn't you be impressed by a degree from American Fitness Professionals & Associates? Turns out, it comes from a P.O. box in Ship Bottom, New Jersey, and can be had for $315.
Through its online certification process, American Fitness Professionals & Associates claims to have produced "over 57,000 Certified Personal Trainers & Fitness Professionals worldwide." That's not surprising, since the only requirements are 18 years on the planet, a GED, and "basic familiarity" with anatomy and resistance-training equipment. You don't need to know CPR, but you do have to score 90 percent on their test. If you fail, no worries: They'll mail you the questions you answered wrong and give you 2 weeks to get them right.
ExpertRating.com makes it even easier: "All you have to do is buy the ExpertRating Personal Trainer certification for $49.99," its Web site states. ExpertRating will then send you its personal-trainer courseware and give you an online certification exam. Get half the questions right and you're in.
Not surprisingly, neither American Fitness Professionals & Associates nor ExpertRating responded to our inquiries.
Perhaps the most shocking fact about outfits like ExpertRating is that people employ their graduates. Why would a gym risk losing customers and fighting a lawsuit by hiring a $49.99 trainer? Two reasons: (1) They desperately need personnel, and (2) they've figured out a seemingly foolproof way to dodge liability.
Because of the boom in personal training over the past 15 years, gyms have been scrambling to hire more staff. Nationwide, fitness training is projected to be one of the strongest-growing occupations, at least through 2012. When the trainers are qualified, that's great--it means more people are being taught and motivated.
But when they're not, the gyms have a way to deny responsibility. "The gyms hide behind two degrees of separation," says Rabinoff. "First, they get you to sign a waiver." If you belong to a gym, you've almost certainly signed that clause yourself, the one that states "You agree that if you engage in any physical exercise or activity or use any club facility on the premises, you do so at your own risk."
"On top of that," Rabinoff continues, "they set it up so trainers are subcontractors. In some cases, I've found outrageous negligence, but because the trainer is categorized as 'independent,' the gym has slipped out of liability." The injured client can always sue the trainer, of course, but if the trainer isn't insured, there's little hope of winning compensation. "If people are foolish enough to hire someone who owns only a van and a jump rope, you can have the best case and no lawyer is going to take it," Rabinoff says. "You'd have to garnishee the trainer's salary for 100 years to make back what you lost in medical bills."
It's little wonder, then, that an estimated 50 percent of all health-club members have sustained minor injuries, says David L. Herbert, an attorney and health-fitness specialist in Canton, Ohio. "As long as the injured parties didn't complain . . . what's the incentive to make sure that everyone is qualified?" Herbert asks.
But Herbert has noticed some encouraging signs lately, from both the legal and fitness communities. Some courts are no longer accepting the exculpatory waivers at face value and are holding gyms accountable; basically, they're allowing experts, like Rabinoff, to testify as to what a realistically safe level of supervision should be. Herbert notes that in 1996, a New York appellate court threw out a lawsuit by a man whose shoulder was injured by an inept trainer, but 3 years later, that same court accepted a nearly identical case.
"The courts are starting to understand the fitness industry, and that's going to put more pressure on the clubs to shape up," Herbert says. And, he's pleased to report, they are. "I'm one of the trustees of the National Board of Fitness Examiners, and we're in the process of developing a single, unifying examination for all personal fitness organizations," he says. "More than 2,000 trainers have already shown individual interest in taking the exam, which is a good sign--they're making the move on their own, without being coerced."
Plus, the fitness industry is now casting an even harder eye on trainer certifications, says Shirley Archer, a lawyer who has served as a consultant to fitness-company insurers. "Health-club owners are interested in more standardized qualifications to ensure consistency among the trainers they hire."
Until trainers become better regulated, you'll need to be as scrupulous about who takes care of your body as you are about who takes care of your car. "Don't blindly trust anyone," Archer advises. "Look around and watch the trainers at work. If you see someone who's attentive, encouraging, and really engaged with his client, you're ready to ask questions." Question number one, she says, is about credentials: Has the trainer earned an certification from either the ACSM or the NSCA?
But before approaching the trainer, talk to his client--and don't waste your time with touchy-feely nonsense about whether the trainer is "nice" or "a good guy." Trainers, after all, are in sales. "You never met a used-car salesman who was a jerk to your face, did you?" asks Steve Grisanti, author of Industry of Illusions: Health and Fitness Industry Scams, Frauds, Fakes and Personal Trainers Exposed. Instead, he recommends, ask the client about the only three criteria that matter: "Are you happy with your progress? Does the trainer provide smart, innovative, and constantly updated workout plans? Is he teaching you technique and whole-body fitness, or just counting reps?"
And once you've found a trainer who makes your heart beat faster, take one last step before falling in love. Get on the phone and check more references: Make sure his--or her--clients are still in one piece.
http://www.menshealth.com/cda/article.do?site=MensHealth&channel=fitness&category=muscle.building&topic=total.body&conitem=6c7825f21a0a5010VgnVCM200000cee793cd____&page=1
