How do you make sure you are staying within your scope of practice as a trainer?

Hi Sandy,

I have to answer that question in two phases. I find it easy to answer it when first approached by a potential client. During the initial conversation when circumstances and expectations are discussed, I can easily see whether this fits in the scope of my practice (and even inclination). For example, I refer people elsewhere for youth training but also in case of pregnancy.

The second part of the answer pertains to existing clients who develop diseases or any other problems. When such client first tells me about the problem, I am challenged with making an assessment. I want to use an example an an illustration: The client comes in and tells me that his knee is bothering him somewhat. That triggers a series of questions: Had there been an event that caused that? Is this something we can 'work around'? Has that happened before? I also often find that clients use me as the first person to consult with. I usually approach it by saying: "If this was me, I would do (fill in the blank)." Some little twitches just go away by themselves, other do not. When that same client somes in a few days later and things have gotten worse, I definitely recommend he see a doctor. There have been instances when I printed off one of my physician approval forms and told the client for a sign off to make sure he went.

I like to think that I have always erred on the side of safety in the second example no matter the circumstances. I tell my clients that I feel flattered that they put so much trust in me that I can 'fix' them but that I know my own scope of practice (and comfort level) and that continued exercise programming may have to be done in conjunction with another expert.

Thanks for the question.

As a personal trainer, my scope of practice is extremely limited. I don't offer recommendations on nutrition because that is outside of my scope of practice. I don't diagnose physical or cognitive impairments because that is also outside of my scope of practice. Most issues that have come up that are in conflict with scope of practice, for me, have been covered under nutrition, physical injury (not related to our training sessions!), and personal problems.

However, I CAN give my clients information. Danielle offered some excellent examples of the types of facts that trainers can share with clients. I encourage others to do their own research and find answers for themselves. I can point people in the right direction as far as sources go. Journals and databases are great and they are suitable for some clients, but sometimes it's good to include a source that's easily understood and read. That means that I have to know what the journals say so that I can verify what's in the source if it's not an academic source. Sometimes other people can say what you, yourself, want to say in a much better way than you ever could at the time. (That sentence might have been a good example). However, with my clients I always refer them to a qualified professional who would be able to give a definitive answer on a question, or a legitimate diagnosis on an illness or physical or emotional problem. The toughest part, so far, about being a personal trainer is that most people don't utilize these health professionals as they should, and they depend on you to point them in the right direction without professional help, which isn't always possible.

if they're hurt its outside without a doctors consent.
if they are asking about nutrition and are not otherwise healthy then it is outside.

if they want to train till exhaustion and continue over training or just get a good sweat on without results...that is outside of my personal scope of practice.

It's really simple...

Your certification will determine your scope of practice. It's like any licensed industry. Your license will determine your scope. If you only have a driver's license you can't legally drive a motorcycle or a fly a plane. Your scope is passenger car.

If your certification says personal trainer who can work with healthy populations, then one should not be training high risk individuals. Hard pill to swallow but that is how scope of practice functions.

Sandy, this is a hotly debated topic and a great question. Because we as fitness professionals are dealing with the human body and its systems, there is a fine line between practicing within our scope and practice, and venturing outside of it. Some information versus too much information is sometimes hard to determine, and can literally be a "case-by-case" analysis. However, with that being said, there are definitely some areas that are clearly outside of the "normal" scope of practice for a fitness professional absent some specialized training and certification. Several of the posters above have already alluded to some of these areas: injury/rehab, special populations such as pregnancy, elderly and youth, and nutrition are all examples.

It seems as if all of the debate about "scope of practice," certification versus license, and minimum levels of education and practical experience requirements are ALL tied together, and are items that State legislatures and others are taking a hard look at for our industry.

Interesting times in our industry indeed!

LaRue, CSCS
www.lecfitness.com
lecfitness@yahoo.com

Simply ... I am a fitness trainer. I am familiar with how exercise impacts health and familiar with the various principles of exercise science and how to apply those principles. As such I am a member of the healthcare system in as much as a physician, nurse, physical therapist, chiropractor, massage therapists. And while these professionals have more knowledge in their fields than do I, it is also true that we have knowledge in those areas they may not.

Obviously you cannot know everything but you should make it a priority to keep up with what's going on in your field. I read ALOT, attend workshops & seminars, watch DVD's and subscribe to trade journals.
And since no trainer knows everything or can be all things to all people, as professionals we should have contacts with other pros when our client's needs fall outside of our scope of practice.

I make it a personal objective not to treat, diagnose or prescribe :)

It is interesting Sandy in your question you wrote "make sure."

Making sure that one is "staying within their scope of practice as a trainer" requires the trainer to know the scope of practice of of their credential.

If the trainer has not become aware of his/her scope of practice how can he/she "make sure" that are staying within the confines of their scope of practice.

Thanks for your question Sandy.

To simplify this, if you haven't done it yourself then don't implement it. If you can't explain it then don't recommend it. Always research something you are not sure of before talking to your clients about it. If you are not always trying to be better by continuing your education then you will at some point go beyond your scope of practice.