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Home » IDEA Answers » Increasing scope of practice with additional training/licensure?
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Question asked by Steve Teahan 348 days ago

Increasing scope of practice with additional training/licensure?

Personal Training: Ethics/Scope of PracticeMassage TherapyNutrition Coaching

The topic of the scope of practice of personal trainers and other fitness professionals has seem to come up quite a bit. At least in Massachusetts and New Hampshire, there does not seem to be any scope of practice defined by law. This seems to be the case for many states if I am not mistaken. There are obviously certain areas that we cannot practice.

I was thinking about additional training to increase my scope of practice. Please understand that I am considering these as a future facility owner working with special populations.

As a personal trainer or fitness professional, we can lead exercise training for healthy individuals or those who are medically cleared. A few thoughts below:

Nutrition:
From what I saw in Massachusetts law, if you do not try to pass yourself off as a nutritionist or dietitian, then the laws cannot stop you from "practicing a health profession that includes a dietetic or nutritional practice component, including, but not limited to, holistic medicine, naturopathic medicine, homopathic medicine, macrobiotics, ayurvedic therapy, polarity therapy, shiatsu therapy, massage therapy, and herbal therapy."

Personal trainers or fitness professionals are not included here, nor anywhere else in any of the laws. In some cases, someone coming from an exercise physiology program could have a background in nutrition similar to those in massage therapy. So, I wonder if we would be included here?

If not, spending an additional 2-3 years after a BS in Exercise Physiology or a related field would allow to you finish a DPD program, go through the 900 hour internship, and now you're a registered dietitian.

Massage:
I am not entirely sure about this one. I do not want to make it seem as if I am trying to be a physical therapy without going through the proper education. However, from the Massachusetts laws:

"the systematic treatment of the soft tissues of the body by use of pressure, friction, stroking, percussion, kneading, vibration by manual or mechanical means, range of motion for purposes of demonstrating muscle excursion or muscle flexibility and nonspecific stretching. Massage therapy may include the use of oil, ice, hot and cold packs, tub, shower, steam, dry heat or cabinet baths, in which the primary intent is to enhance or restore the health and well-being of the client. Massage therapy shall not include diagnoses, the prescribing of drugs or medicines, spinal or other joint manipulations or any services or procedures for which a license to practice medicine, chiropractic, occupational therapy, physical therapy or podiatry is required by law."

There are some skills/practices in there that I think would be of great use. In theory, we could use hot/cold packs and hopefully massage techniques during exercise to improve the quality of training. However, I do not know if you would have to separate your practice of massage and exercise training.

In any case, total training time is ~1 year.

Physical Therapy Assistant:
In theory this would give you a better understanding of rehabilitation as a whole and would allow you to work on both sides, fitness and rehabilitation. I believe that this would increase your scope of practice with modalities. This might include elec. stim. and ultrasound. However, this would have to be done under the practice of a physical therapist. I believe this would take 1.5 years of training with a bachelor's degree.

I'm not sure if this would allow you to use ANY of the techniques without the guidance of a PT.

Emergency Response:
EMT certifications allow the administration of a certain number of drugs. Aspirin, activated charcoal, nitro, etc. However, I found out that this would all be thrown out of the window if you don't have physician orders and/or are employed by an EMS service. I believe that the training in emergency response would still be very beneficial and would be a selling point if working with special populations.

Anyone have any thoughts of what would be the most worthwhile. Being able to give nutrition advice would be very powerful in my opinion. The problem I run into is that if you go too far in another direction, you could spread yourself too thin as far as your skills go.

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Answered by No Name 348 days ago
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Nutrition is the closest related to our field your best bet might even be to get the fitness nutrition specialist or other similar cert from an accredited agency. What you can also to is employ corrective exercise but not rehabilitation. Then learn how to explain to the special populations why they might need your service. Such as a physical therapist will make your injury work again but only a corrective exercise personal trainer can make you strong again.
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Answered by Steve Teahan 348 days ago
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What is the actual scope of a certified fitness nutrition specialist? Assuming that you don't call yourself a licensed dietitian/nutritionist, could you practice within the scope of that certification? I'd be interested if anyone knows where the laws would stand on this.

It's interesting how a nutrition major can become an RD and then become a personal trainer overnight. However, this is not the case for someone who studies exercise science in college.
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Answered by LaRue Cook 344 days ago
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Hi Steve. All very interesting stuff indeed. In reference to your comment:
"It's interesting how a nutrition major can become an RD and then become a personal trainer overnight. However, this is not the case for someone who studies exercise science in college."

I think that this all comes down to the fact that since personal trainers are still not regulated by the States (at least in any State that I'm aware of), there is really nothing preventing not only an RD, but anyone for that matter that satisfies the requirements of the specific certification agency, from qualifying and entering the field of personal training. However, as you point out in your comment, "someone who studies exercise science in college" may not be able to satisfy the more stringent State-mandated entry requirements into the field of RD.

LaRue, CSCS
www.lecfitness.com
larue.cook@lecfitness.com
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Answered by Joanne Duncan-Carnesciali 340 days ago
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Hello Steve,

In short, you have earned your bachelors degree and if you accrue the clinical hours you can earn ACSM CES credential. In this way you can expand our scope of practice.

I hope this is of helpful to you.
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