In addition to proper equipment layout, use, maintenance and storage, signage and adherence to industry standards can help prevent litigation. By Shirley Archer, JD, MA
Clients have won lawsuits in which courts found that injury occurred because weight training equipment had been placed too close to other equipment to be safe. Typically, in such a case, a client is bumped while performing an exercise, loses control and sustains an injury.
Tips: Michael Arbuckle, COO of Peak Pilates Systems in Boulder, Colorado, recommends keeping reformers at least 30 inches apart to avoid bumping incidents. He also advises using caution in placing equipment that uses pole systems too close to mirrors. He suggests using safety glass mirrors as well.
Ken Endelman, founder and CEO of Balanced Body Inc. in Sacramento, recommends maintaining at least a 6-foot-diameter space, measured from the center of the foot end of the reformer, to avoid injuries due to people kicking each other; not so much space is necessary at the top end of the reformer. Successful spatial arrangements include staggering reformers and placing them in a wedge-shaped formation. Endelman also advises that trap tables not be placed too close to mirrors or windows.
Lindsay G. Merrithew, president and CEO of STOTT PILATES in Toronto, agrees with Arbuckle and Endelman on the importance of layout. “Many studio owners try to fit as much equipment as possible in a small space, but you don’t want to learn about liability the hard way,” he says.
STOTT PILATES provides a studio kit to help with spatial planning, although it does not offer specific guidelines on distances between pieces of equipment. (See “STOTT Studio Planning Kit” on this page.) Balanced Body also offers a studio layout service.
Because lack of sufficient illumination can cause injuries, facility lighting can be another safety issue. Endelman recommends full-spectrum light primarily for comfort but does believe that it provides better-quality light.
Although no case study has involved an accident due to lack of appropriate equipment storage, Pilates clients have injured themselves in studios by falling over equipment not put back in its proper place. Another potential source of liability related to equipment storage is unsupervised clients who gain access to equipment, misuse it and injure themselves.
Tips: Establishing storage policies and procedures may prevent such injuries and risk exposure. If using por- table equipment, staff must be trained on how to move and store it safely.
“When planning, many new studio owners forget to consider the importance of the right kind of storage,” Arbuckle notes. If you intend to use balls, rollers, poles and other loose pieces of equipment, designate specific storage places in your workout area so items are not left where people can trip over them.
Endelman stresses that storage issues need to be resolved especially for fitness facilities either creating an in-house Pilates studio or offering group reformer classes. “I know that, in some of the Bally’s clubs offering group Allegro classes, they lock up the equipment between classes,” he says. Other clubs lock up in-house studios when no one is present to supervise equipment use.
“If you store your Pilates equipment in an area that cannot be locked and is not visible to the front desk, find a way to lock it or make it unusable,” says Christine Romani-Ruby, MPT, ATC, cofounder and CEO of PowerHouse Pilates in Pittsburgh. “For example, take the springs off the chair and put them in the office, or lock the stack of reformers so they cannot be unstacked. If you use portable reformers, choose ones that can be set up on one end rather than stacked: They have much less risk of injury because they are easier for instructors to pull out for class. If you do stack your reformers, get the lightest ones you can find and do not stack more than five of them; the pile would be too high for ergonomic lifting. Furthermore, never expect staff to move wooden equipment on a regular basis; it is too awkward and heavy and will result in a staff injury or damage to the equipment.”
In some equipment-related cases, courts focused on whether or not exercise equipment had been maintained appropriately. They evaluated whether or not equipment had been used for its intended purpose and whether or not it had been maintained for that purpose per specific manufacturer guidelines. In particular, courts examined whether or not parts had been replaced in a timely manner and whether or not facility owners had ensured that routine inspections and maintenance were conducted and documented.
Tips: Courts examine appropriateness of use. In one case, hotel management had placed in the hotel gym equipment intended for private home use, and the court found the hotel liable for injuries suffered by the client. A training facility should provide commercial equipment; manufacturers do not design home equipment to withstand the wear and tear of frequent use by multiple users.
Endelman emphasizes regular inspections and maintenance and accurate record keeping. “You need to be sued only once to realize their importance,” he says.
Balanced Body’s guidelines call for routine equipment inspections at least quarterly. (See “Pilates Equipment Safety and Maintenance” on page 4.) Arbuckle agrees that quarterly inspections are the minimum requirement but recommends monthly inspections to be safe. He also suggests that, when conducting inspections, studio personnel follow a checklist to ensure that every item is covered.
“One person in the studio can be assigned responsibility for ensuring that this task is completed. The inspection can even be conducted during regular staff meetings with everyone’s participation to raise staff consciousness of the importance of safety and maintenance issues,” he points out.
According to Arbuckle, the possibility of a broken spring on a piece of Pilates equipment creates the most obvious potential for injury. “I recommend that springs be changed every 2 years, but there is no hard and fast rule. It depends completely on use. The best preventive measure is to conduct regular visual inspections of springs, watching in particular for a gap in the coils, which could lead to failure,” he says.
Merrithew agrees: “Because of its very nature, spring tension is difficult to control, and because parts such as springs require replacement over time, there are inherent safety issues. For example, a spring fatigues every time it is extended. One day, it will break. In general, we recommend that it not be used longer than 3 years, but, again, this depends completely on the amount of individual use.”
Maintenance affects equipment performance over time, so exercise caution when purchasing used equipment. Request all maintenance records and original purchase and warranty information. Thoroughly inspect and test equipment and replace any worn parts.
In multiple exercise equipment cases, courts zeroed in on whether or not instructional and warning signs had been in place near equipment. In its Health/Fitness Facility Standards and Guidelines, the American College of Sports Medicine (ACSM) recommends that facilities use such signage near equipment to alert users to risks associated with certain activities. The American Society for Testing and Materials also has standards pertaining to equipment warnings.
Tips: Equipment manufactured by Balanced Body features a sticker label that reads, “Warning: This machine is potentially dangerous and is only to be used by or with a trained professional.” These warning stickers are important to protect both the manufacturer and the Pilates professionals. Owners should not remove these warnings from equipment.
In her studio, Nora St. John— owner of Turning Point Studios in Walnut Creek, California, and former Pilates trainer at St. Francis Memorial Hospital in San Francisco—has warning signs in addition to the warning stickers on individual pieces of equipment. Romani-Ruby says, “One of our studios is in a wellness center, and the equipment is open. There are signs saying that the equipment is to be used only with the supervision of a trained Pilates personal trainer. We also post safety rules where staff will see them on a regular basis.”
Some studio owners are reluctant to post warning signs for aesthetic reasons. Nonetheless, courts consider the presence of signage critical when determining whether or not a facility owner has provided a safe exercise environment.
In certain cases, courts found that health clubs owe a duty of reasonable care to protect members from injury while they are at the clubs. To protect members, clubs are responsible for ensuring that they know how to use equipment properly. Clubs can fulfill this responsibility by not only instructing members in the use of exercise machines but also supervising members while they use exercise machines.
Tips: Studio owners should exercise special caution regarding their “open studio” policies, or use of equipment by clients without trainers. An open studio policy can be risky because correct use of Pilates equipment requires special training; misuse can result in injury.
If experienced clients are allowed to use equipment on their own, a policy should be set to confirm that they are not new users, that they know how to use the equipment appropriately, that they comprehend the dangers and risks associated with using the equipment and that they agree to assume those risks. Creating and filing a signed document noting each of these points could reduce risk exposure, although no cases have tested the validity of such a document.
Effective supervision of children is also essential. “Little fingers can get stuck in many places,” Arbuckle cautions. “Kids can get their hands in the carriage or underneath the wheels. On the other hand, Peak Pilates Systems’ Euro-style day couch reformer for home use can function as a couch when not in use as exercise equipment. It is specially designed to be closed up so it can be left around kids.”
Whether or not Pilates studio owners and Pilates trainers view themselves as part of the “fitness industry,” courts are likely to consider fitness facility industry standards in any cases involving Pilates facility incidents. Two key publications address standards for health and fitness facilities. The first of these publications is the joint American Heart Association (AHA) and ACSM statement “Recommendations for Cardiovascular Screening, Staffing and Emergency Policies at Health/Fitness Facilities,” updated 4 years later with the supplement “Automated External Defibrillators in Health/Fitness Facilities: Supplement to the AHA/ACSM Recommendations for Cardiovascular Screening, Staffing and Emergency Policies at Health/Fitness Facilities” (Balady et al. 1998; Balady et al. 2002). The second important publication is ACSM’s Health/Fitness Facility Standards and Guidelines (Second Edition) (Tharrett & Peterson 1997). These standards govern issues related to prescreening of facility users, qualifications of facility personnel and use of written emergency policies and procedures reviewed and practiced regularly. All club or studio owners and managers should be familiar with these publications.
Tips: Prescreening not only alerts you to clients who may need medical attention. It also can protect you against future claims related to aggravation of preexisting injuries or even help identify potentially litigious clients.
St. John advises trainers to screen new clients carefully and take preventive measures if necessary. “When I worked in a hospital setting, I encountered clients who told me about all the lawsuits they’d had,” she recalls. “This puts you on special alert that these clients have a litigious pattern of behavior.”
St. John recommends listening closely to what new clients reveal to you. “If you think it is necessary, do not hesitate to refer a person back to his regular physician. It is better to discourage a potential client likely to sue you down the road than it is to accept the client and be sued.”
Numerous industry professionals reiterate the significance of prescreening. Often, clients come in with preexisting injuries and, by training, aggravate them or simply experience flare-ups of what have been chronic conditions. Without some form of prescreening documentation to remind them that their condition existed before they began training, they may forget and blame the Pilates training.
As St. John advises, the best practice in some cases may be to require potential clients to get medical clearance. If a client receives medical clearance, you may also want to request a medical release to increase communication with that client’s health care provider. This alliance not only strengthens your understanding of your client’s needs but also can lead to future referrals from health care practitioners who learn about you and develop respect for your Pilates practice.
With a commitment to safety education and proactive risk management, Pilates professionals can continue to uphold their very low rate of client injury as the Pilates market grows. With a team effort, Pilates professionals can maintain the respect that Pilates currently enjoys because of its quality and results.
Pilates professionals need to bal- ance rapid growth to meet consumer demand with a commitment to maintaining quality. Similarly, facility owners, managers and trainers should consider expanding their practices with attention not only to serving the rapidly increasing number of clients but also to providing each of those clients quality service that focuses on safety and effectiveness.