Pilates Equipment Liability and Safety (Part 2 of 2)
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.”
Use and Maintenance
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
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.”
Industry Standards and Guidelines
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.
Consciousness Is Key
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.
Safety inspections should be performed on all Pilates equipment at least quarterly. Specifically, inspect the following areas.
Quarterly spring inspections are very important for safety. In general, springs under high-volume use should be replaced every 2 to 3 years. Old springs lose their resilience and, in a worst-case scenario, can actually break. Here’s what to look for when you inspect a spring:
- When the spring is at rest, check among its coils for gaps, which indicate weak points. It’s fine for the tapered end of the spring to have a gap, sometimes created when the hook is inserted during the manufacturing process. However, the body of the spring should have no gaps. If you find any gaps in the body of the spring, replace the spring.
- If, when the spring is under tension, the spaces between its coils are not uniform, replace the spring.
- Rotate reformer springs of the same weight each quarter. People tend to use one spring more than others. For example, a right-handed person tends to use the red spring on the right more than the red spring in the middle or the red spring on the left. Rotating these springs helps them wear more evenly. If you have three red springs, rotate them as you would rotate tires on a car.
- If a spring hanging at rest (such as in a trapeze table or wall unit) has visible gaps, replace it.
Snaps on springs and ropes can wear out, so they should be inspected quarterly. First, check that the snap retractors work properly. Next, inspect the snap hooks. In particular, eyebolts on trapeze tables can cause excessive wear on snap hooks. If a hook shows more than 5 percent wear, replace the snap.
Follow these steps when inspecting a reformer:
- Make sure that the risers are installed on the outside of the frame. Whereas only pressure can secure risers installed on the inside, both the frame and the bolts secure risers installed on the outside. That is the only safe configuration.
u Make sure that the springs are hooked beneath the carriage in a downward position. If hooked upward, they can fall off.
- Before a client uses the box and footstrap, make sure that the footstrap is under tension (with snaps pulling from the top of the eyebolt).
- When the reformer is not in use, make sure that at least two or three springs secure the carriage.
- After every session, restore the “default setting” on your reformer by connecting a certain number of springs, setting the footbar at a predetermined height and putting the ropes in place. This ensures that the machine is ready for the next client and that the carriage is secured by the springs.
- If you feel a bump in the ride, dirt has probably adhered to the surface of the rails or wheels. To ensure smooth carriage travel and maintain the longevity of the wheels, wipe down the tracks once a week. Use a cleaner such as Simple Green, Fantastik or 409. Do not use abrasive cleansers or pads; they can abrade the anodizing on the rails. Do not use WD40 or oil on the rails and wheels; these not only attract dust but also can actually rinse out the lubricant in the bearings and shorten wheel life. Moreover, keep hair out of the rails; it can wrap around the axles and eventually cause bearing failure.
Keep these things in mind when inspecting a trapeze table:
- The push-through bar can be dangerous and must be used with caution. A trainer should always keep one hand on the bar while a client uses it. By keeping a hand on the bar, the trainer maintains control of the bar if the client inadvertently lets go of it.
- For bottom-sprung exercises, the safety strap or chain should always secure the bar to the frame. The strap should be attached so the angle of the bar is approximately 4 o’clock to limit the range of the bar and prevent it from coming into contact with the client. Be sure to attach the strap or chain to the canopy frame and around the push-through bar, not the eyebolts. The strap or chain is only as strong as the weakest link; the frame and bar are much stronger than the eyebolts.
- For another measure of safety, use either the middle pivot bolt setting or the high pivot bolt setting when the client’s head is below the push-through bar. Do not use the low setting.
- Manually check all eyebolts every quarter to ensure that they’re tight.
Chairs have special considerations as well:
- When dismounting the chair, clients should release the pedals slowly with control. Do not let the pedals snap back.
- Standing, sitting or lying on the chair increases one’s risk of falling; standing exercises can be particularly precarious. If you have any doubt about your client’s safety, spot him.
Courtesy of Ken Endelman, President and CEO, Balanced Body Inc.
- Are all lock pins in place in the shoulder rests?
- Are all lock pins in place in the strap posts?
- Are all straps equal in length?
- Have all strap catches been checked for tightness?
- Have all machines been wiped and sprayed with lubricant?
From “Reformer Safety and Maintenance” in The Pilates Reformer by Marci Clark & Christine Romani-Ruby, MPT, ATC
The American Heart Association (AHA) and American College of Sports Medicine (ACSM) have approved these publications:
- Balady, G.J., et al. 1998. Recommendations for cardiovascular screening, staffing and emergency policies at health/fitness facilities. Circulation, 97 (22), 2283-93.
- Balady, G.J., et al. 2002. Automated external defibrillators in health/fitness facilities: Supplement to the AHA/ACSM recommendations for cardiovascular screening, staffing and emergency policies at health/fitness facilities. Circulation, 105 (9), 1147-50.
- Tharrett, S.J., & Peterson, J.A. (Eds.). 1997. ACSM’s Health/Fitness Facility Standards and Guidelines (2nd ed.). Champaign, IL: Human Kinetics.
- industry facts and figures about the growth of Pilates equipment risk management checklist
- case studies
- risk management tips
- resource list
You can obtain a single reprint of these recommendations from the American Heart Association by calling (800) 242-8721; writing to AHA, Public Information, 7272 Greenville Avenue, Dallas, TX 75231-4596; or visiting www.acsm.org.
In case you missed the first installment of this article, refer to the January 2003 issue of IDEA Fitness Manager. It provides more useful information:
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