I read an article recently that claimed that personal trainers do not have a scope of practice and thus it is unclear what they should and what they should not do with clients. I respectfully disagree with that opinion. While it is true that not all personal training organizations have adopted the same scope, the National Personal Training Institute (NPTI) has been defining the scope for personal trainers since its inception. The scope of practice for personal trainers is to enhance the components of fitness for the general, healthy population (1, 2). In my mind this scope clearly defines what personal trainers should, and by default should not, do and it clearly identifies who personal trainers are trained to work with. There are 2 key things to explore in this operational definition.
First, fitness is not one singular thing, it is made up of various components. There are 5 classic components of fitness: strength, muscle endurance, flexibility, body composition, and cardiovascular endurance; and there are several subcomponents of fitness including but not limited to power, speed, agility, quickness, balance, and skill. Personal trainers are (or at least should be) experts in the main components of fitness – they should be extremely well versed in understanding what those components are and how to improve them. With this knowledge and experience they will be able to help clients achieve their fitness related goals.
Second, trainers are taught to work with the general, healthy population. This is anyone classified as ‘low risk’ as defined by the ACSM risk stratification guidelines (if you are a trainer and you don’t know what classifies someone as low risk – go back to school and get properly educated in your field). In short it refers to adults with no diseases and minimal risk factors for coronary artery disease. If a client does not fall within the low risk category it doesn’t mean that a trainer can’t work with that person; it does mean the client needs to receive a medical clearance to be placed back in the personal trainer’s scope before intense training.
How Does This Help Us?
Having a clearly defined scope tells one what they should and should not do. Is a personal trainer able to help improve a client’s strength? Of course. Can a personal trainer help a client lose 20 pounds and reduce their body fat? For sure. Is a personal trainer able to help a client work on their 10k time or get better at push-ups? Obviously. Will a personal trainer make a diagnosis about a specific injury? No, tha is the role of a medical doctor. Can a personal trainer write prescriptions for medicine? No, again that is for a doctor to do. Is a personal trainer skilled in cracking someone’s back to adjust their spine back in proper alignment? Definitely not,that is what chiros do. Should a personal trainer run out on to the field and tape up an athlete’s ankle? Nope, that is the job of an athletic trainer. Is a personal trainer trained to manually increase a joint’s range of motion 3 days after surgery? No, that would be the role of a physical therapist. Should a personal trainer write a specific meal plan for someone with diabetes? No, that client would be referred to a registered dietician for that information.
The Gray Areas
There are areas of gray in virtually every field, and because fitness is so broad there are areas of gray in personal training. I don’t think we should shy away from these areas of discussion, instead I think should do our best to flesh them out. And when in doubt refer back to our scope of practice.
What about posture? Posture clearly affects fitness although it is not typically considered a component of fitness. Are trainers experts in posture? I would answer no, posture as a whole is not under our scope. Some organizations, like the NASM, would disagree and a large part of their educational material would be focused around assessing and attempting to improve posture. That is not true for most other US based personal training organizations such as the NSCA or the ASCM. I am not arguing that trainers will not have any knowledge of posture and being informed about some common postural distortions might be valuable. However understanding posture can be complicated; how to improve posture can be even more complicated, and posture itself is not well understood. Even something as simple as “what is normal posture” is a hard question to answer when you try to apply that to the myriad of individual variation we see in our species. Trainers certainly will not be manually adjusting a client’s posture – that falls under the realm of chiropractors. As I see it proper fitness training might improve a client’s posture, but trainers are not, and should not be expected to be, experts in posture.
What about manually stretching a client out, can a trainer do that? I would argue yes, absolutely. Flexibility is a clearly defined component of fitness that lies within our scope. Trainers should be very familiar with all types of stretching including partner and PNF stretches. You don’t have to be a medical doctor or a massage therapist to simply place your hands on a client’s body. However this would be different than manually massaging an area with an end goal of improving flexibility, that is something a massage therapist would be trained to do.
Having a clearly defined scope is very important for our field just like it is for doctors, lawyers, chiropractors, physical therapists, etc. But our scope is not elusive; it is already clearly defined and available for use. Use the scope of practice presented here as a guide and you may find your mission as a personal trainer suddenly became just a bit more clear. If you think you have a better scope that is legally defensible and more precise than the one presented here, please share it, I’m all ears.
- Henriques, T. (2014) NPTI’s Fundamentals of Fitness and Personal Training, Champaign, IL: Human Kinetics