Under pressure

Personal trainers can be an important part of a healthy lifestyle. But poor preparation and bad advice can lead to serious injury.

Personal trainers can be an important part of a fit lifestyle. But poor preparation and bad advice can lead to serious injury. Peta Bee on how to avoid a risky choice They appear to be a picture of health, walking, breathing advertisements for the virtuous lifestyle they endorse. But are personal trainers as healthy as you might think? Researchers reporting in the Journal of Athletic Training recently revealed that, far from leading holistically idyllic lives, many fitness experts fail to practise what they preach when it comes to diet and exercise.

A survey of almost 300 gym trainers by sports scientists at Western Michigan University found that fewer than half - 41 per cent - managed the recommended minimum of 30 minutes of moderate activity five days a week. Seven per cent said they did no exercise at all. None of the fitness experts consumed enough fruit and vegetables, dairy foods, fish or carbohydrates to provide the necessary amount of vitamins and minerals needed to stay healthy.

It may seem incomprehensible that the fitness professionals in whom we put our faith to guide us to better health could be so negligent with their own well-being, but to many it is just another sign that personal trainers are not always what they seem. Physiotherapists increasingly report their workload consists of clients who were injured during personal training sessions. In one case, a woman practising a wide-legged stretch was pushed so forcefully by her personal trainer that she broke her pelvic bone.

"Personal trainers are a popular means of working out," says Claire Small, a spokeswoman for the Chartered Society of Physiotherapy. "But a poorly trained or inexperienced fitness trainer can push a person too far or advise them poorly about technique, all of which could contribute to injury." Part of the problem is that anyone can legally set themselves up as a personal trainer, regardless of their knowledge and experience. Fitness qualifications vary enormously from weekend packages or correspondence courses to rigorous classes and exercise-related degrees that incorporate the study of anatomy, physiology, nutrition and stress management as well as exercise prescription. One report published by the UK consumer watchdog Health Which? found that one-third of gyms questioned were unable to provide evidence of their instructors' qualifications and that seven out of 10 classes held in gyms were badly taught.

"It is actually quite alarming to see the lack of knowledge among some personal trainers," says Louise Sutton, the head of the Carnegie Centre for Sports Performance and Wellbeing at Leeds Metropolitan University. "You get cases where people have been working as a banker one weekend and are allegedly fully qualified trainers the next. In gyms, ordinary staff who are not qualified in personal training individual clients often pull on the personal trainer shirt to earn extra money, but they don't really know what they are doing."

Sutton says that often personal trainers give inaccurate and misleading advice on nutrition and injuries. "Even those who have taken a well-reputed personal training qualification should not give out more than basic healthy eating guidelines," she says. "It can be very risky to start meddling with someone's diet when you don't really know much about it." So how do you make sure hiring a personal trainer is not a risky decision? Sutton says checking qualifications and going by word of mouth are often the best routes. Other than that, use your intuition.

"If you reach a fitness plateau or seem to know more than your trainer does, then that is clearly a bad sign," she says. "And don't assume it is a promising sign that a trainer looks good and has a zero fat percentage. Recent figures show that some cosmetic surgeons estimate 20 per cent of their clients asking for liposuction and muscle sculpting are employees within the fitness industry. Looks can be deceiving."

The risk of hiring a bad trainer was highlighted 10 years ago in one of the first cases of personal trainer negligence that was filed in a court. Anne Marie Capati, a 37-year-old fashion designer from New York, suffered a fatal stroke while working out with her trainer at a Manhattan gym. A lawsuit filed against the trainer by Capati's family alleged that her death was the result of nutritional supplements he advised her to take that included an over-the-counter drug containing ephedra. Capati was taking medication for hypertension (high blood pressure) and ephedra, a herbal substance that contains the natural stimulant ephedrine, is not supposed to be used by people with Capati's condition. Ephedra is often used for weight control but has been linked to dozens of deaths.

Since then, lawsuits against personal trainers have become increasingly common. In October 2008, a northern Virginia jury awarded $300,000 (Dh1.1 million) to a former US Navy sailor who sued a gym for a workout that left him permanently disabled. Makimba Mimms, 29, says the high-intensity circuit training session he attended in December 2005 was led by an underqualified trainer who did not supervise him properly. Medical documents produced at the trial revealed he had suffered a severe case of rhabdomyolysis, a potentially fatal condition caused by the rapid breakdown of muscle fibres. As the muscle fibres are leaked into the bloodstream, their toxicity raises the risk of kidney damage or failure. Three years later, Mimms cannot stand for long periods of time and still experiences pain.

In the UK, a former international swimmer was so badly injured under the guidance of a personal trainer at her gym that she too was left barely able to walk. Nicole Thornley, who swam for Britain in European Championship events, initially hired a trainer to get back into shape after retiring from competitive swimming. She signed up for six sessions and on the fourth was asked to squat 145 pounds - more than her body weight. After her session, Thornley felt excruciating pain in her back, lost consciousness and was taken to hospital for treatment. She endured months of pain and morphine injections until an MRI scan eventually revealed that two intervertebral discs had been ruptured and a segment of disc material lodged on the sciatic nerve. At 29, back surgery was the only option.

"A personal trainer is supposedly someone who guides you to better health, not worse," Thornley says. "The experience has left me in constant pain and unable to follow the fitness regime I'd like to be on." Another cause for concern is the growing anecdotal evidence of personal trainers transgressing boundaries. Male and female clients worldwide are reporting feeling uncomfortable with some trainers, who use the inevitable closeness to try and strike up more than a working relationship. Robin Gargrave, the director of YMCAfit, which trains fitness professionals, says that "recognised organisations have to set strict guidelines and codes of conduct to make sure there are no inappropriate relationships". If you feel uncomfortable in the presence of a trainer, then it is time to give them notice. "Your workout should be a time to relax as well as get fit," Gargrave says. "You should not feel under any pressure other than to work harder."

Cost Can you afford it? Trainers usually charge by the hour but their fees vary. A higher fee does not necessarily mean a better qualification. On average, you will need two to three sessions a week to get results. Personality

Make sure there is no personality clash. Choosing a trainer should be a bit like choosing a nanny for your children - the decision shouldn't be made on a whim. Homework Check out at least three trainers and contact them to discuss your needs. Remember, you are paying them, so if you don't like the way they propose to train you, strike them off your list. Qualification

Before you decide on someone, ask to see their qualification certificates and insurance documents. Any good trainer will have no problem with this.