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ACSM'S Health & Fitness Journal:
doi: 10.1249/FIT.0b013e3181c6709d

Treadmill Injuries: An Analysis of Case Law

Eickhoff-Shemek, JoAnn M. Ph.D., FACSM, FAWHP

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JoAnn M. Eickhoff-Shemek, Ph.D., FACSM, FAWHP, is a professor and the coordinator of the Exercise Science program at the University of South Florida in Tampa. Dr. Eickhoff-Shemek's research focuses on legal liability and risk management issues in the health/fitness field. She is the lead author of a new, groundbreaking, and comprehensive text entitled Risk Management for Health/Fitness Professionals: Legal Issues and Strategies published by Lippincott Williams & Wilkins. Coauthors are Dave Herbert, J.D., and Daniel Connaughton, Ed.D. Dr. Eickhoff-Shemek is the legal columnist and an associate editor of ACSM's Health & Fitness Journal®, and is ACSM Health/Fitness Director® certified, ACSM Exercise Test TechnologistSM certified, and a fellow of ACSM and the former Association of Worksite Health Promotion.

Walking or running on a treadmill can provide numerous health/fitness benefits, but there also are risks of injuries. Treadmill injuries can lead to negligence claims or lawsuits against a health/fitness facility. For example, in a 12-year analysis of health club liability claims by one insurance company, there were 233 claims involving treadmill injuries - the fifth highest among 20 different categories of claims (2).

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Treadmill injuries can be caused by a participant's own carelessness, the facility's negligence, and/or a product defect. The treadmill cases analyzed in this article will focus on negligent claims made against health/fitness facilities. Risk management strategies that facilities can implement to help minimize treadmill injuries and subsequent litigation also will be described.

First, it is necessary to provide an overview of negligence and some of the defenses that health/fitness facilities have to help refute or defend negligence claims. In a negligence lawsuit, the plaintiff must prove four elements: 1) the defendant owed the plaintiff a duty, 2) the defendant breached that duty, 3) the breach of duty caused (or proximately caused) the harm, and 4) a legally recognizable harm occurred. The best defense that facilities have against negligence is to provide evidence that they properly carried out their duties toward their participants because if there is no breach of duty, it will be difficult for the plaintiff to prevail with his/her negligence lawsuit.

Another defense is the primary assumption of risk defense in which the defendant has no liability for a plaintiff's injury when he/she assumed risks that are inherent or inseparable from the activity. However, to be an effective defense, the plaintiff must know, understand, and appreciate the inherent risks and voluntarily assume these risks. It is not a viable defense if the injury is caused by the defendant's negligence.

Facilities also can have their participants sign a waiver that can absolve the facility for its own negligence. However, there are a variety of factors that must be met for a waiver to be enforceable. Generally, when using the assumption of risk or waiver defense, a defendant will likely file a motion for summary judgment requesting the trial court to dismiss the case because there is no legal question to be decided because prior law has already been established in similar cases.

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The plaintiff in this case was a 49-year-old woman who had never been on a treadmill before joining Musclemakers Inc. (3). Her membership included three free personal fitness training sessions. Toward the end of her first session, the trainer placed her on a treadmill at 3.5 mph for 20 minutes and then left her unattended. The trainer did not instruct her on how to adjust the treadmill's speed or operate the control panel. Shortly after she started walking on the treadmill, she began to drift back on the belt, and although she attempted to walk faster, she was thrown from the machine and sustained a broken ankle.

The plaintiff filed a negligence claim against the facility. The trial court granted the defendant's motion for summary judgment that claimed the plaintiff assumed the risks associated with an athletic activity and therefore was not entitled to any recovery. However, the appellate court did not agree that she assumed the risks or that walking on a treadmill was an athletic activity. It stated that "the doctrine of primary assumption of risk… may be applied in cases where there is an elevated risk of danger, typically sporting or recreational events," but a plaintiff's first time on the treadmill does not fall within this principle, not to mention that the trainer did not ensure that the plaintiff "understood the treadmill's operation before using it" (3, p. 863).

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Ning Yan went to the defendant's fitness facility to use a 1-week complimentary pass (6). Each day, he signed a sheet that included a paragraph at the top that appeared to be a release (or waiver) of liability. On his second visit, while using one of the treadmills, he fell off the treadmill resulting in a severe head injury and his death about a month later. Xu, a representative for the decedent, contended in his negligence lawsuit that Yan stumbled while jogging, causing the treadmill to throw him back into the wall or the window ledge behind him and that there was only 2.5-feet clearance behind the treadmills. An expert witness in this case testified that the industry's standard of care (or duty) regarding safety distance behind treadmills should be a minimum of 5 feet.

The trial court granted the defendant's motion for summary disposition (similar to summary judgment) because the waiver that Yan signed absolved the facility for its own negligence, that is, its negligence for not providing a safe distance behind the treadmills. However, the appellate court disagreed stating that the "language at the top of the defendant's sign-in sheet was insufficient to operate as a release, absolving the defendant of any liability for its own negligence, and plaintiff is not barred from pursuing his… negligence claim against defendant" (6, p. 276).

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While exercising on a treadmill at the defendant's facility, Marshall claimed that the treadmill stopped abruptly in the middle of her program (5). After pushing the start button, she alleged that the treadmill restarted at 6.2 mph versus its usual 2.5 mph. Marshall contended that the sudden and unexpected start caused her to be violently thrown from the treadmill, causing severe injuries when her head struck the plexiglass wall behind the treadmill. Nearly 3 years after her injury, Marshall filed a lawsuit claiming that "1) Bally's negligently failed to maintain safe premises; 2) Life Fitness negligently designed and manufactured the treadmill; and 3) Washington Athletic Repair negligently failed to repair and maintain the treadmill" (5, p. 376).

The trial court granted the defendants' motion for summary judgment and dismissed the case because of insufficient evidence to establish proximate cause. It also based Bally's dismissal on the waiver language in the membership contract that Marshall signed. The appellate court agreed with the trial court's decision that the plaintiff failed to produce sufficient evidence to establish proximate cause for her injury. In her testimony, Marshall could not recall what happened - how abruptly the treadmill reached full speed, being thrown from the treadmill, and hitting the glass wall behind the treadmill. In addition, the plaintiff was unable to provide sufficient evidence to demonstrate that the treadmill was defective (improperly designed and manufactured by Life Fitness) or that it was not properly maintained by Washington Athletic Repair. Washington Athletic Repair did provide evidence that the treadmill was continuously used and routinely maintained.

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While walking on a treadmill at the defendant's facility, Darling was injured when she momentarily closed her eyes, lost her balance, and fell, striking an adjacent treadmill (4). She claimed that the staff did nothing to cause her fall, but if the treadmill would have had side bars, she would have knocked against them and got her balance back by grabbing onto them to catch her fall. She filed a negligence complaint against the Sports Clinic. The trial court granted the defendant's motion for summary judgment claiming that Darling assumed the risks. However, the appellate court disagreed and reversed the trial court's decision because the primary assumption of risk defense was not applicable because of the defendant's negligence in this case.

An expert witness for the plaintiff testified that the Sports Clinic failed to carry out its duty to set up the treadmill according to the specifications in the manufacturer's operation manual (e.g., did not meet proper clearance distances between adjacent treadmills) and failed to provide Darling cautions and warnings contained in that manual. The expert also testified that Darling had a medical history that made her susceptible to instability - as did virtually every person at the Clinic because of the injury or illness that brought them there. The patients at this facility had the potential to become unstable and lose their balance for a variety of reasons, and thus the Clinic knew or should have known to provide side safety rails on its treadmills. Given this expert's testimony, the appellate court stated that the very nature of this environment - a controlled medical rehabilitation facility - sets it apart from commercially advertised spas and health clubs and that "the doctrine of primary assumption of risk is not applicable… but the issues of breach of duty… and comparative negligence are viable" (4, p. 689).

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1. Provide instruction to participants (especially novices) on how to use the treadmills and supervise them until they fully know, understand, and appreciate the risks, that is, until they have demonstrated adequate skill to safely use and operate the treadmill.

2. Place treadmills in the facility so there are the necessary clearance distances behind and in between them; for example, the American Society of Testing and Materials (1) states that there should be at least 39 inches behind treadmills and 19.7 inches on each side.

3. Implement the installation, placement, inspection, maintenance, repair, and warning specifications as stated in the manufacturer's operating manual. Document that these specifications have been properly met, and maintain these records in a secure place.

4. Take additional precautions (e.g., provide side safety rails) to help ensure the safety of certain populations that may have an increased risk of becoming unstable and lose their balance.

5. Have participants sign an assumption of risk document. This will help strengthen the assumption of risk defense for injuries caused by inherent risks - but not for injuries caused by the facility's negligence.

6. In states where they are enforceable, have participants sign a waiver. Be sure that a competent lawyer has reviewed the waiver to help ensure that it is properly written to meet individual state requirements and protect the facility from its own negligence.

This column provides general legal information and is not intended to substitute for individualized legal advice.

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1. American Society for Testing and Materials. Standard Specification for Motorized Treadmills. F 2115. West Conshohocken (PA): American Society for Testing and Materials International; 2001. p. 5.

2. Association Insurance Group, Inc. Health club liability claims analysis over a 12-year period [Table 1-2]. In: Eickhoff-Shemek JM, Herbert DL, Connaughton DP. Risk Management for Health/Fitness Professionals: Legal Issues and Strategies. Baltimore (MD): Lippincott Williams & Wilkins; 2009. p. 6.

3. Corrigan v. Musclemakers, Inc, 258 A.D.2d 861 (N.Y. App. Div., 1999).

4. Darling v. Fairfield Medical Center, 142 Ohio App.3d 682 (Ohio Ct. App., 2001).

5. Marshall v. Bally's Pacwest, Inc, 94 Wash. App. 372 (Wash. Ct. App., 1999).

6. Xu v. Gay, 257 Mich. App. 263 (Mich. App. 2003).

© 2010 American College of Sports Medicine


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