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Columns: Fitness Safety

Top Five Reasons to Make Fitness Safety Priority No. 1

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

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ACSM's Health & Fitness Journal: 1/2 2020 - Volume 24 - Issue 1 - p 37-38
doi: 10.1249/FIT.0000000000000540
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Taking steps to help ensure the safety of fitness participants is the no. 1 responsibility of all fitness managers and exercise professionals. Too often, injuries occur that could have been prevented. This new column will focus on specific strategies that will enhance fitness safety. This first column, however, describes five major reasons why fitness safety needs to be the top priority.


Injury data are tracked and categorized from a sample of hospital emergency room departments throughout the United States via the National Electronic Injury Surveillance System. To determine the total number of injuries, estimates are calculated from the actual data. In the category of Exercise/Exercise Equipment, there were 264,921 injuries in 2007 and 498,498 injuries in 2018—an increase of almost 90% (1). These data do not reflect the number of injuries that did not involve a visit to a hospital emergency room, which would likely be far more. These data also do not include sport injuries such as football and soccer injuries. To reverse this trend, a concerted effort is needed. For example, injury prevention education needs to become a priority throughout the exercise profession, e.g., academic preparation, certification preparation, and on-the-job training.


All fitness managers and exercise professionals have a general legal duty to provide reasonably safe facilities and programs for their participants. Reasonably safe means taking precautions to help prevent foreseeable injuries (minor, major, and life-threatening) and death. The failure to take such precautions can lead to costly negligence claims and lawsuits. To fully understand what these precautions are, it is important to first recognize the many legal liability exposures (situations that can create a risk of injury) that exist in fitness facilities and programs. This is best achieved by obtaining a working knowledge of the law, legal liability, and risk management.

Moral duties—doing what is right—are often reflected in a fitness facility’s core values such as ensuring the safety of participants and providing high-quality services. For core values to be effective and meaningful, the facility’s leadership team needs to (a) be sure all staff members are aware of these values and why they are important, (b) practice and uphold them when making decisions, and (c) integrate them into the facility’s culture (2). The Hippocratic oath states among other things—first, do no harm. This is an important ethical code for all exercise professionals to follow. Taking steps to help ensure the safety of participants is not only the top legal duty but also the top moral duty.


A fear of injury may be a significant barrier to exercise, especially among those with medical conditions who could benefit a great deal from regular physical activity. For example, individuals with diabetes have reported fear of injury as a barrier to physical activity more often than with those without diabetes (3). According to the Centers for Disease Control and Prevention, injuries are a leading reason people stop participating in physical activity (4). These individuals likely stop exercising because of a fear of another injury. To meet the many national initiatives to increase and maintain physical activity among Americans, exercise professionals need to realize that some individuals may have a fear of injury or reinjury. One way to help new participants overcome these fears is to emphasize, during the fitness facility orientation, how the facility has made fitness safety a priority, e.g., provides and enforces safety policies, hires only credentialed and competent exercise professionals, and follows industry safety standards and guidelines.


Everyone knows we live in a litigious society and that negligence lawsuits can be very costly and create negative publicity. However, these are not the only concerning outcomes of litigation. It is important to realize the significant amount of time and emotional distress experienced by the defendants (exercise professionals and their employers) after a lawsuit is filed by a plaintiff (injured party). It may be several years before a negligence lawsuit is settled out of court or goes to trial. During this time between the filing of the lawsuit and the decision to settle or go to trial, called the discovery phase, the defendants will have many tasks to complete. For example, they will likely have to (a) prepare answers to a set of written questions (interrogatories) sent by an attorney of one party to the other party, (b) provide testimony (e.g., answer many questions from the plaintiff’s lawyer under oath), and (c) produce various documents of evidence such as injury reports, preactivity screening forms, waivers, exercise equipment inspection records, emergency action plan, etc. In one case (5), the defendant produced more than 750 pages of documents in response to all the discovery requests. Preventing injuries from occurring in the first place is the best way to avoid the many negative consequences of litigation.


When a fitness participant is injured, obviously the physical and emotional harm suffered by the victim is of utmost concern. Sometimes the victims fully recover from their injuries, but sometimes they do not. Those that do not often have life-long limitations and disabilities that have a significant, negative effect on their quality of life. Fitness managers and exercise professionals need to seriously consider this negative effect experienced by the victim but also those close to the victim. This is best expressed by the following quote from safety advocate, George Robotham: “A health and safety problem can be described by statistics but cannot be understood by statistics. It can only be understood by knowing and feeling the pain, anguish and depression and shattered hopes of the victim and of the wives, husbands, parents, children, grandparents and friends…” (6).

“A health and safety problem can be described by statistics but cannot be understood by statistics. It can only be understood by knowing and feeling the pain, anguish and depression and shattered hopes of the victim and of the wives, husbands, parents, children, grandparents and friends…” (6).

Fitness managers and exercise professionals will also have to live with the fact that the victim’s injury occurred under their watch. This can be emotionally distressful for them as well, especially if the injury was preventable.


1. National Electronic Safety Commission (NEISS). U.S. Consumer Product Safety Commission. [cited 2019 July 26]. Available from:
2. Cancialosi C. Two ways to ensure your corporate culture and values align. Forbes. July 20, 2015. [cited 2019 July 2]. Available from:
3. Huebschmann AG, Crane LA, Belansky ES, Scarbro S, Marshall JA, Regensteiner JG. Fear of injury with physical activity is greater in adults with diabetes than in adults without diabetes. Diabetes Care. 2011;34(8):1717–22.
4. CDC Injury Research Agenda 2009-2018. Centers for Disease Control and Prevention (CDC). U.S. Department of Health and Human Services. January 2009. [cited 2019 July 2]. Available from:
5. Jessica H. v. Equinox Holdings, Inc. N.Y. Misc: LEXIS 1215 (N.Y. Sup. Ct.; 2010).
6. Brown D. 14 quotes to strengthen your safety culture. Safety management insights, Basicsafe. August 7, 2014. [cited 2019 July 2]. Available from:
Copyright © 2019 by American College of Sports Medicine.