There are Lots of Reasons NOT to Push Clients Too Far – “Rhabdomyolysis” is One

Avoiding Liability Bulletin – June 2017

As pointed out many times in this column, a good number of claims and suits are asserted against personal trainers and other fitness professionals related to untoward events arising out of the over-exertion of clients. These adverse events include extreme fatigue, pulled or strained muscles, broken bones and even heart attacks or other life threatening events. Pushing clients too hard based upon philosophies related to “no pain – no gain” often lead to these and other unfortunate results as well as claims and litigation.

One of the relatively recent untoward events which is sometimes alleged in these cases is associated with the over-exertion of clients leading to rhabdomyolysis. Rhabdomyolysis, often referred to in the fitness industry as “rhabdo,” is a potentially life threatening condition caused by over-exertion leading to the breakdown of muscle fibers which release a protein into the bloodstream which can proximately cause fatigue, muscle injury and weakness, sometimes damage to the kidneys and even in extreme situations, death. In the fitness industry, claims related to rhabdo are usually caused by over-exertion and in the context of fitness professionals and clients – pushing clients too hard.

While certain medications, illegal drugs and even alcohol abuse can also lead to rhabdo, the fitness industry is just beginning to see adverse claims and litigation associated with this condition. For example, in Kentucky, a 2012 filed lawsuit alleged that a personal fitness trainer established an exercise regime for an airline pilot client who had a poor level of physical fitness and who had not worked out in a gym for over 20 years. Despite his claimed poor physical fitness status, he was allegedly instructed by the fitness professional to use an elliptical machine followed by several directed strenuous exercises involving his legs and the performance of squats with weights.

The lawsuit he subsequently filed alleged that the exercise session lasted some 40-45 minutes during which time the client became overly fatigued and repeatedly fell to the floor. Despite these occurrences, the complaint filed in the case alleged that the client told the personal trainer, I “can’t do more.” After the session stopped because the client said he could do no more, the fitness personnel tried to sell the client personal training sessions. The client declined and began to suffer extreme muscle pain and weakness which led to dark brown urine upon urination and eventually hospitalization for eight days. The case, once filed, was ultimately settled for $75,000.00.

In 2013 another rhabdo case was filed in Illinois which, based upon a release and waiver of liability, resulted in a ruling in favor of the fitness facility. In this case, the plaintiff, a client of the facility and one of its personal trainers, alleged that he contracted rhabdo after the completion of initial exercise sessions with a personal trainer which resulted in hospitalization for several days. While the client’s allegations failed at the trial court level, which decision was affirmed on appeal, the case faltered due to the lack of medical testimony to substantiate the client’s allegations and the existence of the waiver/release document. Despite the ultimate ruling in this case, the costs and expenses associated with the defense of the case were surely substantial.

The bottom line on the rhabdo issue is simply DON’T OVER-EXERT FITNESS CLIENTS – especially during their first few training visits. Make sure and secure relevant health and fitness history information and perhaps most importantly, pay attention to that history! Progress clients through a reasonable exercise program considering their history, goals, desires and abilities. Too much, too soon is not the way to go. Too often such programming leads to claims and suits which can be avoided through the provision of service based upon the applicable standard of care.

Checklist to Avoid Rhabdo Claims and Lawsuits:

1. Secure relevant client history and medical information;
2. Evaluate the secured information in accordance with the applicable fitness standards of care;
3. Develop an exercise prescription based upon the information secured from the client;
4. Establish a progressive exercise program based upon the client’s history information and abilities, goals and desires;
5. Don’t over-exert clients especially during the first few exercise sessions. Don’t do too much, too soon; and,
6. Monitor the client’s exercise program and increase intensity over a reasonable time and upon a progressive basis in accordance with the applicable standard of care