Health: Heading for injury time

Substandard fitness instruction can lead to injury - and litigation.

IN THE UK there are no legal controls over who can claim to be a fitness or personal trainer. Anyone can set themselves up as an instructor, which can lead to devastating injuries. The injured tend to blame themselves, accepting the damage as par for the course. However, one plucky lady, Sarah Howells, was so incensed by damage to her knees that she not only sued her health club for personal injury, but won too.

Sarah was approaching 60 in 1995, when she joined Lady in Leisure Health Club. She spent an hour with a personal instructor who, after being told of a previous knee injury, mapped out a personalised exercise programme.

"At first the exercises were painless and I enjoyed them, but despite not increasing the frequencies and weights as I was told, they became harder and more painful. My knees hurt so much that I couldn't walk to the club any more, but the staff gave me the old chestnuts - no gain without pain, put your back into it - making me feel like a wimp. After two months my physiotherapist and GP advised me to take a break, feeling that the exercises might be causing damage to my knees.

"I explained this to the club, asking for a refund, as I felt pounds 445 for only a few months was exorbitant. They sent me a cheque for pounds 273, which I considered derisory and returned to them. After consulting my local Citizens Advice Bureau, I contacted my lawyers who instigated proceedings for personal injury damages."

Following lengthy litigation, in April Sarah accepted damages of pounds 5,500 for pain and suffering from Lady of Leisure in an out-of-court settlement, although there was no admission of liability. She also received pounds 838 for out of pocket expenses, and a large proportion of her legal expenses, which had risen to pounds 1,593.31. In total she got pounds 7,924.

"I am left with two painful, swollen knees which neither straighten fully nor bend more than 90 degrees. I cannot kneel and walking any distance is painful. Sometimes the knees sublux [bend round the other way] which is excruciating. Standing is also painful and pushing a supermarket trolley can be agony. Various orthopaedic consultants have said nothing can be done, that I must wait until there is enough deterioration to necessitate a double knee operation.

"Originally all I wanted was my money back. This money may be some recompense but I'd rather have my health and strength."

How can such incidents be prevented, when there are no controls over fitness instructors? Dr Andrew Craig, chief executive and operations director of the Exercise Association of England Limited, is battling to remedy the problem. In January this year, this National Governing Body for Exercise and Fitness, supported by the English Sports Council, launched an exercise and fitness register.

"This is a voluntary self-regulation scheme, ensuring that trainers have appropriate qualifications and a code of ethics, participate in continuing education and agree to a complaints procedure if concerns about their practice cannot be resolved locally," says Dr Craig. "Will enough instructors join it? The answer is in the hand of employers in leisure centres, health clubs and the NHS. If employers and the public demand registration of instructors and trainers as a guarantee of quality, then the register will fulfil its mission to protect and inform. Without this pressure, the register will only be preaching to the converted and the public will have no reliable reference point to guide their choice of instructors and fitness services."