Is it time to regulate personal trainers?

Can you guess my answer to that question?  But it does seem to be coming:

After decades of unregulated existence in all 50 states, the booming field of personal trainers is braced for a wave of scrutiny that is expected to transform the industry and could make or break some of the biggest fitness companies in the country.

The new regulations, being written by and for the nation’s capital city, will create a registry of all personal trainers in the District only. But they are expected to become a model that winners and losers in the fight believe will be replicated elsewhere.

The credit or blame, as you may care to describe it, goes to the Affordable Care Act:

A variety of workplace wellness programs and preventive health-care initiatives called for in the law could soon translate into rivers of billable hours for those with credentials to keep American waistlines in check.

And that means the race is on to be eligible for those credentials…

I believe the excess bureaucratization of the ACA is just beginning to show all of its implications…

The story is by Aaron C. Davis.  And the article is sad throughout:

“We all have heard anecdotal reports of injuries, sexual misconduct and misrepresentation of titles by persons claiming to be competent in that area,” Simpson testified before a D.C. Council committee. She called the lack of any registration or licensure of personal trainers “a nationwide failure.”

Well, that is one “failure” we seem to be on the verge of remedying…

Comments

“We all have heard anecdotal reports of injuries, sexual misconduct and misrepresentation of titles by persons claiming to be competent in that area,”

By that logic shouldn't we be licensing parents?

Because they didn't say "rape" when they definitely would have if they could, we know there have been none.

"By that logic shouldn’t we be licensing parents?"

It's probably only a decade or so before we start hearing calls for mandatory classes for first time parents.

As if a state-issued piece of paper ever protected anyone from these things. What a cronyist power grab.

Cardio will be blessed. Strength training will be discouraged, especially Crossfit. Pilates and other exercise involving expensive machines will be blessed.

Well, the food pyramid worked out perfectly, so this will even be better!

Love it. As my very conservative dad likes to say, "I'm beginning to lose my faith in government!"

But how much personal training is there really for cardio? If they really want to maximize regulation they will go for the strength trainers, which I'd guess is the large majority of trainers.

Potentially, there is a huge amount of cardio training, assuming a person sets relevant cardiovascular fitness goals the same way they set strength training goals.

Here's one I hear a lot: "I want to qualify for the Boston Marathon."

Yeah, but economically, it isn't as big a deal. Much less skill is required to operate an elliptical than, say, a squat bar. This is one of the reasons that pushes American gyms in the direction of being a big space filled with cardio machines. It's the reason Planet Fitness looks the way it does and has ads trying to drive away the people who want to try hard.

There are people who take cardio seriously and treat it as a sport, but most cardio people aren't like that. They're just in the gym trying to create a thin female-looking body.

"Much less skill is required to operate an elliptical than, say, a squat bar."

I disagree with this. It's a lot more difficult to do cardio effectively than to just spin around on a machine. And nobody does squats with a bar unless they're serious about lifting, so you're comparing serious people to casual people.

"so you’re comparing serious people to casual people."

Yes, that's kind of the point. You require coaching only at a level in cardio that few people achieve. So most cardio coaching consists of learning how to turn on the machine.

Squatting, much less snatching, is technically difficult right from the start. Only Crossfit has really solved (*) the problem of making money on that model. And they do so by skimping on coaching and marketing exclusively to the wealthy.

(*) Arguably the jury is still out on this.

Your claim: The comparative easiness of cardio makes it less economically significant.
Your evidence: Doing serious weight lifting (e.g. squatting) requires more skill than doing casual cardio.

I'm saying that's bad evidence. Fun runs are a big industry and have been for a long time. They are significant economically. As for skill, I'm suggesting that there is no less skill involved in doing cardio safely than in lifting safely. Evidence I might supply is the booming sports medicine business that aims to treat running injuries.

"Your claim: The comparative easiness of cardio makes it less economically significant."

My claim is that the comparatively low-skill nature of cardio makes the demand for coaching lower. This is pretty common knowledge in the gym business, and it's why most gyms are structured the way they are. Coaching is expensive, treadmills are cheap.

And while it's obviously lower intensity (anything you can do for two hours can't be that hard), I don't believe cardio is easier in any big picture sense. Maybe more accessible. Obviously at the top everybody is trying hard.

In fact, your fun run example is a good illustration of my point. Most sedentary office workers can go out and do a three mile fun run with little risk and zero coaching. But there's no such thing as "fun squat day."

Arguably, Crossfit deserves some blame for bringing this on. Poor training and poor safety standards are rife in that organization, and it's very visible.

That said, I feel it's done more good than bad by showing Americans that there's more to fitness than running slowly, and by encouraging regular people to try hard. The WSJ had an article about C.J. Cummings this morning, and the resurgence of Olympic lifting wouldn't have happened without Crossfit.

That's weird. I'd predict the opposite. It's in everyone's best interest to promote weight-lifting over cardio: Better for gym owners, better for meathead trainers who never learned how to properly train someone for cardio fitness, and better for trainers' clients, who share our national aversion to cardio because it's hard, and so we continually invent pseudo-clinical reasons why it is of no use, even though it's the only form fitness that is strongly correlated to greater longevity.

But I can see why you say what you say, too. So it'll be interesting to see how it plays out.

Oh boy.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962000-6/abstract
http://www.ncbi.nlm.nih.gov/pubmed/12242311
http://www.ncbi.nlm.nih.gov/pubmed/26163682
http://www.ncbi.nlm.nih.gov/pubmed/26147527
http://www.ncbi.nlm.nih.gov/pubmed/26017097

Also, what do you think "properly training someone for cardio fitness" entails?

I don't think this is a good read on the state of exercise in America. Running took over in the 70s to the exclusion of everything else. We're just now recovering from that.

Doug puts it more strongly than I would, but the reason there's study of the effects of cardio on longevity is bias (and the evidence is not great). Cardio = exercise in much of the literature. That's only now changing.

"our national aversion to cardio because it’s hard"

I find it hard to believe you could live in the US and say that.

Do you have any specific data on the notion that "cardio = exercise in much of the literature?" I don't want to argue over it until I have seen the same facts you have.

There's an undercurrent out there of "despite what you're told, carbs are bad; despite what you're told, cardio is bad;" etc. etc. The fitness industry is 95% marketing gimmicks and fashion statements and it's easy to post competing links between Mark's Daily Apple and the American Heart Association or whatever.

But I'd argue that anyone between the ages of 15 and 45 who is incapable of running a 7-minute mile for at least two miles in a row is unfit. I've heard many people claim that their strength workouts are "good cardio workouts" because "it gets my heart rate up." That's crazy. That's the sort of mentality I'm arguing against.

"Do you have any specific data on the notion that “cardio = exercise in much of the literature?”"

Check out PubMed: http://www.ncbi.nlm.nih.gov/pubmed

It sounds like you are suggesting cardio well beyond the point of negative returns. The positive health effects come from cardio around the intensity of walking, not running, and really not fast running.

People who suggest positive longevity effects from lifting are not suggesting those effects come from heart health. If anything, lifting might be mildly negative for heart health since the circulatory system response is not unlike that seen in high blood pressure patients. But I understand this is not well studied. Part of the reason it's not well studied, ironically given our topic, is that it requires too much coaching to get people lifting in a realistic routine whereas anyone can move on a treadmill. So lifting studies tend to be smaller, shorter, and over-simplified. You see things like leg extensions used as a proxy for "lifting", because that's tractable in a research setting and the big three lifts just aren't.

Is that a joke? I ask you for your information and you just give me a link to pub med and invite me to do my own research. This conversation has gone beyond the point of negative returns.

It's not a joke - I gathered you have no background in this from your posts. There's a search engine on PubMed. Terms like "exercise" will rapidly give you an idea of what US research looks like. You asked me to characterize the literature and I pointed you to the best way to do that.

This got spam-filtered the first time, so posting again:

http://www.ncbi.nlm.nih.gov/pubmed/25982160 ("Grip strength was inversely associated with all-cause mortality (hazard ratio per 5 kg reduction in grip strength 1·16, 95% CI 1·13–1·20; p<0·0001), cardiovascular mortality (1·17, 1·11–1·24; p<0·0001), non-cardiovascular mortality (1·17, 1·12–1·21; p<0·0001), myocardial infarction (1·07, 1·02–1·11; p=0·002), and stroke (1·09, 1·05–1·15; p<0·0001). Grip strength was a stronger predictor of all-cause and cardiovascular mortality than systolic blood pressure.") (Also see the citations.).

http://www.ncbi.nlm.nih.gov/pubmed/26017097 ("Decreases in leg muscle and grip strength were significantly associated with 5-year mortality and low physical performance in both sexes.")

http://www.ncbi.nlm.nih.gov/pubmed/26147527 (" Other recent studies have reinforced the concurrent relationship of grip strength with measures of nutritional status or muscle mass and measures of function and health status. Studies published in the past few years have confirmed the value of grip strength as a predictor of mortality, hospital length of stay, and physical functioning.")

http://www.ncbi.nlm.nih.gov/pubmed/26163682

http://www.ncbi.nlm.nih.gov/pubmed/26147527

http://www.ncbi.nlm.nih.gov/pubmed/25921097

Out of curiosity, RP, what do you think "proper training for cardio" is?

The fun will start when the personal trainers have to certify the efforts of trainees in the gym. This will be needed for insurance companies (gov or otherwise) to verify that they really are getting something for the money they spend promoting exercise.

It took me years to figure this out, but the purpose of health regulations in the USA is to make things easier to pass muster, not more difficult. It will be a rubber stamp, and you'll quickly have people gaming the system this way. If that's what you had in mind, kudos to your foresight.

well, I think we should unregulate economists, myself. Anybody should be able to call themselves an economist and disburse advice for whatever they can charge. No need to demonstrate any formal training, or provide any infrastructure for anyone to check any claims that they might make about their education or achievements.

oh

I think that pretty much describes the current situation, doesn't it?

+1

I laughed. And it's true.

The commenter makes a compelling case that Australians may have a reputational interest in regulating who may call themselves Australians...

Trust me, I think 90% or more of PTs are full of utter crap, totally ignorant of the evidence and basically exist to bilk the desperate out of their money. But the government is the one group even more braindead about health and fitness. This was the same institution that willfully told the public for four decades that resistance training causes heart disease, that getting more than half of your calories from white bread and paste is a "balanced diet", that weight irregardless of body composition is a measure of health, that dietary cholesterol causes serum cholesterol, and that emaciated marathon runners are the pinnacle of fitness.

Now we're facing an epidemic of hip fractures, dementia, diabetes, sarcopenia obesity, osteoporosis, and god knows what else. This wasn't just an innocent misunderstanding of the science. Evidence to the contrary was suppressed, ignored and ridiculed by a cabal of government bureaucrats, academic charlatans and food industry opportunists. Much of this is politically driven by the left-wing bias of government agencies and research universities. We know that upper-body strength is highly correlated to right-wing political opinions. So when you have institutions staffed with 95% self--identified left-wing researchers, that produces a tremendous agenda against certain vital measures of health. By characterizing free weight squats and deadlifts as something done by freakish bodybuilders and meathead jocks in flyover country, instead of fundamental human movements, thousands have been pushed into isolated depression, total loss of independence and early graves.

Yeah, unless you can show some evidence of malicious intent, I’m just going to chalk this up to incompetence.

I'm going to split the difference and regard it as malicious incompetence.

You were doing so well until you made it about left-wing/right-wing.

I assumed that was a joke.

Perhaps it was, but stereotypically, the left runs and the right lifts. Marathons are SWPL and deadlifts aren't.

Your two paragraphs contradict. One says government is braindead, the other assumes a brilliantly orchestrated left-wing conspiracy. It can't be both. I'd go for a third explanation. Official advice has been wrong, as you nicely set out. But I think it's a case of groupthink rather than merely stupidity; it takes some nous to 'refute' all the contrary evidence.

I think I'm misunderstood. I didn't posit a conspiracy, simply an inbuilt bias. If my health researchers, and the journal referees, and the policymakers are all avid cross fitters, would you be surprised to find that the publications systematically overstated crossfits effectiveness? No conspiracy necessary, just normal human biases.

Go to a university campus and assess the strength body mass of the faculty. You'll find very few people who look like they could have been power lifters or linebackers. You'll find a lot who were plausible cross country runners. The former types of bodies are disproportionately represented in business, particularly finance and energy, with very few in academia. The stereotype of the wiry, nebbish nerd has persisted largely because theres a lot of truth to it.

Best part: We know that upper-body strength is highly correlated to right-wing political opinions.

Ok, I just had to look that up. Here is the study that idea comes from. And no it does not say what Doug thinks it says.

http://pss.sagepub.com/content/early/2013/05/13/0956797612466415.full.pdf+html?ijkey=aQgdXL1bx/R8k&keytype=ref&siteid=sppss

http://www.businessinsider.com/study-strength-politics-conservatives-liberals-2013-5

To save everyone else the trouble

As predicted, physical strength was positively correlated with support for economic redistribution among
low-SES males. However, as SES increased above average, the effect of upper-body strength on support for redistribution became negative; in other words, among higher-SES men, physical strength was correlated with opposition to redistribution.

Research academics and policy makers are universally high-SES, so yes the study does confirm my point about their biases.

The givernment never advocated white bread. It did encourage whole grains.

And is "paste" supposed to be "pasta"?

Look at the famous 1992 food pyramid. "Grains" are a monolithic category forming the base, and consist of "bread, pasta and rice". No attempt to separate refined carbs from whole grains. And of course nearly everyone prefers refined over whole grain, so what do you think will happen? Might as well just throw potato chips and pizza in there, then get shocked when people aren't eating quinoa.

Yeah, unless you can show some evidence of malicious intent, I'm just going to chalk this up to incompetence.

Oops, this was supposed to be a reply to Doug. Please ignore.

I'll just hire an Uber trainer.

Indeed. Regulation/licensing of personal trainers can work as long as trainers offering services through a phone app are exempted.

I don't like the bodies that consumers have selected. I want more sexy people

This is a dumb profession to regulate. Credentialing need not be a public endeavor--all manner of professions have private certification programs that work well. That would seem to be the best approach here.

The ACA doesn't require there to be any public regulation of personal trainers--it actually increases the size of the incentive employers can give to employees for success in health-contingent wellness programs. But these are totally optional. The law doesn't create wellness programs or require them.

I believe the excess bureaucratization of the ACA is just beginning to show all of its implications. Again, I don't think this is an ACA thing at all, but please if I am wrong tell me what part of the law implies this profession must be regulated.

But think of the powerful lobbying group we can create if we choose an existing credentialing organization as the government approved credentialing agency. The best part of a public private partnership, a government backed guild that raises costs and barrier to entry without providing any sort of public service..

The funny thing is there are tons of private certification programs for trainers and they seem to function perfectly well

When will the democrats be logically consistent and require people to get licenses before they can have sex?

That will only come after we pass legislation that defines sex as between a man and a man.

That leaves you out.

Yes! But probably not for the reason you think. I'm of the XY variety and only go for ladies. Really, just my wife.

I knew that. I was impugning the function of that Y chromosome of yours.

The ACA connection seems strained. Employer wellness programs are very weak part of the ACA and I see no strong connection to personal trainers with those programs, and Presidential health initiatives are also very ephemeral and focus mainly on schools where personal trainers aren't an issue.

Look, here's a job people do! Let's insert bureaucrats and politicians into the process! Because that makes EVERYTHING BETTER ALWAYS.

This comes at a time when the Obama administration just released a report calling for reduction of occupational licensing.

In the District of Columbia, the penalty for first-degree sexual abuse (basically aggravated rape), can be over 30 years in prison provided certain aggravating factors are met. (DC Code 22-3002(b)). Even for "mere" fourth degree sexual abuse, you can get up to five years. (DC Code 22-3005).

Mr. Simpson apparently believes that's not enough to stop personal trainers from raping their clients, but a $100 occupational licensing fee will do the trick.

Begone, background checks, security clearances and bar admission investigations (not to mention drug tests)! The criminal law can do it all.

How about licensing and certification of politicians? And what about voters? It is very interesting how progressives are inclined to favor greater government oversight of all facets of society, except for the one that grants them political power.

The crux of why medical care under the Affordable Care Act is not so affordable after all: the provisions within it that mandate coverage leading to those "rivers of billable hours"?

Trainers are already regulated by their own private certification organizations. I guess whichever one gets the Big Deal with the bureaucrats will end up making all the money. Ugh.

Such proposals predate the ACA. See:

http://www.ideafit.com/fitness-library/personal-trainer-licensing-debate

Tyler:--Journalists can be sloppy even if they appear to be adding weight to your views.

“People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices.”

So Adam Smith knew all about this 239 years ago.

If I were an economist, I could say something more profound about this, but let's see what our audience can make of this:

For about 10 years, the physical therapy profession has turned out graduates who have the title of doctor, and their training has grown in length to justify the title, just ask. In addition, the numbers of schools and total number of graduates is increasing annually.

On the other hand, reimbursement rates are level to descending in most categories including workers compensation. So, I predict growing numbers of unhappy graduates who may turn out to become resentful personal trainers! At some point in the future, your own trainer may have a long list of degrees, something you might feel extra good about. (Sarc off/ we don't need physical therapists to be trained this much).

When will we license parents? Abortion is a right. Soon to be a duty.

Next stop: life coaches and consultants, as the lucky ones who still have high-paying "permanent" jobs try to stem the outsourcing tide?

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