If you know I like to add a bit of spark to any presentation, so I initiated the Forum at the 2007 IHRSA Conference in San Diego by explaining that I would share personal opinions based on my own experiences, knowing full well that some of them would stimulate some agitation and perhaps get a few trainers hot under their collars. My intention was to elicit honesty and open up some much-needed discussions in a field where norms and standards are as varied as the trainers themselves.
I built the presentation around the concept of responsibility, criticizing the thought process that allows trainers to blame clients for a lack of improvement. I discussed professionalism and drew a complete agreement that the low barriers of entry into the personal training realm allow for unprofessional behavior to marry incompetence, contributing to a limited public perception of the position of the personal trainer. I discussed compensation and concluded that, despite conventional practices, fitness professionals deserve to be compensated in line with the value of their time.
Should We Offer Advice without Expertise?
About 30 minutes into the session, I clicked the little wireless remote, and the Powerpoint presentation on the big screen read, "Is discussing nutrition within our scope of practice?"
I shared some of my thoughts regarding the damage an overwhelming array of misinformation has brought upon the health and waistlines of our population and the limitations on achieving optimal outcomes without a client understanding the synergistic relationship between eating and exercising. I also shared some of the loopholes that allow food manufacturers to deceive, and I moved into a revelation of the misuse of some of the scientific research that becomes fodder for snack food sales.
Hands were raised throughout the theater. Trainers were squirming in their seats anxious to contribute. I went on to share my insights into the power of the sugar lobby and the impact simple sugar ingestion has upon health and metabolism, and then I opened it up to discussion.
One trainer responded, "Phil, we have to talk about nutrition. If we don't tell our clients how to eat, if we don't tell them what they should do nutritionally, we can't accept responsibility for delivering results." I presented a distinction between "sharing information" and "telling our clients how or what to eat." Another trainer offered his opinion, explaining that his certification prep curriculum included foundational nutritional information and that by achieving the certification, he's well-qualified to share the information he's proven competent in addressing.
As the "we need to talk about nutrition" camp seemed to swell, one trainer in the fourth row sat shaking her head, grimacing and struggling to prevent her hand from rising. The body language suggested she might burst into flames, so I nodded at her as if to say, "Let loose." She did, with a simple question. "Who do we think we are?" She continued, "Just because we've achieved knowledge in exercise, we seem to think we are experts in everything. What allows us to talk about nutrition when we aren't licensed to do so?"
Suddenly, new hands were raised. A trainer in the back echoed and expanded upon her sentiments. "How would we feel if nutritionists or doctors started giving people exercise routines? They don't have any formal training in exercise science or physiology, so we'd feel they're overstepping their bounds."
I agreed; however, wouldn't we applaud the doctor who told his patients of research that validated the link between aerobic exercise and cardiac output, resistance exercise and bone density or exercise and reduced risk of heart disease? Wouldn't we applaud the nutritionist who said, "Calcium alone is not going to build strong bones, and restricting calories will not ensure reduction in body fat. If you want to gain control of your body and health, you're going to have to incorporate resistance exercise."
There's a vast difference between sharing information validated by science and prescribing without credential. I would never prescribe a diet, but I wouldn't hesitate to explain the relationship between glucose ingestion, blood sugar, energy and fat release. I would share the metabolic perils of yo-yo dieting without giving it a second thought. I'd happily explain the relationship between the building blocks of protein and the cells you look at in the mirror every day. I would be embarrassed to have a client enter into a program with the goal of facilitating long-term change without a discussion about intake.
"Professionals" learn to create alliances. When appropriate, I'll gladly create a triangle featuring myself, a nutritionist and the client as the three necessary points. At times, a series of medical professionals and a trainer become the allied team that can help a client move away from hypertensive or hyperglycemic conditions.
What Is the Personal Trainer Capable Of?
The debate continued, with the divide growing between those who said "never" and those who said "we must." Before I brought the room back to a sense of unity, I wanted to push things just a bit further with the following series of statements:
1. Conventional medicine has been overtaken by the process of "diagnose and medicate."
2. Many "patients" are given labels (i.e. hypothyroid) without being provided a sense that they can be proactive in attempting to improve their health.
3. Personal trainers can cure disease.
That pushed some buttons. A few people walked out. I'm sure they perceived me as arrogant and outside the realm of my own scope of practice. Those who walked out missed my explanation: The word "cure" can be defined as "restore to health."
If we consider the word disease as a prefix and a noun ("dis-ease"), we can interpret it as the absence of ease. Every day, personal trainers are helping people alleviate joint pain, helping clients improve skeletal integrity, increase the efficiency of the heart and lungs and develop functional strength. To suggest that we can restore those who have lost a sense of "ease" in specific areas of their lives to a place where they feel healthy and functional would be readily embraced. The words "cure and disease" are so attached to medicine that many reject the notion that trainers have an unrecognized power.
I would not dare suggest we step over the lines of medicine or nutrition, but the lines are not clearly defined. Over the course of the next decade, as trainers gain professional respect and maintain a commitment to continued education, their place in the allied health field gains greater recognition.
What Are Our Aspirations?
Here is the question that took the discussion from "let's debate" to "let's ponder": What do we strive to be?
If we seek to be exercise facilitators, if the aspiration is limited to prescribing safe and effective exercise, if we are to screen, assess, prescribe and monitor to motivate, inspire and coach, then the lines are far simpler to define.
If, however, we seek to change people's lives, to help them sort their way through the 21st century's mazes of confusion, deception and misinformation, if we are to partner with our clients in taking responsibility for their fitness outcomes, I suggest we consider how we can connect them with sound nutrition, with an awareness of what "better choices" means and with the power they have to alter physical outcomes by altering lifestyle. I suggest we take responsibility for providing information related to recuperation, down time, stress management and anti-aging. I am not suggesting we become one-stop saviors, but without a mutual awareness of the factors that contribute to physical betterment, we may be setting ourselves up to under-deliver.
Had I not discussed nutrition with them, explained some things about exercise moderation and consistency and given them a sense of power, they would have certainly continued on a path of frustration. As of the time I'm writing this article, I can't say they've changed their habits, but I can say there's a possibility of it, and that's far better than certain frustration. It would have seemed absurd for me to say, "I'm listening to you, but I'm a personal trainer, so I'm not allowed to talk about nutrition or your health conditions."
I present this to you while it's fresh in my mind and invite you to participate, email me, contribute to the blogs or discussion boards at www.fit-pro.com and, most of all, to spend some time asking the hard questions: What will it take to make you feel fulfilled? How can you best prepare to best serve your clients? How can you ensure that you deliver more value than your clients expect? How will you move forward in your career with the knowledge that you'll sleep well each and every night knowing that you love what you do for a living, you're operating with unquestionable ethics and morality and you carefully considered how you can find true prosperity with a long line of clients saying thank you?
"Who do we think we are?" is a very good question, indeed.
Phil Kaplan is the author of Personal Training Profits and a Secure Fitness Future and the e-program, Change Your Mind, Change the World. Respond to Phil's arguments by emailing him at email@example.com, or visit philkaplan.com for more information.