Is there a such thing as a medical scope of practice for a personal trainer, or do we need to be sensitive to how best to handle clients’ medical issues when they arise?

If you’re a certified personal trainer, you more than likely get comments and questions like these, all of which challenge the limits of your professional scope of practice: “My ankle hurts, what did I do to it?” or “I’ve been feeling chronically fatigued, do you suppose I have some illness?” or “I’ve had a bad headache for several days in a row, what could it be from?”

Because you’re a fitness professional and you have a sophisticated working knowledge of the human body and its various systems, it’s common for clients to assume that you know all the things there is to know about the human body and its mysterious interworkings. This is not the case, however. While these questions aren’t unusual, there are tactful ways to handle these types of situations with clients while still remaining within your scope of practice.

Let the questions come. You can do very little to stop them and why would you want to? Your clients view you as a safe person to disclose all kinds of information to – and that’s great. If they do this on the regular, it means you’ve successfully built rapport and trust with them – that’s priceless. Good for you! This also means you must address questions outside your scope (such as medical or physical therapy-related topics) delicately and professionally.

Prioritize Building Your Network Outside of Your Medical Scope of Practice

Having a well-developed professional network is key to any professional’s success. This is especially true if you work as an independent fitness consultant and don’t work directly with other colleagues in a gym, studio, or health center environment.

The best way to field questions outside your scope is to prioritize building a professional referral network that includes physical therapists and medical practitioners. This way, when a client comes to you with a medical-type question, you have a referral network you can draw upon for appropriate guidance. You will benefit by staying within your scope and clients will benefit by receiving the necessary medical attention they require. Both sets of needs are then satisfied.

What You Should Say

As these types of questions come, and they will, here are a few ways you can address them. First, fitness professionals are “suspectitians”, not diagnosticians. While you might possess enough base knowledge to identify or suspect when a client has a sprained ankle versus a torn ligament, your best approach is to offer something like the following:

“That sounds painful. Can you tell me what you were doing at the time the injury occurred? How long has it been plaguing you?”

Gather what information you can without saying what you suspect the issue is. You want to be responsive, affirming, and listen actively while you’re conversing with your clients about their ailments and various obstacles. Follow-up the information gathering with statements such as:

“I’m going to recommend you see my friend and colleague X. I think he/she will be better able to assess this situation as injury rehabilitation is within his/her scope of licensed practice.”

Or, “Let me reach out to my friend and colleague who is a physical therapist (or athletic trainer) and see if he/she might have some availability to see you. Given that you have a suspected condition right now, let’s focus on active recovery and change today’s workout to be flexibility-based.”

Similar responses can be made if a client is unintentionally seeking medical advice from you for a condition that isn’t related to an injury (i.e. chronic fatigue, inappetence, headaches, dizziness, etc.). Again, gather as much information as possible to determine if contraindications are present that would force a session cancellation and then recommend your client see his/her primary care provider, mental health professional, or other qualified professional that is best equipped and educated to address the situation at hand.

The Bottom Line

The bottom line is, personal trainers do not technically have a medical scope of practice. That does not mean to shy away from the questions that come your way. It means you’re both trusted and valued by your clients, making you responsible for knowing when to refer important medical questions to the correct professional rather than leaving it to your client to deciper. Concentrate on building and using your referral network to help you provide a holistic approach to client care.

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Erin Nitschke

Dr. Erin Nitschke, NFPT-CPT, NSCA-CPT, ACE Health Coach, Fitness Nutrition Specialist, Therapeutic Exercise Specialist, and Pn1 is a health and human performance college professor, fitness blogger, mother, and passionate fitness professional. She has over 15 years of experience in the fitness industry and college instruction. Erin believes in the power of a holistic approach to healthy living. She loves encouraging her clients and students to develop body harmony by teaching focused skill development and lifestyle balance. Erin is also the Director of Educational Partnerships & Programs for the NFPT. Erin is an editorial author for ACE, IDEA, The Sheridan Press, and the Casper Star Tribune. Visit her personal blog at