01:00 AM EST on Sunday, December 28, 2003

BY SUSAN KUSHNER-RESNICK
Journal Health & Fitness Writer

Mike Silva couldn't believe what he was seeing.

Silva, a physical therapist, had come to a health club to speak to the owner about renting some space. The owner, who was a personal trainer, proceeded to conduct their business meeting during a paying customer's session. Besides chatting with Silva, the trainer took several cell phone calls while the client balanced weights over her head.

"She could have dropped the weights on herself, or passed out," says Silva, an exercise physiologist with a master's degree in physical therapy and the owner and president of Foundation Performance, in Pawtucket. "Anything could happen and cause that weight to fall on her."

Carol Ewing Garber knows more directly what can befall people working with inferior personal trainers. The Providence resident is a professor at Northeastern University's Bouve College of Health Sciences, and an official with the American College of Sports Medicine. She's also an expert witness in a Massachusetts lawsuit that pits an injured woman against a trainer.

The woman, who had recently had hip surgery, hired a personal trainer who supposedly had expertise working with older people. She claims he wasn't spotting her during balance exercises and she fell, breaking her other hip.

Now, the 72-year-old depends on a walker.

Such anecdotes serve to illustrate the point that Silva, Garber and a host of other exercise professionals make: personal trainers should be licensed and have college degrees in some sort of exercise science.

"We're playing with people's health and well-being," says Kevin Brochu, Rhode Island director for the National Strength & Conditioning Association. "We can have positive results on their lives and we also can have detrimental effects."

PERSONAL TRAINERS don't need to be licensed in Rhode Island or in any other state in the nation. Most health clubs require their trainers to be certified, but getting certification can be as easy as buying a blender from eBay. Hundreds of certifying bodies -- Brochu thinks there are 254 -- will issue a card that says "certified personal trainer" in exchange for some money and a passing score on a multiple-choice test. Many certificates can be earned with a few clicks of a mouse and a test that arrives in the mail.

Others require a few hours of lectures prior to the test. Only two certifying groups -- the American College of Sports Medicine and the National Strength & Conditioning Association -- require potential trainers to have a bachelor's degree in an exercise science program before sitting for the exam.

"Many certifications are reasonable, but because they don't require a standard background degree, the person's ability to treat many different people is unknown," says Garber, who has a Ph.D. in exercise physiology from the University of Connecticut.

She's especially concerned with certifications that can be had after a weekend workshop and a test that "almost everyone passes."

Or, as Scott Read, a college-educated personal trainer at Gold's Gym in Warwick, says, "You cannot absorb everything you need in a weekend to help someone change their lives."

Another problem with most of the certification exams is that they lack a practical segment.

"Nobody ever observes them in clinic to see if they get it," says Donna Behr, who has a Ph.D. in physical therapy and teaches at Simmons College in Boston. "They don't have the pathophysiology background to know, if someone has knee pain, what 10 things it could be."

"A lot of online certifications are really not that good," says Aileene Palm, an exercise physiologist at Miriam Hospital in Providence who also works in the fitness room at the South County YMCA. "They're multiple choice. It's one thing to answer on paper that an elbow needs to be at a 90-degree angle and another to know an actual elbow is at 90 degrees."

In essence, the certification means little. That's why a college degree is so important, experts say. A study conducted by UCLA researchers compared personal trainers with years of experience but no formal education with trainers who had a bachelor's degree in exercise science and certification from the American College of Sports Medicine or the National Strength & Conditioning Association. The educated trainers scored much higher on various fitness-related tests.

"These findings suggest that personal fitness trainers should have licensing requirements, such as a bachelor's degree in exercise science and certification by an organization whose criteria are extensive and widely accepted before being allowed to practice their craft," the study's authors concluded.

ALI LEBLANC couldn't believe what she was hearing.

The University of Rhode Island junior was working at a health club when she heard yet another personal trainer giving inaccurate information. She was showing a client an abdominal exercise and telling her that it would build just her upper abs. LeBlanc, a fitness and wellness major, knew that wasn't true.

"I learned in school that the muscles work together," LeBlanc says.

Such flubs illustrate the difference between a college-educated personal trainer and one who is merely certified.

Personal trainers with a relevant college degree have a valuable "body of knowledge," according to Peter Holmes, owner of Davol Square Fitness and Spa in Providence.

"They have an understanding of how the body works, of physiology, and an understanding of how to access research," says Holmes, who has a master's degree in exercise physiology.

Exercise educators say knowing how to unearth and interpret studies helps keep trainers current in a constantly evolving field.

"A degree also helps these students to determine if something on the market is legitimate or not," says Deb Riebe, an associate professor of exercise science at URI.

Exercise majors also learn to do thorough assessments before designing an exercise program. Riebe says personal trainers should be doing more than asking clients about health history and previous injuries. They also need to know where clients stand on five measures: cardiovascular endurance, muscle strength, muscle endurance, body composition and flexibility.
"It helps to tailor the exercise to some objective date," Garber says.

Students also learn to take blood pressure, calculate the ideal amount of weight a person should lift and measure body fat, among other things.

"I would rather have my personal trainers have a college degree so they can do blood-pressure readings and know what they mean," says Jennifer Marston, a URI exercise-science major.

"If their heart rate was sky high, you'd know what to do," adds Adria Bahr, another exercise-science major at URI.

Finally, experts say, a college degree shows a passion for fitness.

"Do you want someone who went to college for this or do you want someone who's a bartender at night and does personal training to supplement their income?" Brochu asks.

EVEN THOSE who would prefer that trainers have a sheepskin hanging in their lockers don't insist on it. Some say experience is just as valuable.

"Four years of education or four years of experience -- give me one or the other," says fitness center owner Holmes.

"There are good trainers out there who do not have a bachelor's degree," says Brochu, who has a bachelor's degree in sports medicine and is working on a master's degree in sports training. "Sometimes you have trainers with a bachelor's or master's who aren't that good at it."
Vinny Malaga, the owner of Gold's Gym in Warwick, likes his personal trainers to have college degrees, but he's more concerned with integrity. When he and his partner took over the gym last spring, they fired most of the personal trainers who worked there.
Basically, "they were babysitting and taking money," Malaga says.

Many of them also lacked liability insurance and certification, which Malaga requires. Besides making sure his new trainers know what strength exercises to give someone with sciatica, for example, he looks for people with vibrant personalities.

"It's a people business," he says.

Read, who has studied health and fitness at the University of Maine at Orono, trains people at Gold's Gym in Warwick and in their homes. He says a college degree would be irrelevant if the personal-training industry were regulated.

"Honestly, I think personal trainers should have to pass a board," Read says. "You're working with people's bodies. A lot of people don't realize that things that happen now can affect them years later."
He's not alone in calling for legal standards.
"I would love to see this profession turned into a licensed profession," says Silva, the physical therapist from Pawtucket.

The cost of a trainer can range widely. At Gold's Gym, in Warwick, for example, a session costs between $25 and $35. At Davol Square Fitness, a session costs $65.
"Personal trainers can do what they want and charge what they want and nobody regulates that," Brochu says.

But while hairdressers and interpreters for the deaf need to be licensed, there is no formal effort to require the same of personal trainers. That means consumers must do their own investigating or pay with their health.
TOM COULDN'T believe what he was feeling.

The Providence businessman, who didn't want his real name used, had recently recovered from back surgery. A personal trainer he hired at a gym pushed him to lift a barbell off the floor. His back started to arch and to hurt.

"The guy was like a drill sergeant," Tom says. "He never said, 'You're starting to arch your back, you're getting tired. Put the weight down.' "
Even when Tom argued that he didn't think a particular exercise was good for his back, the trainer insisted he do it. Finally, Tom headed back to his surgeon to see if he'd reinjured himself.

"He said it wasn't the kind of lift I should be doing," Tom said.

Tom's trainer never gave him an evaluation before working out with him. And Tom never inquired about his credentials.

"He had the business card, like they all do, that says certified personal trainer," Tom says.

Tom would never again use a personal trainer he hadn't checked out. But for people who may already feel vulnerable in the gym, probing into the trainer's background can be awkward.

"It's very, very hard," Behr says. "You can meet someone and they can engage you, but you don't know if they're going to train well. You really need to advocate for yourself, expecially if you have an underlying problem."

Experts say people should look for a trainer with:
A college degree in fitness, or at least some college coursework.

Certifications from reputable bodies -- the American College of Sports Medicine, the National Strength & Conditioning Association and the American Council on Exercise are often praised.

Liability insurance.

Thorough pre-exercise assessments.
References.

"If I'm not willing to give out references, is there something I'm hiding?" Brochu says.

People should be wary of trainers who aren't paying attention during a session, and those who push despite protests.

"Some people will say that their back is getting stiff and the trainer says, "Just push through it,' " Silva says. "Some still say, 'no pain, no gain.' "

In reality, joints should never hurt, according to Dr. Jerrold Rosenberg, a Providence specialist in rehabilitation medicine.

"When you feel the 'burn' it should be in the muscle," he says. "If you're feeling the pain in the joints -- wrists, shoulders, elbows -- that's an indication that something is not right."

It also means that you're not strengthening anything except the possibility of injury.

Garber warns people to stay clear of trainers trying to sell equipment or supplements. Palm, the exercise physiologist at Miriam Hospital, would add "wacky diets" to that list.

"I would send them to a registered dietitian," she says.
Another red flag is a trainer with a long-term training plan.

"After people know the correct form and know they won't hurt themselves, they don't need me to sit there and watch them," Silva says.

Experts also warn against being seduced by a trainer's appearance.

"A lot of people who become personal trainers are active, they have good bodies and their friends have been asking them how they do it," Silva says.

"People think if someone looks good, they know what they're doing."

NONE OF the experts would suggest, however, that using a personal trainer is a waste of time.

"If it helps somebody exercise, it's a good thing," Garber says.

"They can do incredibly wonderful things for people who aren't in shape," Rosenberg says.

"It gets people committed," Behr says. "It's nice to have someone to chat with. They change your weights for you. They fill your water bottles. It's pampering."

But working with a personal trainer can also be hazardous.

"We can give a better outlook on their health, we can give them a better physical appearance and make them feel better," Brochu says. "We can decrease their blood pressure, but we can also cause serious injury or death."