Oregon is now the only state where 1:1 personal training is not allowed inside* (see back up documentation). Washington is opening 1:1 training with protocols effective on 1/11.
1:1 personal training uses the exact same exercises that are currently allowed inside by physical therapists and chiropractors. Like physical therapy, 1:1 training is appointment-based. As research presented by Oregon officials details, there is a wide range of COVID transmission rates among the wide range of activities classified as “fitness” or “gym.” For this reason, it is essential to look at methodology, data and science to create more specific guidelines around the different classifications of fitness activities in Oregon.
Our industry has been especially hard hit by COVID, but not every fitness activity offers the same risk level for transmission. We should not be grouped together.
Based on the ability to control distancing, capacity, mask wetness and air circulation, my request is for Oregon to re-open inside personal training with strict protocols in place.
The following information provides the supporting evidence for the above summary.
Same exercises, different intention
When professionals work with the physical body, the tool kit of resources is actually very small. My husband has a master’s degree in Kinesiology and holds a certified strength and conditioning specialist (CSCS) which is the gold standard credential for personal training. My sister is a Doctor of Physical Therapy (DPT). I am well poised to be able to share the intricacies and nuances of the two roles.
While they are a licensed medical professional, a physical therapist’s scope of practice in Oregon does not allow them to prescribe medication or break the skin. Their primary tools are body mechanics assessment, corrective exercise and manual therapy. Some therapists choose to use other topical modalities including things like cold lasers, ultrasound or similar.
A physical therapist’s job is to restore the body to baseline, to repair an injury, to alleviate pain. A personal trainer’s job is to build and maintain strength to be proactive and preventative. Therapists fix a problem. Trainers prevent a problem.
But they use the exact same exercises to accomplish these jobs.
All strengthening exercises for the body originate from 4 key functional areas – Squat, Hip Hinge, Pushing, Pulling. The spine moves in 6 directions and we both use exercises focused on rotation, anti-rotation, flexion and extension to build strength through the core.
Below are four examples of commonly used exercises and the ways therapists and trainers employ them. Weight amounts and repetitions are similar for both practitioners.
Squat
Therapist use: Increasing pain free range of motion for patient’s sport, improving strength and stability for patient’s job requirements, improving lower body stability to reduce/prevent back pain, improving strength and reducing pain after any lower extremity injury to restore function.
Trainer use: Activity of daily living, enforces, strengths and stabilizes ranges of motion people use in everyday life, sports activities and recreational pursuits. It trains and conditions the body to be proficient in movement patterns that are replicated in everyday life. It develops musculature, tendon and ligament strength in the hips and legs to help prevent injury, stave off age related sarcopenia, and maintain bone density.
Deadlift (hip hinge)
Therapist use: teaching a new parent how to safely bend down and place their child in their crib without pain, implementing strategies to a weekend warrior golfer to pick up their ball without pain, repairing strength and function to hamstring tendons after rupture or strain.
Trainer use: Foundational movement to improve strength and coordination between legs, hip and core. Improves grip strength (weight in hand), builds muscle, tendon and ligament strength in the legs, hips, back and arms. Develops proficiency in a movement pattern used in everyday life.
Overhead press
Therapist use: Safely restoring function with or without weight for an overhead throwing athlete, improving pain free range of motion after surgery or trauma to the shoulder, improving scapular and shoulder joint mechanics for any functional overhead reaching activity to reduce or eliminate pain, developing core engagement and muscular coordination for those with back pain.
Trainer use: Builds muscle, tendon and ligament strength in the forearms, upper arms, shoulders, chest and upper back. Develops proficiency in a range of motion used in many activities of daily living. Gently loads spine and core, helping to develop postural stability and strength.
Row
Therapist use: Rehabilitation from injury for return to sport, education on improved biomechanics to avoid injury in a factory/warehouse workplace setting, teaching core engagement with any pulling activity for those experiencing back pain.
Trainer use: Muscle, tendon, ligament strength in the arms and back. Develops postural strength in particular for people who work at a computer, drive or sit for long periods of time. Develops grip strength and shoulder stability to help prevent injuries.
How do appointments differ between physical therapists and personal trainers?
Appointment style varies largely among physical therapists. Some therapists work in 1:1 settings, but others work in clinics where one therapist might be responsible for several patients at once, relying on aides and care extenders to oversee exercise and care.
In a 1:1 setting most similar to personal training, both therapists and trainers have their patient perform a gentle warm up such as riding the bike or walking on a treadmill. This is followed by a series of exercises that are carefully curated to match the individuals goals and physical abilities. Both therapists and trainers provide an individualized exercise prescription. Therapists might then perform some kind of hands-on modality such as cold laser, massage, ultrasound, manual therapy such as a graston type treatment. Physical therapists touch and have close proximity to their patients during manual therapy. Trainers rarely need to physically touch their clients or get closer than 6 – 12 feet.
Maintenance and prevention are important
While physical therapists and personal trainers use the same tools and techniques to work with clients/patients, please note that a trainer’s scope of practice reaches more holistically into long-term support of their clients. Trainers support all health related goals of their clients, including nutrition and other behavior change metrics.
Prevention of future health problems is a key component of personal training. In addition to general strength and preparedness for life at any age, age related sarcopenia is a driver of deterioration and physical ailments of the body. In the absence of strength and conditioning work the human body loses 30% of it’s muscle mass by age 70. That includes structural muscles as well as internal organs like the heart. Decreased physical strength and heart capacity seriously limit activities of daily living, while at the same time increasing risk for falls, joint replacements, cardiac incidents and general wear and tear that requires medical interventions. It is common that once medical interventions begin they lead to additional interventions and diagnoses.
In the multifaceted industry of fitness, the work of personal trainers is MOST similar to the work that physical therapists do. Personal training is an important service to provide to a healthy, thriving population. Physical therapists have been open and allowed to perform the same physical activities/exercises that trainers use. Despite their differing intentions, if an exercise is safe to perform inside for a physical therapist it should be considered safe for a personal trainer.
Science and data driving Oregon’s decisions
The data and science informing much of Oregon’s decisions** points to large variance in COVID transmission among different fitness activities. Group spin and dance classes where uncertain mask use and high heart rate work is at play, are much higher transmission risk than 1:1 personal training. While The Nature study points to mobility in the community, it also largely supports that distance from others, capacity, ventilation of a space and actual length of time spent in that space are the largest predictors of transmission. In March (date of the article), masks and distancing were not applicable in gyms. Any gyms in the country that were open during that time were not in states with any real restrictions or protocols in place.
What data or science do we have as it relates to actual contact tracing in Oregon, and gyms or personal training?
Have there been cases reported through physical therapy offices with Oregon contact tracing? This environment is the most similar to 1:1 personal training. And physical therapy offices have never been mandated to close in Oregon.
With 5 months of data, were there masked, distanced transmission reports in Oregon gyms?
At Hyatt Training, we are open from 5 a.m. – 8 p.m. Monday-Thursday, 5-3 on Fridays, and 7-2 on Saturdays – a total of 77 hour per week. We operated inside with our protocols for just shy of 1700 hours from June 22 – November 17. We had no reported cases of exposure or transmission at our facility during that time.
Governor Cuomo in New York released contract tracing data last month and re-calibrated his opening of gyms because they were so far down the list for actual transmission when operated with appropriate protocols in place.
Additionally, a study released from the University of Oregon illustrated the low risk nature of transmission in gyms.
As a state moving forward out of the pandemic, I encourage Oregon leaders to look closely at these more recent research and data. We as a society have learned so much about COVID transmission over the past 10 months. It’s imperative that we use this emerging data to make the best decisions for our community as we face these final months of the pandemic. New data and science will help keep Oregonians safe while allowing the economy to begin its long road to recovery.
Hyatt Training’s journey: Then and now, an example of a responsible and proactive response to the pandemic.
I’d like to circle back to The Nature study dated March 30, 2020. I’d like to compare that study to what I, as a business owner and professional, knew about COVID-19 on March 16, 2020.
I knew that I didn’t know what kind of disinfectant killed the virus. I scoured the internet looking for answers and none were to be found. Dwell times, movement in space, everything about how the virus transmitted or was killed, was a solid mystery.
I asked for my team to “use one space” and not move around our studio excessively to avoid reusing equipment before it was re-sanitized, some of them didn’t do it.
So we closed. A full week before Governor Brown’s mandate to do so. On March 16 it was clear that we couldn’t keep our members and trainers safe. We didn’t know enough and the health of our members/trainers and liability of our business was at too great a risk to stay open.
Over the course of our 100-day closure, we studied, we collaborated with peers around the country, and most importantly we enlisted public health and legal experts to help us navigate and develop our reopening protocols.
When we re-opened on June 22, I knew without a doubt that we had created the safest environment possible for our members. Our comprehensive protocols exceed those released by the state. In October when the CDC updated guidance around droplets we purchased 4 highly rated BlueAir HEPA type air purifiers for the studio.
We have changed and evolved our protocols and safety measures to meet new data and science. I want to be a resource and help update the data and science that is being used to make critical decisions.
Masks
I understand that mask effectiveness is a concern around inside exercise. In real-life application, our members simply change masks if they get wet. Though my team reports that during inside exercise this was not a common problem or occurrence with the type of exercises our trainers program for their clients.
Did you know that masks get MUCH wetter exercising or training outside? One of my trainers reports changing her mask every hour when she trains outside (not exercising, simply talking to her client through their session).
It is uncomfortable to do cardiovascular exercise with a mask on. Hard cardiovascular work makes masks the most wet. For that reason our trainers typically prescribe that cardio work be done outside independently, not in session. 1:1 personal training has a totally different intention than a group spin class or cardio style class (as noted in the links provided by Oregon leadership highlighting spin class exposures**).
In a spin class or a group boot camp the whole point is to elevate your heart rate and perform interval work. While interval work is an important part of a comprehensive exercise plan, and research supports the tremendous benefits it has on overall health, inside during a pandemic is not the time and place to do that kind of exercise. Credentialed and educated trainers understand this and develop a custom plan for each session they perform.
Outside operations
While general science supports decreased COVID transmission outside, operating 1:1 personal training outside presents significant challenges to professional personal trainers and their clients. Masks become wet more quickly, decreasing effectiveness. It’s difficult to keep our clients warmed up properly to perform weight training without injury risk. And the extreme conditions cause difficulties for our professionals, some of whom work outdoors for many hours each day.
We offer a high-end, custom service. Our members pay $75 per session. They simply do not want to train in our parking lot. January is a time of year that we typically see an uptick in new members. However this year we are hearing from existing members that they would like to pause their membership until we are open inside again. While we can hope they will return, there is a very real risk that this once loyal member will find another solution while we wait for inside opening and never return, adding to the continued devastating financial impact COVID and mandated closures have had on our business.
New protocols
Washington outlines an approach to 1:1 training that makes good sense based on the 5 months of practical experience in our studio. 500 – 900 square feet per session is generous spacing allowing for adequate distance from trainer to client, limited session length of 45-50 minutes, effective sanitization, strict facility capacity limits and dry masks are the straightforward and key elements of effective COVID protocols that would allow 1:1 training to resume inside.
Dynamic interpretation of current guidelines
Given the varied nature of the fitness industry, we’ve seen varied approaches to how different organizations interpret the guidelines set forth. As an industry, we need more clarification and guidance around specific activities. Businesses who are operating outside of the current guidelines create a hardship for business owners who are following the rules. Even medical professionals like physical therapists and chiropractors are directly marketing and offering fitness classes while gyms are closed. While I understand that I could report these violations to OSHA, it is not my role or responsibility to spend time policing this policy.
The power of personal training
Properly designed exercise truly is medicine. The toolkit and exercises we use are the same toolkit and exercises used by physical therapists. Beyond the physical body it’s important to note the tremendous benefits of properly designed exercise programs to impact brain neurotransmitters making significant contributions to mental health and wellness.
We have dedicated 9 years of our lives to sharing our expertise and passion with our members and trainers. Our ask is simple. We seek to be part of the solution in Oregon moving forward, helping to create and establish updated protocols for the varied fitness industry activities that Oregonians use to stay healthy.
Back up information and sources
*Oregon is the only state not allowing any form of inside 1:1 personal training.
NY Times link tracking state closures
As of 1/11 Washington allows 1:1 training inside with protocols
California allows 1 inside 1:1 training session per address, reported from personal contact operating a personal training studio in San Francisco.
**Data and Science driving Oregon’s decisions
Email forwarded by Robert Ault dated 1/6/2021 from Dean E. Sidelinger, MD MSEd
Subject: Use of Fitness Facilities
Information from OHA regarding fitness activities/fitness centers and potential risks. It may help, if you get calls from people who have concerns.
Here’s what I’ve used and that we’ve share with media. There are some flaws in the CO work. I have not reviewed the data from NY. It addresses fitness activities broadly, not personal training.
In October, the CDC updated guidance due to the fact that COVID-19 may spread through the droplets and airborne particles that are formed when a person who has COVID-19 coughs, sneezes, sings, talks, or breathes. The guidance states:
“Circumstances under which airborne transmission of SARS-CoV-2 appears to have occurred include:
· Enclosed spaces within which an infectious person either exposed susceptible people at the same time or to which susceptible people were exposed shortly after the infectious person had left the space.
· Prolonged exposure to respiratory particles, often generated with expiratory exertion (e.g., shouting, singing, exercising) that increased the concentration of suspended respiratory droplets in the air space.
· Inadequate ventilation or air handling that allowed a build-up of suspended small respiratory droplets and particles.”
COVID-19 transmission risk is elevated during cardiovascular exercise and increased respiration; forceful respiration when coughing, sneezing, and yelling; close physical contact; and sustained physical contact.
A modeling study published in Nature, also relying on mobility data from cellphones, simulated the effects of reopening by category with a return to mobility patterns from early March 2020. There was a large variation of predicted risks with full-service restaurants, gyms, hotels, cafes, religious organizations, and limited-service restaurants producing the largest predicted increases in infections when reopened.
A CDC published report detailed cluster of COVID-19 cases associated with fitness dance classes. During 24 days in Cheonan, South Korea, 112 persons COVID-19 infection were associated with fitness dance classes at 12 sports facilities. Intense physical exercise in densely populated sports facilities could increase risk for infection. The report concluded that vigorous exercise in confined spaces should be minimized during outbreaks. In addition, there are numerous news media stories summarizing COVID-19 outbreaks associated with gyms.
When exercising, individuals often perspire. Perspiration can dampen a face mask and may decrease the effectiveness of the mask in preventing the spread of the virus causing COVID-19. A wet mask can make it difficult to breathe and the mask may not work as well when wet. A CDC report on effectiveness of cloth masks found that the poor performance of cloth masks in the study may have been because the masks were not washed frequently enough or because they became moist and contaminated.
Finally, here’s a summary of the fitness class outbreak in Canada. The information is not all in one place on the Ontario or Hamilton pages, as they do not report business names, so this is the best overview I could find.
Regards,
Dean
Dean E. Sidelinger, MD MSEd
Health Officer and State Epidemiologist
OREGON HEALTH AUTHORITY
Public Health Division
Hyatt Training is owned and operated by husband-wife team Jeremy Hyatt and Lee Carson. They bring 30+ years of professional experience to Hyatt Training and are dedicated to creating the best Portland personal training gym for members and trainers alike.
Jeremy and Lee created Hyatt Training because they believed whole-heartedly that one-on-one personal training is the best way to get the most out of your workout time and reach optimal results. Learn more about them, or get in touch with them by emailing Go@HyattTraining.com.
