Why trainers work through the pain of an injury, even if you shouldn't

Several months ago, Sarah Walls, a prominent Northern Virginia fitness and conditioning expert, was demonstrating a single-leg jump for a client – essentially hopping forward on one leg to test agility and balance – when she twisted her ankle.

The painful ankle roll bothered her for a while, Walls recalled recently, but "in the moment you sort of have to shake it off and keep moving, which is what I did." But later, she rolled the same ankle again while running outdoors, and the pain lingered on.

Walls, 36, founder of Strength & Performance Training (SAPT), is responsible for conditioning and training amateur, collegiate and professional athletes, including members of the Washington Mystics women's basketball team. But even she is susceptible to something that rarely gets attention in the physical fitness industry: nagging injuries to personal trainers and coaches.

Personal trainers are keenly aware of their clients' injuries and aches and pains, and they tailor workouts to speed up recovery and avoid a recurrence of an injury. But when taking care of themselves, trainers are often inclined to try to work through the pain, reluctant to halt a session or seek medical assistance.

"I feel like we're a group that really ignores things as long as humanly possible before seeking the correct medical help," Walls said.

Personal trainers are vital cogs in the $24 billion-a-year health and fitness industry, a national collection of roughly 36,000 health clubs and fitness centers that includes such giants as LA Fitness, 24 Hour Fitness, Life Time Fitness and Equinox, according to Statista.

Last year, more than 299,000 fitness trainers and instructors earned a median annual wage of $38,160, according to the Bureau of Labor Statistics. The bottom 10 percent of the trainers earned about $19,150 while the top 10 percent received more than $72,980.

Trainers suffer a wide variety of occupational injuries, including sprains, muscle tears, lower-back injuries, cuts and fractures, according to a January 2016 report on adverse working conditions in the fitness industry jointly produced by Slate and the Investigative Fund at the Nation Institute.

Workplace injuries are not only a nuisance for trainers. They can also disrupt their gym's or studio's operating schedules, upset or anger clients who don't like having their weekly routines interrupted and result in the loss of hourly fees of $75 or more that typically are divvied up between the gym and the trainer.

At many fitness centers, trainers are responsible not only for working out with clients but also for bringing in new business. Bandaged or limping trainers don't project the image that many fitness studios strive for in recruiting new customers.

What's more, most trainers – who operate as independent contractors – aren't entitled to health insurance coverage from their gyms and are reluctant to rack up costly medical bills.

Even those in the best shape can hurt themselves simply by bending over the wrong way to pick up a weight or a piece of equipment or by demonstrating a squat. Some trainers have injured themselves trying to prop up frail or wobbly clients to keep them from falling. And one trainer in New Jersey said he hurt his back years ago rescuing a client who attempted a bench press with too much weight and nearly crushed his neck.

Gerald Davis, a trainer for more than three decades who owns a studio in Washington, D.C., says that the fitness business can be very tough on trainers' bodies, even younger ones in the best of shape. "Gyms abuse the hell out of trainers," he said.

Cameron Krug, a powerfully built and well-conditioned 26-year-old who became a certified professional fitness trainer shortly after graduating from Walter Johnson High School in Bethesda Maryland, in 2008, is a case in point.

Krug, who is largely self-taught, trains clients at Crunch Fitness and Chevy Chase Personal Training. He is a talented, highly athletic instructor who pushes many of his clients to their physical limits. "I try to work as high on the intensity spectrum as people can handle safely," he explained.

But in pushing himself and his clients, Krug has suffered a shocking array of injuries – both on the gym exercise floor and on city streets while biking to meet clients for in-home sessions. "My whole life is one big injury," he quips.

Krug banged up and sprained his right ankle during several bike collisions with cars, and he broke his collarbone in a 2012 mishap that required hospitalization and surgery. That injury kept him in a sling for weeks, but it didn't prevent him from continuing to work.

Meanwhile, in the studios, Krug suffered a number of lower-back injuries, ankle injuries and muscle strains – in some cases from stumbling over kettlebells, weights and other equipment that had been left on the floor. He also repeatedly hurt his shoulder and wrist helping to adjust thick bands for clients while they were performing tension exercises and pullups.

"Most trainers will find, unless they are having their clients doing exclusively machine exercises or if the setup is just totally ergonomic, that you will be lifting things from odd angles," he explained. "And if your positioning is not sound and stable and all that, or if you're not bracing your spine, you can tweak a muscle in your back pretty easily just in the course of a day's work."

Trainers say that parts of their bodies most vulnerable to injuries are the lower back – especially if they are doing squats, picking up heavy weights or moving equipment around – as well as the knees, ankles and rotator cuffs. But unless the pain is excruciating, trainers generally ignore the injury and complete the session.

"Typically, if I hurt myself, I'm not going to end the session," Krug said. "I'll just keep going and, you know, lie on my back or do an isometric squat in between sessions if I need to. But normally, I never had one so severe that I couldn't find one position that was tolerable."

Krug stressed that, over time, he gradually learned how to skirt many of the minefields of injuries in the gym.

Davis, 65, the owner of Chevy Chase Personal Training, specializes in training middle-aged and older people and seniors with serious health or cognitive issues. (Disclosure: This reporter has worked out with Davis for years.) Davis discovered the hard way the difficulty of helping his clients after he seriously injured his right ankle in a motorcycle accident on his way to work on July 4.

The injury has slowed him down and made it harder to keep up with the daily demands of operating and cleaning his studio and making sure it is properly stocked with clean towels and refreshments. It also has made it far more difficult to provide the personalized attention he has long given his clients. "When a trainer has an injury, that limits the population the person can work with," Davis said.

He has four elderly clients whom he must lift onto a bench and properly position for therapeutic rubdowns or stretching exercises. "And if I don't position them, I have to explain to them I can't lift them because of my ankle," he said. "And by the end of the session, they say, 'It's not like it was.' "