SC Standards and Guidelines

8/19/2019 SC Standards and Guidelines

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1 Appalachian State University Department of Health, Leisure,and Exercise Science

Associate Professor and Director,Graduate ProgramBoone, North Carolina

2Norman Regional Health Club Wellness CoordinatorNorman, Oklahoma

3Castleview High SchoolHead Strength and Conditioning CoachCastle Rock, Colorado

4 Valdosta State University Head Speed/Strength and Conditioning CoachValdosta, Georgia

Update Task ForceN. ravis riplett, PhD, CSCS,*D, FNSCA 1; Chat Williams, MS, CSCS,*D, NSCA-CP ,*D2;

Patrick McHenry, MS, CSCS,*D, CP3; Michael Doscher, MS, CSCS,*D, CP4

Strength & ConditioningProfessional Standards

and GuidelinesApproved July 8, 2009


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National Strength and Conditioning Association

Table of ContentsStrength and Conditioning Professional Standards and Guidelines: Overview ..............................................................................

Notice ...........................................................................................................................................................................................

IN RODUC ION ......................................................................................................................................................................1

Scope of Practice .......................................................................................................................................................................

Duties & Concepts ....................................................................................................................................................................ypes of Standards ....................................................................................................................................................................

Standards of Practice As Tey Apply to Risk Management .........................................................................................................

Liability Exposure in the Strength & Conditioning Profession .............. .............. .............. .............. .............. .............. ...............

Injury rends & Standard of Care Load: Effects of Rising Athletic Participation ............. .............. .............. .............. .............. ..

1. PRE-PAR ICIPA ION SCREENING & CLEARANCE......................................................................................................10

Standard 1.1 ............................................................................................................................................................................1

Guideline 1.1 ...........................................................................................................................................................................1

2. PERSONNEL QUALIFICA IONS .......................................................................................................................................10

Guideline 2.1 ...........................................................................................................................................................................1

Guideline 2.2 ...........................................................................................................................................................................1

Guideline 2.3 ...........................................................................................................................................................................1

3. PROGRAM SUPERVISION & INS RUC ION .................................................................................................................10

Standard 3.1 ............................................................................................................................................................................1

Standard 3.2 ............................................................................................................................................................................1

Guideline 3.1 ...........................................................................................................................................................................1

4. FACILI Y & EQUIPMEN SE -UP, INSPEC ION, MAIN ENANCE, REPAIR & SIGNAGE ............. .............. .......... 11

Standard 4.1 ............................................................................................................................................................................1

Standard 4.2 ............................................................................................................................................................................1

Standard 4.3 ............................................................................................................................................................................1

Standard 4.4 ............................................................................................................................................................................1

Guideline 4.1 ...........................................................................................................................................................................1

Guideline 4.2 ...........................................................................................................................................................................1

Guideline 4.3 ...........................................................................................................................................................................1

5. EMERGENCY PLANNING & RESPONSE .........................................................................................................................11

Standard 5.1 ............................................................................................................................................................................1

Standard 5.2 ............................................................................................................................................................................1

Guideline 5.1 ...........................................................................................................................................................................1


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National Strength and Conditioning AssociationII

Table of Contents—continued6. RECORDS & RECORD KEEPING .....................................................................................................................................11

Guideline 6.1 ...........................................................................................................................................................................11

7. EQUAL OPPOR UNI Y & ACCESS ..................................................................................................................................12

Standard 7.1 ............................................................................................................................................................................12

8. PAR ICIPA ION IN S RENG H & CONDI IONING AC IVI IES BY CHILDREN .............. .............. .............. ..... 12Guideline 8.1 ...........................................................................................................................................................................12

Guideline 8.2 ...........................................................................................................................................................................12

Guideline 8.3 ...........................................................................................................................................................................12

9. SUPPLEMEN S, ERGOGENIC AIDS & DRUGS ..............................................................................................................12

Standard 9.1 ............................................................................................................................................................................12

APPENDIX A. Strength & Conditioning Practitioner Denition ............... .............. .............. .............. .............. .............. .......... 13

CSCS® Examination Content Outline .....................................................................................................................................13

APPENDIX B. Certied Strength & Conditioning Specialist® (CSCS®) ............. .............. .............. .............. .............. ............... ..15

Accreditation ............. .............. .............. .............. .............. ............... .............. .............. .............. .............. .............. ............... ..15

CSCS Examination Format .....................................................................................................................................................15

Continuing Education Program ...............................................................................................................................................15

NSCA Code of Ethics for Certicant .......................................................................................................................................16

APPENDIX C. Strength & Conditioning Performance eam Development ............. .............. .............. .............. .............. .......... 17

APPENDIX D. Strength & Conditioning Facility Scheduling ............. .............. .............. .............. .............. .............. ............... ..18

APPENDIX E. Strength & Conditioning raining Plan Development........................................................................................19

NSCA Position Statement Summaries .....................................................................................................................................19

[http://www.nsca-lift.org/Publications/posstatements.shtml] ...................................................................................................19

APPENDIX F. NCAA Division I Athlete-to-Coach Ratios .............. .............. .............. .............. .............. ............... .............. ....... 20

APPENDIX G. Emergency Care & Planning..............................................................................................................................22

Emergency Care ......................................................................................................................................................................22

Emergency Plan Example emplate .........................................................................................................................................22

APPENDIX H. Protective Legal Documents ............. .............. .............. .............. .............. .............. ............... .............. .............. 25

ypes of Protective Legal Documents.......................................................................................................................................25

Causes of Injury Associated With Physical Activity ..................................................................................................................25

Making Protective Legal Documents Enforceable ....................................................................................................................26

References ...................................................................................................................................................................................27

Acknowledgments ............. ............... .............. .............. .............. .............. .............. ............... .............. .............. .............. ............ 30


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Strength and ConditioningProfessional Standards andGuidelines: OverviewTe Strength & Conditioning profession has come to a deningmoment. Te profession involves the combined competenciesof sport/exercise science, administration, management, teachingand coaching. Its practitioners must also comply with various

laws and regulations while responding to instances of potentialinjury, and related claims and suits. Tis creates remarkable chal-lenges, and requires substantial experience, expertise and otherresources to effectively address them, especially in multi-sport(e.g., collegiate and scholastic) settings.

Ample resources are available in some of these settings. In manyothers, however, they are not. Budgets, equipment, facilities andstaff are often limited (or lacking altogether), with a resultingmismatch between the participants’ demand for safe and effec-tive programs and services, and the institution’s provision ofthem. It is important for Strength & Conditioning practitionersand their employers to understand that this standard of care is

a shared duty; the institution and individual are thus jointly re-sponsible for fullling it. Collectively, these issues are the drivingforces behind this project.

Te purpose of the NSCA Strength & Conditioning Profession-al Standards & Guidelines project is to help identify areas of riskexposure, increase safety and decrease the likelihood of injuriesthat might lead to claims, and ultimately improve the standardof care being offered. Tis document is intended to be neitherrigid nor static. On the contrary, the need for discretion andinsight is a fundamental theme throughout; and the informa-tion presented here will be revised periodically as the professioncontinues to evolve. It is hoped that Strength & Conditioning

practitioners and the institutions employing them will mutuallybenet from applying this information, and in turn signicantlyenhance the quality of services and programs provided to theirparticipants.

NoticeTis document is intended to provide relevant practice pa-rameters for Strength & Conditioning professionals to utilize when carrying out their responsibilities in providing servicesto athletes or other participants. Te standards and guidelinespresented here are based on published scientic studies, perti-nent statements from other associations, analysis of claims, and

a consensus of expert views. However, this information is not asubstitute for individualized judgment or independent profes-sional advice.

Neither the NSCA nor the contributors to this project assumeany duty owed to third parties by those reading, interpreting orimplementing this information. When rendering services to thirdparties, these standards and guidelines cannot be adopted for use

with all participants without exercising independent judgmentand decision-making based on the Strength & Conditioning pro-fessional’s individual training, education and experience. Further-

more, Strength & Conditioning practitioners must stay abreasof new developments in the profession so that these standarand guidelines may evolve to meet particular service needs.

Neither the NSCA nor the contributors to this project, by reasonof authorship or publication of this document, shall be deemeto be engaged in practice of any branch of professional discipli(e.g., medicine, physical therapy, law). Strength & Conditioing practitioners utilizing this information are encouraged tseek and obtain such advice, if needed or desired, from licensprofessionals.

IntroductionScope of PracticeTe responsibilities and professional scope of practice foStrength & Conditioning professionals can be subdivided inttwo domains (58): “Scientic Foundations” and “Practical/Aplied”. Each of these involves corresponding activities, respobilities and knowledge requirements (refer to Appendices A B):

Scientic Foundations• Exercise Sciences (Anatomy, Exercise Physiology,

Biomechanics,etc)

• Nutrition

Practical/Applied• Program Design

• Exercise echnique

• Organization & Administration

• esting & Evaluation

Duties & ConceptsStrength & Conditioning practitioners have duties to provide anappropriate level of supervision and instruction in order to mea reasonable standard of care, and to provide and maintain a saenvironment for the participants under their supervision. Teseduties also involve informing users of risks inherent in and reled to their activities, and preventing unreasonable risk or harmresulting from “negligent instruction or supervision”(28, 29, 36Greenwood & Greenwood (Chapter 21 [pp. 543 – 568] of Essentials Of Strength raining & Conditioning 7) summarize thefollowing key liability concepts for the Strength & Conditioninprofessional:

• Assumption of risk: voluntarily participation in activity with knowledge of the inherent risk(s). Athletic activitieincluding Strength & Conditioning, involve certain risksParticipants must be informed of the risks of activity, anrequired to sign a statement to that effect.

• Responsibility, duty or obligation; Strength & Condi-tioning professionals have a duty to the participants theyserve to take reasonable steps to prevent injury, and to aprudently when an injury occurs. (12)


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National Strength and Conditioning Association2

• Standard of care: what a prudent and reasonable person would do under similar circumstances. A Strength &Conditioning professional is expected to act according tohis/her education, training and certication status (e.g.,CSCS, NSCA-CP , CPR, and First Aid).

• Negligence: failure to act as a reasonable and prudentperson would under similar circumstances. Four elementsmust exist for a Strength & Conditioning professionalto be found liable for negligence: duty, breach of duty,proximate cause, and damages (65). Simply stated, aStrength & Conditioning professional is negligent if he/she is proven to have a duty to act, and to have failed toact with the appropriate standard of care, proximatelycausing injury or damages to another person.

Standards vs. GuidelinesIt is important to distinguish between “standards” and “guide-lines” because each term has different legal implications (9,83):

• Standard: a required procedure that probably reectsa duty or obligation for standard of care (note that thestandard statements in this document utilize the word

“must”). Te standards set forth in this document mayultimately be recognized as a legal standard of care tobe implemented into the daily operations of Strength &Conditioning programs and facilities.

• Guideline: a recommended operating procedure formu-lated and developed to further enhance the quality ofservices provided (note that the guideline statements inthis document utilize the word “should”). Guidelines arenot intended to be standards of practice or to give rise tolegally dened duties of care, but in certain circumstancesthey could assist in evaluating and improving servicesrendered.

While the publication of this document does not amount to adetermination of the standard of care to be applied in a particu-lar case, it is presumed, that the standards stated herein may begiven authoritative weight.

Published Standards of Practice = Potential DutiesProof of duty or standard of care case can be determined invarious ways, one of which is from standards of practice pub-lished by professional associations and organizations. Publishedstandards of practice can be used particularly to help determine

whether a person was negligent in carrying out his/her duties(19), where they are generally recognized as being indicative of widely accepted practices. Some courts examining these issues innegligence cases have ruled that violations of such professionalstandards constitute a breach of duty.

If properly adopted and applied, published standards of practicecan minimize liability exposures associated with negligence, andthereby serve as a shield for those who comply with them. Teycan also be used as a sword against those who do not comply

with them, potentially increasing liability risks associated withnegligence (19). Te key issue in this regard appears to be the

practitioner’s consistent application of established standards ofpractice in the provision of daily service. For example, if his/herconduct is proven to be consistent with accepted standard(s), it

will be difficult to show breach of duty, thereby providing greaterprotection against negligence. If his/her conduct is not provento be consistent with accepted standard(s), however, it may beeasier for the injured party to show breach of duty by failure tofollow such standards, which can lead to a ruling of negligence.

Types of StandardsIn addition to standards for desired operational practices pub-lished by professional organizations such as the NSCA, there arealso standards for technical/physical specications published byindependent organizations such as the AMERICAN SOCIE YFOR ES ING & MA ERIALS (AS M) or U.S. CONSUM-ER PRODUC SAFE Y COMMISSION (CPSC). Tese arebriey described below:

Operational PracticesEstablished standards of care can be used to gauge a practitio-ner’s professional competence by comparing his/her actual con-duct with written benchmarks of expected behavior. In addition

to the standards and guidelines from allied professional orga-nizations such as the AMERICAN COLLEGE OF SPOR SMEDICINE (8,23,83), AMERICAN HEAR ASSOCIA-

ION (8,52) and NA IONAL A HLE IC RAINERS’ AS-SOCIA ION (73) referenced in this document, the followingassociations have also published standards of practice:

• AEROBICS & FI NESS ASSOCIA ION OF AMER-ICA. Exercise Standards & Guidelines. Ventura CA:

AFAA, 1995.

• AMERICAN ACADEMY OF PEDIA RICS. Strengthraining by Children and Adolescents. Pediatrics 2008

121: 835 – 840. http://aappolicy.aappublications.org/cgi/search

• AMERICAN PHYSICAL HERAPY ASSOCIA ION.Guide to Physical Terapist Practice (2nd Edition). Alex-andria VA: AP A, 2001.

• AMERICAN PHYSICAL HERAPY ASSOCIA ION. Administration of physical therapy services. AlexandriaVA: AP A, 2001. http://www.apta.org/AM/ emplate.cfm?Section=Policies_and_Bylaws&CON EN ID=33912& EMPLA E=/CM/ContentDisplay.cfm

• NA IONAL ASSOCIA ION FOR SPOR & PHYSI-

CAL EDUCA ION. National Physical EducationStandards (3rd Edition). Columbus OH: McGraw-HillHigher Education, 1995.

• NA IONAL ASSOCIA ION FOR SPOR & PHYSI-CAL EDUCA ION. National Standards for AthleticCoaches. Reston VA: NASPE, 1995.

• NA IONAL A HLE IC RAINERS’ ASSOCIA IONBOARD OF CER IFICA ION. Standards of Profes-sional Practice. Dallas X: NA A, 2000. http://www.


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bocatc.org/index.php?option=com_content&task=view&id=51&Itemid=54

• PRESIDEN ’S COUNCIL ON PHYSICAL FI NESS AND SPOR S. Youth Resistance raining. ResearchDigest 4(3): 1 – 8, 2003. http://www.tness.gov/Read-ing_Room/Digests/Digest-September2003.pdf

Technical/Physical Specicationsechnical/physical specications relevant to the Strength &

Conditioning profession have been published by the CPSC (e.g.,“Prevent Injuries to Children From Exercise Equipment”; CPSCDocument #5028) and AS M (3,4). Te former organizationalso operates the National Electronic Injury Surveillance System(NEISS), a surveillance and follow-back system that gathers datafrom hospital emergency departments to provide timely infor-mation on consumer injuries associated with certain productsor activities. Some of this data has been used to research weighttraining injuries, as will be addressed in the Injury rends, Liti-gations & Standard of Care Load discussion.

Standards of Practice As They Apply to RiskManagementRisk management is a proactive administrative process that helpsminimize liability, as well as decrease the frequency and severityof injuries and subsequent claims (18). It may not be possible toeliminate all risk of injury and liability exposure in Strength &Conditioning settings; however, it can be effectively minimizedby implementing risk management strategies. Te Strength &Conditioning coordinator is ultimately responsible for risk man-agement, but all practitioners should be involved in the variousaspects of the process. Eickhoff-Shemek (20) proposes a 4-stepprocedure [adapted from Head & Horn(33)] for applying stan-dards of practice to the risk management process:

1. Identify and select standards of practice, as well as allapplicable laws.Because so many standards of practiceare published by various organizations, it is challengingfor the Strength & Conditioning professional to be awareof all of them, and determine which ones are appropriate

when implementing the risk management plan. In termsof participant safety, the most conservative or stringentstandards in a given industry should generally be used.

2. Develop risk management strategies reecting standards of practice and all applicable laws.Tis step involves writ-ing procedures describing specic responsibilities and/orduties that staff would carry out in particular situations.Te procedures should be written clearly, succinctly, and without excessive detail (too much detail may not allowthe exibility practitioners need in particular situations,and make implementation of those strategies difficult orimpractical). Once the written procedures are nalized,they should be included in the staff policies and proce-dures manual.

3. Implement the risk management plan. Implementation ofthe risk management plan primarily involves staff train-ing to ensure that the practitioner’s daily conduct will beconsistent with written policies and procedures, stan-dards of practice, and applicable laws. Te policies andprocedures manual should be used in conjunction withthe initial training of new employees, as well as duringregular in-service training where all employees practice particular (e.g., emergency) procedure. It is also impor-

tant to explain to staff why it is essential to carry out sucduties appropriately.

4. Evaluate the risk management plan. Like the law, stan-dards of practice are not static and need to be updatedperiodically to reect change. Te risk management planshould be formally evaluated at least annually, as well aafter each incidence of accident or injury to determine

whether emergency procedures were performed correctland what could be done to prevent a similar incident inthe future.

Liability Exposure in the Strength &Conditioning Profession While each Strength & Conditioning program and facility iunique, the NSCA Professional Standards & Guidelines asForce has identied nine (9) areas of potential liability exposuas delineated below. It is important to note that they are interrlated. For example, proper instruction and supervision is assoated with personnel qualications, as well as facility layout ascheduling issues. Noncompliance in any area can therefore fect others, and in turn compound the risk of liability exposurFurthermore, the Strength & Conditioning practitioner and his/her employer share the corresponding duties and responsibiliti

Collectively within these liability exposure areas, eleven (standards and thirteen (13) guidelines for Strength & Condtioning practitioners have further been identied (these are prsented in the next section of this document). Tese standardsand guidelines are intended to serve as an authoritative and ubiased source for professional guidance. Te rationale for each summarized below.

1. Pre-participation Screening & Clearance. A physical examination is imperative for all participants prito participating in a Strength & Conditioning program (preferably conducted by a licensed physician). Tis should include comprehensive health and immunization history (as dened bcurrent guidelines from the CEN ERS FOR DISEASE CON

ROL & PREVEN ION), as well as a relevant physical exampart of which includes an orthopedic evaluation. Some type cardiovascular screening, as discussed below, is also recommeed. Te Strength & Conditioning professional does not need acopy of the results, but must require a signed statement verifyiproof of medical clearance to participate. Participants who areturning from an injury or illness, or who have special neemust also be required to show proof of medical clearance prior beginning or returning to a Strength & Conditioning program.


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Currently there are no universally accepted standards for screen-ing participants; nor are there approved certication proceduresfor health care professionals who perform such examinations.However, a joint Pre-participation Physical Evaluation askForce of ve organizations (AMERICAN ACADEMY OFFAMILY PHYSICIANS, AMERICAN ACADEMY OF PEDI-

A RICS, AMERICAN MEDICAL SOCIE Y FOR SPOR SMEDICINE, AMERICAN OR HOPAEDIC SOCIE Y FORSPOR S MEDICINE, and AMERICAN OS EOPA HIC

ACADEMY OF SPOR S MEDICINE) has published a widelyaccepted monograph including detailed instructions on per-forming a pre-participation history and physical exam, deter-mining clearance for participation, and a medical evaluationform to copy and use for each examination (64). Additionally,the AMERICAN HEAR ASSOCIA ION and AMERICANCOLLEGE OF SPOR S MEDICINE have published state-ments on pre-participation screening for those involved in t-ness-related activities (8,52). Relevant points can be summa-rized as follows:

• Educational institutions have an ethical, medical and pos-sible legal obligation to implement cost-efficient, pre-partici-

pation screening strategies (including a complete medical his-tory and physical examination), and thereby ensure that highschool and college athletes are not subject to unacceptablerisks. Support for such efforts, especially in large athleticpopulations, is mitigated by cost-efficiency considerations,practical limitations, and an awareness that it is not pos-sible to achieve zero risk in competitive sports.

• Pre-participation athletic screening should be performed bya properly qualied health care provider with the requisitetraining, medical skills, and background to reliably performa physical examination, obtain a detailed cardiovascularhistory, and recognize heart disease. A licensed physician is

preferred, but an appropriately trained registered nurseor physician assistant may be acceptable under certaincircumstances in states where non-physician healthcare workers are permitted to perform pre-participationscreening. In the latter situation, however, a formalcertication process should be established to demonstrateexpertise in performing cardiovascular examinations.

• A complete and careful personal and family medical historyand physical examination designed to identify (or raise sus- picion of) cardiovascular risk factors known to cause suddendeath or disease progression is the best available and most practical approach to screening populations of competitive

sports participants. Such screening is an obtainable objec-tive, and should be mandatory for all participants. Initial-ly a complete medical history and physical examinationshould be performed before participation in organizedhigh school athletics (grades 9 – 12). An interim historyshould be obtained in intervening years. For collegiateathletes, a comprehensive personal/family history andphysical examination should be performed by a qualiedexaminer initially upon entering the institution, beforebeginning training and competition. Screening should be

repeated every two years thereafter unless more frequentexaminations are indicated; and an interim history andblood pressure measurement should be obtained eachsubsequent year to determine whether another physicalexamination, and possible further testing, is required (e.g.,due to abnormalities or changes in medical status).

• Health appraisal questionnaires should be used before exer-cise testing and/or training to initially classify participantsby risk for triage and preliminary decision-making. Follow-ing the initial health appraisal (and medical consultationand/or supervised exercise test, if indicated), participantscan be further classied for exercise training on the basisof individual characteristics. When a medical evalua-tion/recommendation is advised or required, writtenand active communication between facility staff and theparticipant’s personal physician or health care provideris strongly recommended. Furthermore, participantsshould be educated about the importance of obtaining apre-participation health appraisal and medical evaluation/recommendation (if indicated), as well as the potentialrisks incurred without obtaining them.

2. Personnel Qualications.Qualied and knowledgeable personnel must be hired in orderto properly supervise and instruct participants utilizing Strength& Conditioning facilities and equipment. A three-pronged ap-proach is recommended.

First, the Strength & Conditioning practitioner should acquireexpertise, and have a degree from a regionally accredited college/university in one or more of the topics comprising the “Scien-tic Foundations” domain identied in the Certied Strength& Conditioning Specialist® (CSCS®) Examination ContentDescription (58) (i.e. exercise/ anatomy, biomechanics, physi-ology, nutrition; Appendix A), or in a relevant subject (e.g.,exercise/sport pedagogy, psychology, motor learning, trainingmethodology, kinesiology). Note that the NSCA’s EducationalRecognition Program has been developed to recognize institu-tions of higher learning that meet such requirements; and alsohelps to identify an educational career path for the Strength &Conditioning profession. Likewise, practitioners should makean ongoing effort to acquire knowledge and competence in thecontent areas outside their primary area of expertise. In 2004,Commission on Accreditation of Allied Health Education(CAAHEP) began accrediting programs in exercise science andexercise physiology (http://www.coaes.org/accreditedprograms.html), so if the practitioner is unable to attend an NSCA-ERP

institution, training in an accredited program in exercise scienceor exercise physiology will ensure that the “Scientic Founda-tions” are thoroughly covered.

Second, certications offered through professional organizations with continuing education requirements as well as a code of eth-ics (e.g., the NSCA’s CSCS® credential; Appendix B) are availableto Strength & Conditioning practitioners interested in acquir-ing the necessary competencies. Another option is the NSCA’sFly Solo program (http://www.nsca-lift.org/Fly%20Solo%20Program/default.shtml), endorsed by the National High School


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Athletic Coaches Association. Depending on the practitioner’sspecic duties, responsibilities, and interests, relevant certica-tions offered by other governing bodies, such as USA Weightlift-ing, may also be appropriate.

Tird, a Strength & Conditioning practitioner’s knowledge andskill development can be enhanced by applying the “perfor-mance team” concept (i.e. aligning a staff comprised of qualiedprofessionals with interdependent expertise and shared leader-ship roles; Appendix C) (43,44). Te scope of practice for theStrength & Conditioning profession has expanded and diver-sied to the point where it is very challenging, and often un-realistic for each individual to acquire prociency in all areas.Furthermore, the productivity of a hierarchical (single-leader) work group can be signicantly improved by applying the teammodel to staffing; and the same team dynamics that augment thegroup’s effectiveness also tend to enhance individual members’learning and skill acquisition (43).

3. Program Supervision & Instruction.It has been estimated that 80% of all court cases concerningathletic injuries deal with some aspect of supervision (12). Al-though serious accidents are rare in supervised exercise programs,the liability costs associated with inadequate or lax supervisionare very expensive; and the plaintiff’s recovery rate in such neg-ligence lawsuits is almost 56% (54). Te main causes of theseincidents are poor facility maintenance, defective equipment,and inadequate instruction or supervision. Te importance ofstaffing is readily apparent in each circumstance. For example,Rabinoff (66) reviewed 32 litigations arising from negligent weight training supervision, and found that three issues wereraised by the plaintiff’s attorneys in each case: poor instruction(or instructor qualications); lax/poor supervision; and failure to warn of inherent dangers (in the equipment, facility, or exercise).Te standard of care used in each case cited in the Rabinoff in-

vestigation was based upon statements established by the NSCA, ACSM or AAHPERD. A prevalent trend in these litigations isthe issue of “professional instructor qualications,” i.e. appropri-ate degrees, recognized certications, training, experience, andcontinuing education (refer to item 2, and Appendices A & B).

Participants in a Strength & Conditioning facility must be prop-erly supervised and instructed at all times to ensure maximumsafety, especially because of the athletic, skillful nature of manyactivities implemented in Strength & Conditioning programs,in accordance with the dynamic correspondence (74) and prac-tice specicity (69,70) principles. Bucher & Krotee (12) recom-mend the following cardinal principles of supervision:

• Always be there.

• Be active and hands-on.

• Be prudent, careful, and prepared.

• Be qualied (e.g., accredited degree, CSCS, CPR, First Aid).

• Be vigilant.

• Inform participants of safety and emergency procedures

• Know participants’ health status.

• Monitor and enforce rules and regulations.

• Monitor and scrutinize the environment.

In addition to the physical presence of qualied professionaduring Strength & Conditioning activities, effective instru

tion and supervision involves a range of practical consideratio(5,7,16,35,36,38,49):

• A clear view of all areas of the facility, or at least the zobeing supervised by each practitioner and the participanin it (this issue is related to facility design and layout, i.eequipment placement with respect to visibility, versatilitand accessibility; refer to item 4)

• Te practitioner’s proximity to the group of participantsunder his/her supervision, (i.e. the ability to see and communicate clearly with one another; and quick access toparticipants in need of immediate assistance or spotting)

• Te number and grouping of participants, (i.e. to makeoptimal use of available equipment, space and time)

• Te participants’ age(s), experience level(s) and need(s)

• Te type of program being conducted, (i.e. skillful/explo-sive free-weight movements vs. guided-resistance exercand corresponding need for coaching and spotting)

In theory, Strength & Conditioning activities should be scheduled to distribute activity throughout the day, and thereby promote an optimal training environment (refer to Appendix Dfor basic guidelines on calculating space needs). Even with c

ful planning, however, most facilities have times of peak usa(e.g., as a result of team practices and participants’ class schules). Beyond a certain point, it is impractical to simply spreStrength & Conditioning activities over a wider range of timein order to maintain an acceptable professional-to-participanratio. Te central issue is to accommodate peak usage times bproviding adequate facilities and qualied staff, such that all pticipants are properly instructed and supervised (refer to item (31,38,50,83). Furthermore, proper techniques, movement mechanics and safety should be emphasized in order to minimiinjury risk and liability exposure (refer to Section 3 [Chapte13 – 14] of Essentials of Strength raining & Conditioning7 a well as the NSCA position statements (15,22,40,61,76,86,87

summarized in Appendix E). Likewise, instructional methodprocedures, and progressions that are consistent with accepteprofessional practices should be utilized. (1,7,10,15,21,22,227,31,32,39,40,42,45-47,55,59,62,69-72,74-76,78-82,84-89).

While reasonable steps should be taken to make optimal uof the Strength & Conditioning facility and staff, a potentiamismatch between available resources and demand for programand services exists in many institutions during times of peak age. As explained below in the Injury rends, Litigations & Sta


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dard of Care Load discussion, the combined effects of explosivegrowth in collegiate/scholastic athlete participation (especiallyamong females), corresponding liability exposures, and equalopportunity/access laws create a standard of care load and liabili-ty challenge for Strength & Conditioning practitioners and theiremployers. A two-pronged approach can thus be recommended.

First, Strength & Conditioning activities should be planned, andthe required number of qualied staff should be present, suchthat recommended guidelines for minimum average oor spaceallowance per participant (100 ft2), professional-to-participantratios (1:10 junior high school, 1:15 high school, 1:20 college),and number of participants per barbell or training station (upto 3) are applied during peak usage times (5,7,38,42). In idealcircumstances, this corresponds to one Strength & Condition-ing practitioner per 3 – 4 training stations and/or 1,000 ft2 area(junior high school); 5 training stations and/or 1,500 ft2 area(high school); or 6 – 7 training stations and/or 2,000 ft2 area(college), respectively. Professional discretion can be used to ad- just these guidelines with respect to the practical considerationsdiscussed above.

Second, Strength & Conditioning practitioners and their em-ployers should work together toward a long-term (e.g., 3 – 5yr) goal of matching the professional-to-participant ratio inthe Strength & Conditioning facility to each sport’s respectivecoach-to-athlete ratio. Tis is relatively straightforward in col-legiate settings where the NCAA limits the number of coachesper sport in Division I (NCAA Division I Manual, Bylaw 11.7;updated annually), and also provides sports participation data(refer to Appendix F; note that coach-to-athlete ratios for indi-vidual-event sports are lower than those for team sports) (56).In the absence of similar information in other (e.g., scholastic)settings, such determinations can be made on an individual in-stitution basis; or possibly according to trends within a district,

division or state.4. Facility & Equipment Set-Up, Inspection,Maintenance, Repair & Signage.In some cases, Strength & Conditioning professionals are in-volved in all phases of facility design and layout. Perhaps morecommonly, however, they assume responsibility for an existingfacility, in which case the opportunities to plan or modify it maybe limited. In either case, the Strength & Conditioning practi-tioner and his/her employer are jointly responsible for maximiz-ing the safety, effectiveness and efficiency of the facility, suchthat the allotted space and time can be put to optimal use (referto Greenwood [Chapter 21, pp. 543 – 568] in Essentials Of

Strength raining & Conditioning7 as well as the table on cal-culating equipment space needs in Appendix D).

Te Strength & Conditioning professional should establish writ-ten policies and procedures for equipment/facility selection, pur-chase, installation, set-up, inspection, maintenance and repair.Safety audits and periodic inspections of equipment, mainte-nance, repair and status reports should all be included. Manufac-turer-provided user’s manuals, warranties and operating guides,as well as other relevant records (e.g., pertaining to equipment

selection, purchase, installation, set-up, inspection, maintenanceand repair; refer to item 6), should be kept on le and followedregarding equipment operation and maintenance12.

Te Strength & Conditioning professional should understandthe concept of “product liability”, which refers to the legal re-sponsibilities of a product manufacturer and/or vendor if a per-son sustains injury or damage due primarily to a defect or de-ciency in design or manufacturing9. While this issue applies tomanufacturers and vendors, there are actions and/or behaviorsthat can increase the Strength & Conditioning professional’s re-sponsibility, consequently putting him/her at risk for claims. Tefollowing steps should be taken to minimize liability exposurescaused by Strength & Conditioning equipment: (12,16,48)

• Buy equipment exclusively from reputable manufacturers,and be certain that it meets existing standards and guide-lines for professional/commercial (not home) use.

• Use equipment only for the purpose intended by themanufacturer; do not modify it from the condition in

which it was originally sold unless such adaptationsare clearly designated and instructions for doing so areincluded in the product information.

• Post any signage provided by the manufacturer on (or inclose proximity to) the equipment.

• Do not allow unsupervised participants to utilize equip-ment.

• Regularly inspect equipment for damage and wear thatmay place participants at risk for injury.

5. Emergency Planning & Response. An emergency response plan is a written document that detailsthe proper procedures for caring for injuries that may occur toparticipants during activity (refer to Appendix G for sampleguidelines for the collegiate environment). While all Strength& Conditioning facilities should have such a document, it is im-portant to appreciate that the document itself does not save lives.Indeed, it may offer a false sense of security if it is not backedup with appropriate training and preparedness by astute, profes-sional staff. Terefore, all personnel in Strength & Conditioningfacilities must:

• Know the emergency response plan and the properprocedures for dealing with an emergency (i.e. location ofphones, activating emergency medical services, designat-ed personnel to care for injuries, ambulance access, andlocation of emergency supplies).

• Review and practice emergency policies and proceduresregularly (i.e. at least quarterly).

• Maintain current certication in guidelines for cardiopul-monary resuscitation and automated external debrillator(CPR-AED) as established by the AMERICAN HEAR

ASSOCIA ION & IN ERNA IONAL LIAISONCOMMI EE ON RESUSCI A ION (2). Several


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organizations, such as the American Heart Association,the Red Cross, the National Safety Council, and St. John

Ambulance, offer acceptable certications. First Aidtraining and certication may also be necessary if SportsMedicine personnel such as an A C or MD are not im-mediately available.

• Adhere to universal precautions for preventing exposureto and transmission of blood-borne pathogens, as estab-lished by the CEN ERS FOR DISEASE CON ROL &PREVEN ION (14) and OCCUPA IONAL SAFE Y& HEAL H ADMINIS RA ION (60).

6. Records & Record Keeping.Documentation is fundamental to the management of Strength& Conditioning programs and facilities. In addition to develop-ing and maintaining a policies and procedures manual [refer toEpley (Chapter 22, pp. 569 – 588) in Essentials Of Strength

raining & Conditioning (7)], a variety of records should bekept on le: (12)

• Manufacturer provided user’s manuals, warranties andoperating guides; and equipment selection, purchase,installation, set-up, inspection, maintenance and repairrecords

• Personnel credentials

• Professional standards and guidelines

• Safety policies and procedures, including a written emer-gency response plan (refer to item 5; Appendix G)

• raining logs, progress entries and/or activity instruction/supervision notes

• Injury/incident reports, pre-participation medical clear-ance, and return to participation clearance documents(after the occurrence of an injury, illness, change in healthstatus or an extended period of absence) for each partici-pant under their supervision

• In collegiate and scholastic settings, athletes are requiredto sign protective legal documents (e.g., informed con-sent, agreement to participate, waiver; refer to AppendixH) covering all athletically-related activities, includingStrength & Conditioning; however in other settings, theStrength & Conditioning professional should considerhaving participants sign such legal documents.

Medical records should be kept on le as long as possiblein the event of an injury claim. Statutes of limitations(i.e. the time in which individuals may le a lawsuit) varyfrom state to state, so it is a good practice to maintainles indenitely or consult with a legal authority (37). Asis the case with other organizational and administrativetasks, adequate staff are necessary to properly keep andmaintain such records.

7. Equal Opportunity & Access.Federal, state, and possibly local laws and regulations prohidiscrimination or unequal treatment (e.g., according to raccreed, national origin, gender, religion, age, handicap/disabilior other such legal classications) in most organizations, institions and professions. For example, practitioners employed federally-funded educational (i.e. collegiate or scholastic) tings must comply with civil rights statutes including itle Iof the Education Amendments of 1972, which mandates gende

equity in providing opportunity and access to athletic facilitieprograms and services. Te Strength & Conditioning professional must obey the letter and spirit of these laws when worki

with participants as well as staff.

8. Participation in Strength & Conditioning Activitiesby Children.Resistance training can be an important component of youthtness, health promotion and injury prevention. Such programare safe when properly designed and supervised; and can increachildren’s strength, motor tness skills, sports performance, pchosocial well-being and overall health (22,23). Indeed, manof the benets associated with adult Strength & Conditioninactivities are attainable by prepubescent and adolescent partipants who participate in age-specic training. However, it is iportant for the Strength & Conditioning practitioner to takecertain precautions with children.

In a 20-year retrospective review of weight training injuries th were evaluated and/or treated in U.S. hospital emergency dpartments (based on NEISS data from the U.S. CONSUMERPRODUC SAFE Y COMMISSION), Jones et al. (41) foundan alarming incidence of injuries to young children. Childre15 years of age, with the majority (80%) resultinfrom playing with or around weight training equipment in thhome. Te CPSC estimates that about 8,700 children


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ing age (i.e. number of years experience in resistance training)is less than 3 – 4 years or physical development is behind whatis expected for the chronological age. Nonetheless, attentionto NSCA-prescribed guidelines (7) for lifting technique shouldalways be followed.

9. Supplements, Ergogenic Aids & Drugs.Te issue of using ergogenic aids, including nutritional supple-ments and drugs, is complicated by several factors. First, dietarysupplements are regulated as foods rather than drugs accordingto the Dietary Supplement Health & Education Act of 1994.Consequently, many people have concerns regarding qual-ity control/assurance and possible consequences for consumers.Strength & Conditioning practitioners are often approached foradvice on nutrition and supplementation, and therefore shouldbe aware of the following:

• Te FEDERAL RADE COMMISSION has primaryresponsibility for advertising claims. Simply stated, ad-vertising for any product, including dietary supplementsmust be truthful, substantiated, and not misleading.

• Te U.S. FOOD & DRUG ADMINIS RA ION hasprimary responsibility for product labeling claims. Telegislation enforced by this agency includes current goodmanufacturing practice regulations, and selected portionsof the Federal Food, Drug & Cosmetic Act related todietary supplements. Note that the U.S. Pharmacopeia& National Formulary, which establishes manufacturingpractices for nutritional supplements (i.e. standards foridentity, strength, quality, purity, packaging, labeling andstorage), is cited as a primary resource in this legislation.

A second complicating factor is that the boundaries betweendietary supplements, drugs and conventional foods are notclear. Tis is especially problematic for competitive athletes andcoaches, because such products may contain substances thatare banned by one or more sport governing bodies despite themanufacturer’s or vendor’s use of terms such as “herbal”, “le-gal”, “natural”, “organic”, “safe and effective”, etc. Furthermore,supplement manufacturers are constantly developing new prod-ucts with different combinations of ingredients, making it morechallenging to identify those that may be problematic.

A third factor is that banned substance policies and procedures,testing protocols, and related rules and regulations differ amongsport governing bodies (e.g., MLB, NBA, NCAA, NFL, NHL,USOC). Terefore, a compound that is legal according to onegoverning body may be illegal according to another. Furthermore,Strength & Conditioning practitioners at NCAA member insti-tutions need to be aware of Bylaw 16.5.2.2: “An institution mayprovide only non-muscle-building nutritional supplements to astudent-athlete at any time for the purpose of providing addi-tional calories and electrolytes, provided the supplements do notcontain any NCAA banned substances.” Te NCAA Commit-tee on Competitive Safeguards & Medical Aspects of Sports hassubsequently developed lists of permissible vs. non-permissiblenutritional supplements*, although these will probably change asthe market continues to evolve and new products are evaluated.

*Note: According to the legislative assistance section ofthe August 14, 2000 NCAA News (vol. 37 no. 7; p. 24),there is an error on p. 209 of the 2000-01 NCAA DivisionI Manual. Te second sentence should read: “Permissiblenon-muscle-building nutritional supplements are identiedaccording to the following classes: carbohydrate/electrolytedrinks, energy bars, carbohydrate boosters, and vitaminsand minerals.”

Injury Trends & Standard of Care Load:Effects of Rising Athletic ParticipationTe lack of qualied instruction and supervision can be iden-tied, either directly or indirectly, as a causative factor in theavailable information on injuries and litigations associated

with weight training. In some cases this is clearly documented(41,67), while in others it can be inferred. For example, the rela-tively high coach-to-athlete ratio (and corresponding standardof care) in Olympic-style weightlifting is a likely reason for thelow incidence of injury in this sport despite its technical and ath-letic nature (30,77). Based on the collective information sum-marized below, it is difficult to overemphasize the fundamentalimportance of qualied staffing in fullling the institution’s andStrength & Conditioning professional’s shared legal duties forsafety, supervision and standard of care.

Collegiate Settings. Year-round Strength & Conditioning activities are now the rulerather than the exception in collegiate athletic programs. Ac-cording to NCAA data on student-athlete participation (56), theoverall number of participants increased 66% (from 231,445 to384,742) between 1981 – 82 and 2004 – 05. Of special inter-est are the changes in female participation during this period.Te relative increase in women’s participation was 156% (from64,390 to 164,998) as compared with 32% for men (from167,055 to 219,744); whereas absolute growth was two-foldhigher.

Te total number of, and time of participation in, athletically-related activities has also expanded accordingly. While desirablein terms of preparation, the allowance of nontraditional seasons,off-season skill instruction, and year-round Strength & Condi-tioning activities increases each student-athlete’s liability expo-sure and potential for injury, as well as the corresponding stan-dard of care load placed on support staff. Te NA A recentlypublished a detailed overview of injury incidence in collegiateathletics, and found that it has risen sharply and consistently

with the increase in participants and exposures (73). Te po-tential liability issues for Strength & Conditioning professionalsand their employers are further compounded by the explosiverise in female participation, and laws mandating equal opportu-nity and access to athletic programs, services, and facilities (referto item 7).

Scholastic Settings.Te sheer number of high school athletes, and growing emphasison year-round Strength & Conditioning activities in scholasticsettings, presents a tremendous challenge in terms of demand for


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standard of care, and accompanying liability exposure. Student-athlete participation in organized high school sports increased65.1% (from less than 4 million to over 6.5 million) between1971 and 1999 – 2000 (57). Of special interest are the changesin female participation during this period. Te relative increasein girls’ participation was 810% (from about 0.3 million to 2.7million) as compared with 5% for boys (from about 3.7 millionto 3.9 million); whereas absolute growth was more than twelve-fold higher.

As is the case in collegiate settings, the combination of increas-ing participation in athletic activities (especially among females),a corresponding rise in liability exposures, and laws mandatingequal opportunity and access creates a standard of care load—and challenge in terms of legal duties—for Strength & Condi-tioning practitioners and their employers (refer to item 7).

Other Populations.Reeves et al. (67) performed a study of NEISS data in 1986and observed that, while serious injuries are relatively rare, anestimated 43,400 weight training injuries were evaluated/treatedin hospital emergency departments out of a total of 5.6 millionvisits for all sports. By comparison, emergency room visits for weight training injuries in 1995 totaled 56,400 out of more than5.4 million visits for all sports, representing a 9-year increase ofapproximately 30%.

Studies examining the incidence and types of weight traininginjury report varying injury rates, but similar distributionsof injury types. Brown & Kimball (11) found that 39.4% ofcompetitive adolescent powerlifters sustained injuries in train-ing, with an injury rate of 0.0027 per 100 hours of participa-tion. In contrast, Risser et al. (68) observed that only 7.6% ofadolescent football players in a supervised weight training pro-gram sustained injuries. Zemper (90) found only a 0.3% rateof weight training injuries in a 4-year study of college footballplayers participating in supervised training. While risk-factorstudies of acute weight training injuries are lacking, recognizedcontributing factors include poor technique, lack of supervision,skeletal immaturity, and steroid abuse (11,53,67a,68). Someof these factors are conrmed in the NCSA (22) and ACSM(23) published statements on youth resistance training. Chronic weight training injuries, on the other hand, have been attributedto excessive weight training and improper training techniques(67b). Each of these factors can be positively inuenced withqualied instruction.

Jones et al. (41) conducted a 20-year retrospective review ofNEISS data on weight training injuries that were evaluated and/or treated in U.S. hospital emergency departments from Octo-ber 1978 through December 1998. An estimated 980,173 inju-ries related to weight training activity or equipment occurred na-tionwide during the study period, representing a 35% increaseover 20 years (note that the population increased by 20% duringthe same period). While adolescent/young adult males (15 – 24years old) had the highest reported incidence of injury, alarmingincreases in injury rate were reported for females and older males,most likely because of growing participation in these groups.Boys (5 – 14 years old) were the only group reporting a decline

in injury rate. Te most common recorded venues of injury werethe home (40.2%), sports or recreation sites (17.8%) and schoo(9.4%). Based on available reports, the most common causes injury appear to be unsafe behavior (63%), equipment malfuntion (37%), lack of supervision (30%) and inattention (10%Once again, these factors can be positively inuenced with qued instruction and supervision.

Weight training injuries seem to be associated with various meods (e.g., bodybuilding, powerlifting, Olympic-style weightling, tness/recreational weight training) and equipment (e.gfree weights, machines). Of these, explosive types of trainand free-weight apparatus are often incorrectly believed to be herently more dangerous than other methods. Hamill (30) conducted a survey of sport injury rates in 13 – 16 year old schochildren, and found that the injury rate in weightlifting (0.001per 100 hours) is even lower than that for weight training (0.003per 100 hours); and that each of these injury rates were muclower than those observed for other, more popular sports (e.gbasketball 0.03; football 0.10; gymnastics 0.044; athletics 0.5Stone et al. (77) reviewed the research literature on injury potetial and safety aspects of Olympic-style weightlifting moveme

and concluded that injuries related to competitive weightliftinare neither excessive nor serious when compared to other spoCalhoon & Fry (13) analyzed weightlifting injury reports at thU.S. Olympic raining Centers over a 6-year period, and founthat elite weightlifters’ injuries are strains, tendinitis or spraitypical of acute (59.6%) or chronic (30.4%) overuse or inammation, rather than recurrences or complications. Tere wereno indications of the traumatic problems commonly observein other sports. Injury rates were calculated to be 3.3 per 100hours of weightlifting exposure, and the recommended numbof training days missed for most (90.5%) injuries was one dTese authors concluded that weightlifting injury patterns andrates are similar to those reported for other sports and activitie


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1. PRE-PARTICIPATIONSCREENING & CLEARANCE

Standard 1.1Strength & Conditioning professionals must require partici-pants to undergo health care provider screening and clearanceprior to participation, in accordance with instructions speciedby the AAFP-AAP-AMSSM-AOSSM-AOASM Pre-participa-tion Physical Evaluation ask Force (64), the AHA & ACSM(8,52), as well as relevant governing bodies and/or their constitu-ent members [e.g., the NCAA (63) for collegiate athletes; statelegislatures, or individual state high school athletic associations/districts for scholastic athletes]. In most cases in the collegiateathletics environment, the Athletic raining staff is involved inthis process along NA A guidelines. In recreational activity pro-grams, Strength & Conditioning professionals must require par-ticipants to undergo pre-participation screening and clearance inaccordance with AHA & ACSM recommendations (8,52). Forchildren, the clearance decision must include a determinationor certication than the child has reached a level of maturityallowing participation in such activities as addressed in the “Par-

ticipation in Strength & Conditioning Activities by Children”standards statement (refer to item 8).

Guideline 1.1Strength & Conditioning professionals should cooperate witha training participant’s health care providers at all times, andprovide service in the participant’s best interest according to in-structions specied by such providers.

2. PERSONNEL QUALIFICATIONSGuideline 2.1Te Strength & Conditioning practitioner should acquire abachelor’s or master’s degree from a regionally accredited col-lege or university (verication by transcript or degree copy) inone or more of the topics comprising the “Scientic Founda-tions” domain identied in the Certied Strength & Condition-ing Specialist® (CSCS®) Examination Content Description (58)(Appendix A), or in a relevant subject. An ongoing effort shouldalso be made to acquire knowledge and skill in the other contentareas.

Guideline 2.2Te Strength & Conditioning practitioner should achieve andmaintain professional certication(s) with continuing educationrequirements and a code of ethics, such as the CSCS® credentialoffered through the NSCA (Appendix B). Depending on thepractitioner’s scope of activities, responsibilities, and knowledgerequirements, relevant certications offered by other governingbodies may also be appropriate.

Guideline 2.3Te productivity of a Strength & Conditioning staff, as well aslearning and skill development of individual members, shouldbe enhanced by aligning a performance team comprised ofqualied practitioners with interdependent expertise and shared

leadership roles (Appendix C). Once the team is assembled, re-spective activities and responsibilities from the “Practical/Ap-plied” domain identied in the Certied Strength & Condition-ing Specialist® (CSCS®) Examination Content Description (58)(Appendix A), as well as appropriate liaison assignments, shouldbe delegated according to each member’s particular “ScienticFoundations” expertise.

3. PROGRAM SUPERVISION& INSTRUCTION

Standard 3.1Strength & Conditioning programs must provide adequate andappropriate supervision with well-qualied and trained person-nel, especially during peak usage times. o achieve maximumhealth, safety, and instruction, Strength & Conditioning profes-sionals must be present during Strength & Conditioning activi-ties; have a clear view of the entire facility (or at least the zonebeing supervised by each practitioner) and the participants init; be physically close enough to the participants under their su-pervision to be able to see and clearly communicate with them;

and have quick access to those in need of spotting or assistance.

Standard 3.2In conjunction with appropriate safety equipment (e.g. powerracks), attentive spotting must be provided for participants per-forming activities where free weights are supported on the trunkor moved over the head/face (refer to Earle & Baechle [Chapter14, pp. 325 – 376] in Essentials Of Strength raining & Con-ditioning (7)).

Guideline 3.1Strength & Conditioning activities should be planned, and therequisite number of qualied staff (refer to item 2) should be

available such that recommended guidelines for minimum aver-age oor space allowance per participant (100 ft2), professional-to-participant ratios (1:10 junior high school, 1:15 high school,1:20 college), and number of participants per barbell or train-ing station (3) are achieved during peak usage times (5,7,38,42).

Younger participants, novices or special populations engaged insuch Strength & Conditioning activities should be provided

with greater supervision (refer to item 8). Strength & Condi-tioning practitioners and their employers should work togethertoward a long-term goal of matching the professional-to-partici-pant ratio in the Strength & Conditioning facility to each sport’srespective coach-to-athlete ratio (e.g., refer to Appendix F).


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National Strength and Conditioning Association 1

4. FACILITY & EQUIPMENTSET-UP, INSPECTION,MAINTENANCE, REPAIR& SIGNAGE

Standard 4.1Exercise devices, machines and equipment, including free weights, must be assembled, set up and placed in activity areasin full accordance with manufacturer’s instructions, tolerancesand recommendations; and with accompanying safety signage,instruction placards, notices and warnings posted or placed ac-cording to AS M standards (3,4) so as to be noticed by usersprior to use. In the absence of such information, professionalsmust complete these tasks in accordance with authoritative in-formation available from other sources.

Standard 4.2Prior to being put into service, exercise devices, machines or free weights must be thoroughly inspected and tested by Strength &Conditioning professionals to ensure that they are working andperforming properly, and as intended by the manufacturer.

Standard 4.3Exercise machines, equipment and free weights must be inspect-ed and maintained at intervals specied by manufacturers. Inthe absence of such specications, these items must be regularlyinspected and maintained according to the Strength & Condi-tioning practitioner’s professional judgment.

Standard 4.4Exercise devices, machines, equipment and free weights whichare in need of repair, as determined by regular inspection or asreported by users, must be removed from service and taken outof use until serviced and repaired; and be re-inspected and testedto ensure that they are working and performing properly beforebeing returned to service. If such devices are involved in inci-dents of injury, legal advisors or risk managers must be consultedfor advice prior to service/repair or destruction.

Guideline 4.1Strength & Conditioning professionals and their employersshould ensure that facilities are appropriate for Strength & Con-ditioning activities. Factors to be reviewed and approved priorto activity include, but are not limited to, oor surface, light-ing, room temperature and air exchange (refer to Greenwood

[Chapter 21, pp. 543 – 568] in Essentials Of Strength raining& Conditioning (7)).

Guideline 4.2Manufacturer provided user’s manuals, warranties and operatingguides should be preserved and followed (refer to item 6).

Guideline 4.3 All equipment, including free weights, should be cleaned and/disinfected regularly as deemed necessary by staff. Users shobe encouraged to wipe down skin-contact surfaces after each u

5. EMERGENCY PLANNING& RESPONSE

Standard 5.1Strength & Conditioning professionals must be trained andcertied in current guidelines for cardiopulmonary resuscitatio(CPR) established by AHA/ILCOR (2); as well as universal pcautions for preventing disease transmission established by tCDC (14) and OSHA (60). First Aid training/certication isalso necessary if Sports Medicine personnel (e.g., MD or Aare not immediately available during Strength & Conditioninactivities. New staff engaged in Strength & Conditioning ativities must comply with this standard as soon as possible aftemployment.

Standard 5.2Strength & Conditioning professionals must develop a writtevenue-specic emergency response plan to deal with injuriand reasonably foreseeable untoward events within each facilTe plan must be posted at strategic areas within each facilityand practiced and rehearsed at least quarterly. Te emergencyresponse plan must be initially evaluated (e.g., by facility rmanagers, legal advisors, medical providers and/or off-prememergency response agencies) and modied as necessary at relar intervals. As part of the plan, a readily accessible and worktelephone must be immediately available to summon on-premise and/or off-premise emergency response resources.

Guideline 5.1Te components of a written and posted emergency responseplan should include: planned access to a physician and/oemergency medical facility when warranted, including a plfor communication and transportation between the venue andthe medical facility; appropriate and necessary emergency caequipment on-site that is quickly accessible; and a thorough uderstanding of the personnel and procedures associated with thplan by all individuals (e.g., refer to Appendix G).

6. RECORDS & RECORD KEEPINGuideline 6.1In conjunction with written policies and procedures, Strength &Conditioning professionals should develop and maintain vaous records including: manufacturer-provided user’s manua

warranties and operating guides; equipment selection, purchainstallation, set-up, inspection, maintenance and repair recordpersonnel credentials; professional standards and guidelinsafety policies and procedures, including a written emergenresponse plan (refer to item 5); training logs, progress entriand/or activity instruction/supervision notes; injury/incidenreports, pre-participation medical clearance, and return to paticipation clearance documents. In settings where participan


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are not otherwise required to sign protective legal documents(e.g., informed consent, agreement to participate, waiver; referto Appendix H) covering all athletically related activities, theStrength & Conditioning professional should have such legaldocuments prepared for participants under his/her supervision.Tese records should be preserved and maintained for a periodof time determined by professional legal advice and consultation.

7. EQUAL OPPORTUNITY& ACCESS

Standard 7.1Strength & Conditioning professionals and their employersmust provide facilities, training, programs, services and relatedopportunities in accordance with all laws, regulations and re-quirements mandating equal opportunity, access and non-discrimination. Such federal, state and possibly local laws andregulations apply to most organizations, institutions and profes-sionals. Discrimination or unequal treatment based upon race,creed, national origin, sex, religion, age, handicap/disability orother such legal classications is generally prohibited.

8. PARTICIPATION IN STRENGTH& CONDITIONING ACTIVITIESBY CHILDREN

Guideline 8.1Children under seven (7) years of age should not be permit-ted to engage in Strength & Conditioning activities with free

weights or exercise devices/machines in facilities designed for useby adults and adolescents, and should be denied access to suchtraining areas. Other forms of Strength & Conditioning activi-

ties may be benecial for such children, and should be recom-mended according to the practitioner’s professional judgment,and with a greater degree of instruction and supervision thanthat supplied to adolescents and adults. Children participatingin such activities should be cleared as specied in the NSCA’s

“Standard for Pre-participation Screening & Clearance” (refer toitem 1).

Guideline 8.2Children between seven (7) and fourteen (14) years of age whohave reached a level of maturity allowing participation in speci-ed Strength & Conditioning activities, as determined and certi-ed by their medical care provider (or by the Strength & Condi-

tioning professional acting in concert with a child’s medical careprovider), and after clearance for participation as specied in theNSCA’s “Standard for Pre-participation Screening & Clearance”(refer to item 1), should be individually assessed by the Strength& Conditioning professional in conjunction with the child’sparent(s)/guardian(s)/custodian(s) and health care provider(s) todetermine if such children may engage in such activities in areascontaining free weights and exercise devices/machines generallyused by adults and older children. If so permitted, such activitiesshould be developed and implemented according to the practi-

tioner’s professional judgment, in conjunction with the child’shealth care provider(s), and with a greater degree of instructionand supervision than that supplied to adolescents and adults.

Guideline 8.3Children fourteen (14) years of age and older who, according tothe Strength & Conditioning practitioner’s professional judg-ment, have reached a level of maturity allowing them to engagein specied Strength & Conditioning activities (provided they

have been cleared for participation as specied in the NSCA’s“Standard for Pre-participation Screening & Clearance”; refer toitem 1), may engage in such activities in areas containing free

weights and exercise devices/machines generally used by adults,and with a greater degree of instruction and supervision thanthat supplied to adult populations while training.

9. SUPPLEMENTS, ERGOGENICAIDS & DRUGS

Standard 9.1Strength & Conditioning professionals must not prescribe,

recommend or provide drugs, controlled substances or supple-ments that are illegal, prohibited, or harmful to participants forany purpose including enhancing athletic performance, condi-tioning or physique. Only those substances that are lawful andhave been scientically proven to be benecial, or at least notharmful, may be recommended or provided to participants byStrength & Conditioning professionals, and only to individualsage 18 or above.


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APPENDIX A.Strength & ConditioningPractitioner DenitionIn 1996, and again in 2004, the NSCA Certication Depart-ment (www.nsca-cc.org) and its examination service (APPLIEDMEASUREMEN PROFESSIONALS) conducted a Job Anal-ysis study with the purpose of surveying the activities, respon-

sibilities, and knowledge requirements of a Certied Strength& Conditioning Specialist® (CSCS®). Te results were used todescribe the job activities of the CSCS in sufficient detail toprovide a basis for the development of a professional, job-re-lated certication examination that will certify S&C specialistsas competent professionals. An early step in the process was tocreate a “practitioner denition”. Essentially, this denition is a

job description that establishes the legal and professional scopeof practice of the appropriate activities of a CSCS (refer to Ap-pendix B): (6,7)

Certied Strength & Conditioning Specialists are professionals who practically apply foundational knowledge to assess, moti-

vate, educate, and train athletes for the primary goal of improv-ing sport performance. Tey conduct sport-specic testing ses-sions, design and implement safe and effective strength trainingand conditioning programs, and provide guidance for athletesin nutrition and injury prevention. Recognizing their area ofexpertise is separate and distinct from the medical, dietetic, ath-letic training, and sport coaching elds, Certied Strength &Conditioning Specialists consult with and refer athletes to theseprofessionals when appropriate.

Te CSCS Job Analysis study evaluated the results of a ques-tionnaire sent to 1,020 randomly selected NSCA members who

were CSCS-certied as of October 1996. Respondents were

asked to assign an importance to 112 tasks that a CSCS typi-cally performs on the job. From this data, the NSCA’s CSCS Job Analysis Committee determined the inclusion criteria of thetasks (5 of the original 112 were excluded), the distribution oftasks within each CSCS exam domain and its subcategories, as

well as distribution of the exam question type (i.e. recall, appli-cation, and analysis) within each domain and its subcategories.Te document resulting from the CSCS Job Analysis study isthe “CSCS Examination Content Outline” (refer to the abbrevi-ated summary below), which forms the basis for the CertiedStrength & Conditioning Specialist (CSCS) Examination Con-tent Description (58), an exam preparation resource availablethrough the NSCA. Te 2004 questionnaire was sent to 770employers of certied individuals and the new results were usedto change the format of the exam, with more emphasis placed onthe practical/applied section.

CSCS® Examination Content Outline Adapted from: Certied Strength & Conditioning Specialis(CSCS®) Examination Content Description59

Scientic FoundationsI. Exercise Sciences (57 questions)

A. Develop training programs that demonstrate an under-standing of human muscle physiology.

B. Develop training programs that demonstrate an under-

standing of human neuromuscular adaptations.C. Develop training programs that demonstrate an under-

standing of the basic principles of human biomechanics with respect to exercise selection, execution, and sportperformance.

D. Develop training programs that demonstrate an under-standing of human bone, muscle, and connective tissueadaptations.

E. Develop training programs that demonstrate an under-standing of human bioenergetics and metabolism.

F. Develop training programs that demonstrate an under-

standing of human neuroendocrine responses.G. Develop training programs that demonstrate an un-

derstanding of human cardio-pulmonary anatomy andphysiology.

H. Develop training programs that demonstrate an under-standing of acute and chronic physiological responses anadaptations to aerobic and anaerobic exercise.

I. Develop training programs that demonstrate an under-standing of the anatomical, physiological, and biomechancal differences of athletes.

J. Use sport psychology techniques to enhance the trainingand/or performance of an athlete.

K. Explain the effects, risks, and alternatives of variousperformance-enhancing substances and methods.

II. Nutrition (23 questions)

A. Explain nutritional factors affecting health and performan

B. Explain the techniques to manipulate food choices andtraining methods to maximize performance.

C. Recognize signs, symptoms, and behaviors associated weating disorders.

D. Recognize the nature of an athlete’s nutritional status anddetermine the appropriateness of a referral to a registereddietician or related nutritional professional.

III. New “untried” questions (10 non-scored questions)

Practical/AppliedI. Program Design (40 questions)

A. Design training programs that maximize performance byprescribing various training methods and modes basedupon an athlete’s health status, strength and conditioninglevels, and training goals.


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B. Design training programs that maximize performance byselecting exercises based upon an athlete’s health status,strength and conditioning levels, and training goals.

C. Design training programs that maximize performanceby applying the principles of exercise order based uponan athlete’s health status, strength and conditioning levels,and training goals.

D. Design training programs that maximize performance bydetermining and prescribing appropriate loads/resistances(including heart rate guidelines) based upon an athlete’shealth status, strength and conditioning levels, and train-ing goals.

E. Design training programs that maximize performance bydetermining and prescribing appropriate volumes (de-ned as sets x reps) based upon an athlete’s health status,strength and conditioning levels, and training goals.

F. Design training programs that maximize performance bydetermining and prescribing appropriate work/durationand rest periods and training frequencies based upon anathlete’s health status, strength and conditioning levels,and training goals.

G. Design training programs that maximize performance byutilizing the principles of periodization.

H. Design training programs that maximize performanceand/or decrease injury susceptibility by prescribing exercis-es to develop and/or maintain muscular balance betweenantagonistic muscles, muscle groups, and/or body parts.

I. Communicate with the athletic medicine staff and/ormedical professional to coordinate the rehabilitation/re-conditioning of an athlete.

II. Exercise echniques (39 questions)

A. Describe and instruct exibility exercises.

B. Describe and instruct conditioning exercises.

C. Describe and instruct plyometric exercises.

D. Describe and instruct strength/power training exercises.

E. Describe and instruct spotting procedures.

III. Organization & Administration (11 questions)

A. Establish policies and procedures associated with the day-to-day operation of the strength and conditioning facility.

B. Determine the layout of the facility for effective use oftime and space.

C. Maintain equipment and facility to provide a safe trainingenvironment.

IV. esting & Evaluation (20 questions)

A. Select and administer appropriate tests to maximize testreliability and validity.

B. Evaluate and identify the signicance of testing results.

V. New “untried” questions (10 non-scored questions)


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APPENDIX B.Certied Strength &Conditioning Specialist®(CSCS®)Te CSCS certication exam program was initiated in 1985 toidentify individuals who possess the knowledge and skills to de-

sign and implement safe and effective Strength & Conditioningprograms. Tis certication program encourages a higher levelof competence among practitioners, which in turn, raises thequality of strength training and conditioning programs to ath-letes by those who are CSCS-certied.

Te CSCS educates and trains primarily athletes in properstrength training and conditioning practices. Tese profession-als are a diverse group; however, the primary practitioners areStrength & Conditioning coaches, athletic trainers, and physicaltherapists. CSCS professionals work in a variety of environments,including high school, college, university and professional insti-tutions, Sports Medicine clinics, health and tness clubs, corpo-

rate wellness centers, and in professional sports. Competenciesassessed in the four-hour CSCS examination were determinedvia a national task analysis conducted by an independent pro-fessional examination service. Tus, Strength & Conditioningprofessionals identied the competency areas. Every step in theprocess leading to the development of valid certication examsmet the NCCA’s stringent guidelines. Pass/fail rates and reliabil-ity statistics are published annually. Te NSCA’s CerticationExam Program is the only tness-related certication programto provide public disclosure of this information.

Writers of the exams include renowned practitioners, researchers,educators, and psychometricians. While there are many certi-

cation programs associated with physical training, the CSCScertication examination program was the rst specically de-signed to assess the competencies of those who strength trainand condition athletes.

AccreditationIn 1993 the NSCA certication exam program became the rst,and is still accredited by the esteemed NA IONAL COMMIS-SION FOR CER IFYING AGENCIES*. Te rigorous CSCSand NSCA Certied Personal rainer® (NSCA-CP ) examina-tions are the most challenging in the industry.

SC Standards and Guidelines

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