International Journal of Health Sciences and Research

DOI: https://doi.org/10.52403/ijhsr.20210408
Vol.11; Issue: 4; April 2021
Website: www.ijhsr.org
Original Research Article ISSN: 2249-9571

Prevalence of Musculoskeletal Pain and Injuries in

Gym Instructors
Nikita Shinde1, Priya Sahasrabuddhe2
1
Clinical Physiotherapist (B.P.Th), Symbiosis University Hospital and Research Centre, Pune, India
2
Assistant Professor, Musculoskeletal Sciences, Smt. Kashibai Navale College of Physiotherapy, Pune, India
Corresponding Author: Nikita Shinde

ABSTRACT

Background: The gym instructors perform high intensity work during their personal session or while
assisting their clients during their workout session. This is one of the major reasons for various
injuries and subsequent pain. This study evaluated the prevalence of musculoskeletal pain and injuries
in gym instructors.
Objectives: To obtain the prevalence of musculoskeletal injuries and pain in gym instructors.
Methods: A cross sectional study was performed on108 gym instructors from different fitness clubs.
A self-administered questionnaire was used. Percentile analysis of the scores was done.
Results: 16% of gym instructors suffered with injures of shoulder, low back and knee. About 82% of
gym instructors had pain in various body areas.
Conclusion: The prevalence of pain and injuries was high in gym instructors which demands fitness
industries to adapt prevention strategies.

Keywords: Gym instructors, musculoskeletal pain, injury

INTRODUCTION injuries leading to pain. [2] A descriptive

Musculoskeletal injuries and epidemiological study proved that the
associated pain is a common consequence of prevalence of acute and overuse injuries was
work related hazards. Different causes of higher in high instruction loading as
musculoskeletal pain are unusual or compared to low instruction loading and the
repetitive activities that put strain on the common site was ankle and lower leg. The
muscles, tendons and sprain the ligaments; most frequent site of musculoskeletal pain
it also can be the result of traumatic events was shoulder and neck. [2]
due to jerky movements, falls, fracture or Fitness instructors have limited
underlying musculoskeletal diseases. knowledge regarding the injuries and injury
Musculoskeletal pain mostly affects the prevention. An epidemiological study has
bone, muscle, ligaments and tendons. [1] provided evidence regarding the overuse
There is an increase in the number of injuries seen in competitive cyclists and the
attendants in the fitness industry in the last common site is low back and knee. [3]
10– 15 years. The gym instructors in the Monotonous exercise loading was a
industry helps an individual to increase the predominant factor among the instructors. [4]
cardiovascular endurance, strengthen the Cardio kickboxing has also become a
muscle and bone, boosts immune system, popular activity and studies have found that,
improves mobility and balance, improves the most prevalent site of injuries in cardio
posture. Though there are numerous health kickboxing instructors are knee and hip.
related benefits of physical activity and One of the wide spreading and upcoming
exercise, a major disadvantage is the risk of program which consists of series of

International Journal of Health Sciences and Research (www.ijhsr.org) 62

Vol.11; Issue: 4; April 2021
 Nikita Shinde et.al. Prevalence of musculoskeletal pain and injuries in gym instructors.

exercises is crossfit this consists of high Procedure

intensity exercises which are performed According to inclusion criteria
rapidly with successive repetitions having questionnaire was filled by gym instructors.
no or less recovery time. The injury rate in All questions were compulsory to answer.
crossfit is more as compared to Olympic Statistical and data analysis was done to
weightlifting, distance running, track and analyze the results. A self-administered
field, rugby, or gymnastics. [6] Questionnaire adapted from Orebro
Common strength training exercise musculoskeletal pain questionnaire was
is squatting and to avoid overuse injury used, face validity of the questionnaire was
while performing it proper knowledge of done. The questionnaire consists three
loading and posture is important. In a components and eighteen questions. The
previous study it was confirmed that, while three components include “site of pain or
performing restricted squats there was injury, frequency, intensity of the pain”,
increase in the thoracic curvature leading to “physical activities aggravating pain or
stresses at back, whereas performing injury”, “ADLs can be performed in spite of
unrestricted squats there was increase in pain or injury”. The statement are rated
knee ROM and at the trunk small amount of from (score 0) completely agree to (score
segmental movements were seen. [7] 10) completely disagree. A ten point scale is
The aim of this study was to know the used. For measuring the intensity of pain
prevalence of musculoskeletal pain and NRS was used the validity and reliability of
injuries in gym instructors and the this scale is published.
objectives were to obtain the period
prevalence of musculoskeletal pain in gym Statistical Analyses
instructors to obtain the prevalence of The data were analyzed using
musculoskeletal injuries in gym instructors. Microsoft Office Excel 2010. Mean and
standard deviations were analyzed for
METHODS physical activities aggravating pain or
Objectives: To obtain the prevalence of injury, ADLs can be performed in spite of
musculoskeletal injuries and pain in gym pain or injury. Percentile analysis was done
instructors. to analyze the results.

Study Design: Cross-sectional RESULTS

observational study According to figure1 among 108
gym instructors pain was present in
Study Population: 108 gym instructors (90 maximum number of male and female gym
males, 18 females) from fitness clubs of instructor as compared to injury. Pain is
Pune were taken. Convenient sampling present more in male gym instructors as
technique was done. Inclusion criteria was compared to female gym instructors.
gym instructors who handled client According to Figure 3 maximum
manually , age group from 20 years old to gym instructors including male and female
30 years old (young adult) population was had pain in shoulder(79%), lowerback
taken, Minimum 3 years of work experience (18%), knee (17%), wrist(11%), ankle
and minimum 6 hours of working per day. (10%), elbow (6%), neck (4%), hip (2%),
Gym instructors who worked part time, age upper back (1%), other (1%).
below 20 years of age and zumba and yoga
instructors were excluded from the study.

International Journal of Health Sciences and Research (www.ijhsr.org) 63

Vol.11; Issue: 4; April 2021
 Nikita Shinde et.al. Prevalence of musculoskeletal pain and injuries in gym instructors.

According to figure 4 20% of gym gym instructors suffered through pain or

instructors suffered through pain or injury in injury in 4-5 weeks, 3% of gym instructors
6-9 months,17% of gym instructors suffered suffered through pain or injury in 1-2
through pain or injury in 3-6 months,11% of weeks, 1% of gym instructors suffered
gym instructors suffered through pain or through pain or injury in a week.
injury in 9-12 months, 11% of gym According to the figure 5 numbers of
instructors suffered through pain or injury male gym instructors having mild pain were
over 1 year, 9% of gym instructors suffered more compared to female gym instructors,
through pain or injury in 6-8 weeks, 7% of numbers of male gym instructors having

International Journal of Health Sciences and Research (www.ijhsr.org) 64

Vol.11; Issue: 4; April 2021
 Nikita Shinde et.al. Prevalence of musculoskeletal pain and injuries in gym instructors.

moderate pain were more compared to gym instructors having severe pain were
female gym instructors, numbers of male more compared to female gym instructors.

DISCUSSION affected regions were back, shoulder, elbow

In the present study, 82% of gym and wrist. The elbow and wrist region were
instructors had pain and 16% of gym noted to be the highest site of new injuries
instructors had injury [figure 1]. The with no history of previous pain or injury.
severity of pain in male gym instructors was The most common type of injuries were
more as compared to female gym sprain, strain and tendinitis.[5] Reason for
instructors. One of the reasons can be low back pain can be strain on the muscles
maximum male gym instructors are or sprain at the ligaments. Strain of the
undergoing high mechanical loading due to muscles results due to heavy weight lifting
which there is an increase impact on the during high intensity workout. Sudden
body weight, leading to strain on joints, twisting of spine while lifting weight will
ligaments, or tendons causing pain or injury. also cause injury to the lower back. In
The injury rate while performing crossfit absence of core muscle training, lifting
was high in male as compared to female. [8] heavy weights can also be the reason of pain
When we consider site of pain or or injury. In a study they confirmed that in
injury, most affected regions are shoulder endurance sports repetitive action of flexion,
followed by low-back and knee [figure 3] extension and prolong hours of standing had
and the reason can be shoulder joint less effects on LBP and a large mechanical
provides mobility at the cost of stability. loading performed from past year had large
Shoulder joint is prone to instability as the effects on LBP. [9] The other most common
muscles and ligaments holding the joint are region prone to injury or pain is knee joint
stretched beyond limits. Stretching of and the possible reason can be spasm of
shoulder ligaments causes pain that occurs thigh muscle, ligament sprains, tight
either quickly or gradually. Frequent hamstring and quadriceps. During heavy
overhead activities such as abduction and weight lifting there is excessive loading at
flexion of arm produces pressure on the the patellofemoral joint which may give rise
rotator cuff which makes the rotator cuff to retropatellar pain. Heavy mechanical
prone to impingement leading to pain or loading when performed with weights
injury. A study done on Norwegian gym causes the ligaments to stretch leading to
instructors confirmed that the most frequent sprain of ligaments. Spasm of the muscles
site of pain during high instruction loading are caused due to lack of warm up and
was shoulder and neck region. [2] Whereas stretching activity. In one study they
another study performed on cardio confirmed that, the most prevalent site of
kickboxing instructors reported most

International Journal of Health Sciences and Research (www.ijhsr.org) 65

Vol.11; Issue: 4; April 2021
 Nikita Shinde et.al. Prevalence of musculoskeletal pain and injuries in gym instructors.

injuries in cardio kickboxing instructors Conflict of Interest: None

were knee and hip. [5]
In the current study, maximum gym Source of Funding: None
instructors 53(59%) had chronic type of
pain and 36(40%) gym instructors had acute Ethical Approval: Approved
type of pain [figure 4]. More often, acute
micro injuries can lead to chronic injury REFERENCES
which hamper the ability to perform work 1. Paul Dieppe. Chronic Musculoskeletal Pain.
and affects the quality of life. Previous Peninsula College of Medicine and
injury or trauma can also lead to chronic Dentistry, Exeter, UK. BMJ 2013;
346:bmj.f3146
pain resulting in structural changes. Pain 2. Solfrid Bratland-Sanda, Jorunn Sundgot-
which lasts less than 3 months is (how to Borgen & Grethe Myklebust (2015) Injuries
cite article) stated as acute pain [10] and the and musculoskeletal pain among Norwegian
pain that persist beyond the normal time group fitness instructors, European Journal
expected for tissue healing (that is 3 of Sport Science, 15:8, 784-792
months) is known as chronic pain. [11] 3. Clarsen, B., Krosshaug, T., & Bahr, R.
In the current study the severity of (2010). Overuse injuries in professional
the pain is measured by NRS and maximum road cyclists. The American Journal of
number of male gym instructors had more Sports Medicine, 38(12), 2494–2501
amount of moderate to severe type of pain 4. Garrick, J. G., Gillien, D. M., & Whiteside,
as compared to female gym instructors P. (1986). The epidemiology of aerobic
dance injuries. The American Journal of
[figure 5]. Many studies were conducted Sports Medicine, 14(1), 67–72.
regarding the pain tolerance in gender, two 5. Romaine, L. J., Davis, S. E., Casebolt, K., &
of the studies confirm that women are at Harrison, K. A.(2003). Incidence of injury
higher risk for developing pain disorders in kickboxing participation. Journal of
and women show high sensitivity towards Strength and Conditioning Research, 17(3),
noxious stimuli. [12,13] However the number 580–586.
of female gym instructors were less than 6. Klimek C, Ashbeck C, Brook AJ, Durall C.
male gym instructors so ultimately the Are Injuries More Common With CrossFit
severity of pain was more in male gym Training than Other Forms of Exercise? J
instructor. Sport Rehabil. 2018 May 1; 27(3):295-299.
7. List R, Gülay T, Stoop M, Lorenzetti S.
Kinematics of the trunk and the lower
CONCLUSION extremities during restricted and
The prevalence of musculoskeletal unrestricted squats. J Strength Cond Res.
pain in male gym instructors was 88% and 2013 Jun; 27(6):1529-38.
in female gym instructors was 56% and the 8. Weisenthal BM, Beck CA, Maloney MD,
intensity of pain was moderate to severe in DeHaven KE, Giordano BD. Injury Rate
both genders. The prevalence of and Patterns Among CrossFit Athletes.
musculoskeletal injury in male was18% and Orthop J Sports Med. 2014 Apr
in female was 6%. Most affected region was 25;2(4):2325967114531177.
shoulder followed by low back and knee. 9. Foss IS, Holme I, Bahr R. The prevalence of
low back pain among former elite cross-
country skiers, rowers, orienteerers, and
Future scope of the study
nonathletes: a 10-year cohort study. Am J
More data and area can be evaluated Sports Med. 2012 Nov;40(11):2610-6.
and type of injury can be studied in order to 10. Susan Youssef. Clinical guidelines and
prevent or reduce the incidence of pain or evidence base for acute pain management
injury. The Pharmaceutical Journal, online DOI:
10.1211/PJ.2019.20206653
Acknowledgement: None 11. Shaquir Salduker, Eugene Allers, Sudha
Bechan, R Eric Hodgson, Fanie Meyer,

International Journal of Health Sciences and Research (www.ijhsr.org) 66

Vol.11; Issue: 4; April 2021
 Nikita Shinde et.al. Prevalence of musculoskeletal pain and injuries in gym instructors.

Helgard Meyer.et al., Practical approach to 13. Fillingim RB. Sex, gender, and pain:
a patient with chronic pain of uncertain women and men really are different. Curr
etiology in primary care: J Pain Res. 2019; Rev Pain. 2000;4(1):24-30.
12: 2651–2662
12. Rollman GB, Lautenbacher S. Sex How to cite this article: Shinde N,
differences in musculoskeletal pain. Clin J Sahasrabuddhe P. Prevalence of musculoskeletal
Pain. 2001 Mar;17(1):20-4. pain and injuries in gym instructors. Int J Health
Sci Res. 2021; 11(4): 62-67. DOI:
https://doi.org/10.52403/ijhsr.20210408

******

International Journal of Health Sciences and Research (www.ijhsr.org) 67

Vol.11; Issue: 4; April 2021