Safety, Injury Prevention, and Contraindications
Domain 4 - Safety, Injury Prevention, and Contraindications
This domain tests screening, exercise modification, and recognition of red flags. The exam expects you to keep the class challenging without pushing clients into joint or medical risk.
Core rules
- Screen before class: health history, injuries, pregnancy, surgery, medications, and current pain. Obtain informed consent and explain that clients should report pain, dizziness, or numbness.
- Respect scope: do not diagnose or treat. Refer sharp joint pain, radiating symptoms, chest pain, or unexplained swelling.
- Modify common contraindications: avoid loaded spinal flexion and rotation with osteoporosis; avoid supine positions after the first trimester and in some reflux or hypotension cases; limit inverted positions with glaucoma, retinal detachment, or uncontrolled hypertension; support balance with vertigo or neuropathy.
- Protect knees: track knees over toes, reduce turnout if arches collapse, and avoid deep closed-chain flexion with acute knee pain.
- Protect shoulders and wrists: avoid painful end-range extension, keep wrists neutral in plank, and use a mat or fists if wrist extension is limited.
- Offer props: chair, block, band, ball, and wall support are tools, not signs of weakness.
Worked example
A client with osteoporosis enters a barre class and the plan includes seated spinal twists and standing forward folds. Reasoning: both load flexion and rotation, which raise fracture risk in susceptible clients. Replace with supported hip hinge, neutral-spine standing work, and side-body lengthening; keep the twist unloaded or omit it. The class goal-core and posture-remains.
Traps
'Push through pain'; forcing turnout; deep stretches without warm-up; unsupported balance work; ignoring dizziness; using the barre as a crutch rather than a support; and failing to document modifications.