Injury Prevention, Contraindications, and Safety
Domain 6: Injury Prevention, Contraindications, and Safety
This domain tests safe screening, referral, and exercise modification.
Safety rules
- Screen for red flags: progressive neurological symptoms, bowel or bladder changes, unexplained weight loss, fever, severe night pain, and recent trauma. Refer.
- Stay in scope: do not diagnose; modify and communicate with the healthcare provider.
- Osteoporosis: avoid loaded spinal flexion and rotation; favor neutral-spine isometrics and hip hinge.
- Acute disc-related pain: avoid end-range flexion or extension that reproduces symptoms.
- Pregnancy: avoid prolonged supine positions after the first trimester and exercises that provoke coning or pain.
- Diastasis recti: avoid doming; use breathing and regressed anti-extension work.
- Post-surgical: follow surgeon restrictions.
Worked example
A client with osteoporosis requests 'core twists.' Do not prescribe seated weighted twists. Choose a Pallof press with a neutral spine, controlled breathing, and light resistance. The goal is anti-rotation control, not spinal rotation under load.
Traps
- 'No pain, no gain' during core work.
- Ignoring red flags to keep the session moving.
- Prescribing supine exercises late in pregnancy.
- Confusing doming with normal effort.