11 Common Illnesses and Injuries

11 Common Illnesses and Injuries

In order to recognize an emergency, fitness professionals must be familiar with 12 common illnesses and injuries associated with exercise and safety in health clubs including the following:

  1. Allergic reactions
  2. Head injuries
  3. Heart attack
  4. Nosebleeds
  5. Heat-cold-related emergencies
  6. Musculoskeletal injuries
  7. Pregnancy emergencies
  8. Respiratory emergencies
  9. Seizures
  10. Shock
  11. Stroke

Keep in mind that this list is not inclusive. However, along with a brief definition of the illnesses/injuries will be a list of signs and symptoms and the appropriate first-aid response. This overview is not a substitute for the directions that a medical professional gives to patients.

Allergic Reactions

A small population of individuals may experience allergic reactions during exercise. These reactions are called exercise-induced anaphylaxis or (EIA). EIA typically lasts up to 4 hours, and is triggered by certain foods prior to exercise (e.g., eggs). Individuals can keep this under control by waiting a couple of hours after eating and incorporating a sufficient warm-up and cool-down within their workouts.


  • Changes in skin color
  • Heart palpitations
  • Hives
  • Wheezing


1. Generally, skin flushing and hives pose no health risk. Individuals who experience this may safely continue exercising.

2. In the event of respiratory problems or heart palpitations, suggest a medical evaluation and have the individual decrease activity until symptoms are alleviated. Within a short period of time, if symptoms are not alleviated, seek emergency medical help or activate the EMS by calling 911.

3. An individual who experiences induced asthma may have inhalant bronchodilators available.

4. Individuals that have known allergic reactions typically carry an Epi-Pen. These pens are an auto-injector with a preloaded does of 0.3mgs of epinephrine for adults. Should individuals need help, activate the EMS by calling 911.

Head Injuries

Any type of injury to the head could potentially be serious. In a health dub setting, falls and trauma due to weight room apparatus or sports equipment could cause injury to the head.


  • Blood or fluid drainage from the mouth, nose, or ears. Bumps and bruises
  • Changes in level of consciousness (frequently immediate, but can be delayed)
  • Headache, dizziness, or confusion
  • Increased intracranial pressure may also cause the individual to vomit. Take care to protect airway.
  • Lacerations or pain
  • Paralyzed or dysfunctional facial muscles or other body areas. Pupil changes
  • Sleepiness
  • Unconsciousness


1. For minor lumps to the head, apply ice until the swelling and pain subside. Any lacerations should be cleaned and dressed.

2.  Since any head injury can be potentially dangerous, continue to monitor even the most minor injuries until the individual appears fully recovered. The individual should be instructed to follow-up with medical care following any head injury. Frequently, serious signs and symptoms of a head injury may manifest themselves as long as 2 weeks following the incident.

3. If the individual is unconscious, activate the EMS by calling 911, and assume there is a cervical spine injury until proven otherwise. Do not move the person and protect the cervical spine.

4. With serious head injuries, keep the individual lying flat or with head and shoulders elevated if there is no evidence of neck or back involvement. Do not raise the feet.

5. Continually check for changes in breathing patterns.

6. It is important not to give anything by mouth to these individuals since they frequently vomit.

7. Activate the EMS by calling 911.

Heart Attack

The most serious complication of cardiovascular disease is a myocardial infarction or heart attack. A heart attack is the result of a blockage of one of the arteries that supply blood to the heart muscles, preventing the delivery of an adequate oxygen supply. Decreased oxygen supply can cause the portion of cardiac muscle affected. Such changes can prevent the heart from pumping adequate amounts of blood to the rest of the system. The most serious complication of a heart attack can be arrhythmias, cardiogenic shock (total heart failure), or cardiac arrest.


  • Dizziness
  • Nausea
  • Pain or squeezing in the middle of the chest
  • Pain radiating in the arm (usually the left), jaw, or back Pain in the abdominal area (often mistaken for indigestion). Profuse sweating
  • Shortness of breath
  • Weakness


1. Anyone who has signs of a heart attack should stop activity, lie down, and get medical care at once. Blood pooling due to the cessation of exercise is not a consideration at this time.

2. Have the victim chew an aspirin (not Tylenol or Motrin products)

3. A paramedic team should be called via 911 or an established emergency-response system, or someone should take the person to the hospital immediately if such services are not available.

4. If the individual is experiencing chest pain and routinely takes nitroglycerin tablets for the pain, assist them with taking their required dose immediately. This may help to prevent some cardiac damage.

5. If the individual becomes unconscious and has no pulse and respiration, activate the EMS by calling 911 and begin CPR.

Heat and Cold-Related Emergencies

The human body is equipped to withstand extremes of temperature, both hot and cold. However, the body temperature must remain constant for the body to work efficiently. A person can become ill from hot or cold temperatures, even if the temperature does not seem to be extreme. The degree of illness will depend on the likelihood of the following factors: (a)physical activity, (b) clothing, (c) wind, (d) humidity, (e) working and living conditions, (f) a person’s age, (g) and the state of health of that individual.

People at Risk for Heat or Cold Emergencies are those:

  • older than 65 years of age and the frail elderly, who exercise or work strenuously outdoors.
  • who have had heat-/cold-related problems in the past.
  • who have cardiovascular disease or any other condition that can cause poor circulation.
  • who take medication to eliminate water from the body (diuretics) with health problems.
  • younger than 13 years of age or with smaller body mass.

All of these conditions are due to overexposure to heat, and all are preventable. Heat cramps are the least severe, but they can be a signal to the person that the body is being affected by the heat. Proper hydration before exercise is the best preventive measure. In 1996, ACSM issued a position stand on exercise and fluid replacement. These recommendations were intended to guide those who exercise in maintaining an optimal hydration status.

Heat Cramps

Heat cramps are muscle spasms that are painful. It could be a warning signal or sign of a heat-related emergency. They usually occur in the legs or in the abdominal region.


1. Rest the individual in a cool place.
2. Give him or her cool water.
3. Do not give salt tablets or salt water to drink.

Heat Exhaustion

More severe than heat cramps and usually occurs after a long period of strenuous exercise or work in the heat and/or humidity.


Cool, moist, pale, or red skin Headache or dizziness Nausea
Normal or below normal body temperature Weakness and/or exhaustion.


1. Activate the EMS by calling 911.
2. Get the individual out of the heat.
3. Cool the body with cool, wet cloths, such as towels.
4. Loosen all tight clothing.
5. If the individual is able to swallow, give cool water to drink(slowly).
6. Minimize shock.

Heat Stroke

The least common heat emergency, but it is the most severe. lt usually occurs after the signals of heat exhaustion are ignored. In heat stroke, dangerously elevated internal temperatures cause vital body systems to fail.


  • Change in consciousness
  • Rapid, shallow breathing
  • Rapid, weak pulse
  • Red, hot, dry skin


1. Activate the EMS by calling 911.
2. Get the individual out of the heat.
3. Cool the body with cool, wet cloths, such as towels.
4. Loosen all tight clothing.
5. Do not give anything by mouth.
6. Minimize shock.



Hypothermia occurs when the body can no longer generate enough heat to maintain normal body temperature. lt is a general cooling off of the body. The air temperature does not have to be below freezing for hypothermia to develop. Wind and humidity have some affect on the body’s ability to control its temperature. Anyone who remains in cold or wet clothing for an extended period of time may develop hypothermia. Medical conditions, such as infection, diabetes, a stroke, or drinking alcohol, are other things that can affect the body’s ability to maintain normal body temperature.


  • Apathy and decreased levels of consciousness Numbness or glassy stare.
  • Shivering (could be absent in latter stages) Slow, irregular pulse
  • Pale cool skin
  • Patches of cyanosis, or blue color to lips and skin


1. Activate the EMS by calling 911.
2. Remove wet clothing and dry the individual.
3. Gradually warm up the body with blankets and dry clothes.
4. Move to a dry, warmer environment.
5. Do not warm individual too quickly as this could lead to heart problems.
6. Monitor vital signs and wait for the EMS.


Frostbite occurs when body parts (usually those furthest from the heart) are exposed to extreme cold temperatures. The air temperature, wind speed, and length of exposure are all contributing factors to frostbite. Body fluids cool and eventually freeze, destroying cells and tissues. Frostbite can cause loss of fingers, hands, arms, toes, feet, and legs.


Lack of feeling in affected area following intense pain.
Skin that appears waxy.
Skin that is cold to the touch.


1. Handle the area gently and with extreme care.
2. Never rub that area as it can cause further damage. Gradually warm the affected area in 100- 105° water. Affected area should not touch side or bottom of container. Keep in water until area is red and warm to the touch. Bandage area with a dry, sterile dressing.
3. If the affected area is a toe or finger, gently and carefully place gauze between them.
4. Get medical attention as soon as possible.

Musculoskeletal Injuries

Developing a better understanding of the structure and function of the body’s framework can help in better assessing musculoskeletal injuries and in giving the appropriate response. Musculoskeletal injuries are often painful, but they are rarely life-threatening. However, they can have serious consequences and even result in permanent disability if ignored or not cared for properly. It is important to understand the differences between various types of musculoskeletal injuries, both acute and chronic. Examples of acute trauma are sprains, strains, and fractures. Chronic injuries, if not cared for, have the potential to progress to an acute process, such as shin splints leading to stress fractures with constant overuse. At this point in time, the injury should be treated as acute.


  • Abnormal Lumps or deformities (usually only with fracture and/or dislocation)
  • Discolored skin (will Look red at first then it will look bruised) Inability to use or move the affected part (e.g., loss of motion or inability to lean weight)
  • Numbness
  • Pain, swelling (can appear rapidly, gradually, or not at all)

When you don’t know how serious the injury is, treat it as if it was serious.

Some signs of serious injuries include popping or snapping of the bone, numbness, tingling, or change of color in the extremities. The cause of an injury may also suggest its severity.

EMS should be called whenever:
– a fracture, dislocation, deformity, or point of tenderness over bone is suspected.

– individual is unable to move or use injured body part. The injury involves the head, neck, or back.

– whenever the instructor has any doubt as to the severity of the injury, or the safety of the individual.


The best way to deal with an injury is to take precautionary measures in the first place. But accidents do occur and by knowing what to do, you can help prevent further damage to the injured person. For most soft tissue injuries, the first-aid treatment is R.I.C.E.-rest, ice, compression, and elevation. This allows for a quicker recovery. If appropriate, then you should splint the wound.


To immobilize an extremity injury you can use a splint. There are three types of splints: (a) soft, (b) rigid, and (c) anatomic. You should splint only if the injured person needs to be moved.
The purposes of immobilizing an injury are to:

  • lessen pain.
  • prevent closed fractures from becoming open fractures. prevent further damage to soft tissues.
  • reduce the possibility of loss of circulation to the injured part. reduce the risk of serious bleeding.

It is important to support the injured part in the position in which it was found. If the wound is open, then it should be covered with a dressing and bandage. The area below the injury site should be checked for feeling, warmth, and color. The splint should be applied to immobilize the joints or bones above and below the injured area. Once the splint is in place, recheck below the injury site for feeling, warmth, and color, and elevate the splinted part. An ice pack can be applied after the area is immobilized. The person should be encouraged to rest in the most comfortable position. If a fracture of the ankle or foot is suspected, elevate the limb but do not attempt to remove the shoe. This may contribute to further injuring the area due to manipulation.


Nosebleeds, although relatively common, can become severe and require medical attention. They can also be secondary to another disease process such as hypertension, or may be a result of internal or external trauma.


Spontaneous, bloody drainage from the nose


1. Have this individual stop activity and rest. Lean the person’s head forward and apply direct pressure to the bridge area of the nose for 10 minutes or until bleeding stops.
2. To prevent re-bleeding in more severe nosebleeds, an icepack may be applied.
3. If bleeding persists despite the pressure for a prolonged period of time (15 minutes), take the individual to the hospital or urgent care center.

Pregnancy Emergencies

Prior to beginning any exercise program, a pregnant client needs medical clearance from her obstetrician. Generally, pregnancy is not a contraindication to exercise. The pregnant exerciser, however, may have unpredictable complications and may be more prone to musculoskeletal problems.


  • Bloody show (spotting or frank bleeding)
  • Cramping (possibly severe)
  • Premature contractions


1. Have the individual stop exercising and sit or lie down.
2. If the cramping and contractions continue, make arrangements to transport the individual to the hospital.
3. If bleeding is severe, lie the person down in the shock position with legs elevated.
4. ln advanced pregnancy, do not lie the individual flat since this will limit breathing and decrease blood flow to the fetus.
5. Activate the EMS by calling 911.
6. Re-evaluate the individual frequently for changes in breathing or cardiac status.

Respiratory Emergencies

Chronic Obstructive Pulmonary Disease (COPD).

COPD is a condition where the air exchange, especially an exhalation, is limited due to the constriction of the bronchial branches. This narrowing allows for the air to forcefully enter the alveoli (air sacs) under negative pressure, but decreases the speed of air exchange out of the lungs. COPD can have many causes. Smoking and environmental hazards can damage the bronchioles, narrowing the branches and decreasing air flow.

Asthma. A common type of COPD, seen more frequently in the younger population, is asthma. In the asthmatic patient, bronchiole spasms are responsible for decreasing air flow. High levels of activity can precipitate an asthma attack. ln fact, some individuals suffer from exercise-induced asthma.


Bluish tint to the nails, lips, or skin
Shortness of breath and difficulty exhaling
Skin color may change to a dusky hue
Sweating and increase in heart rate
Wheezing or a “squeaking” or “whistling” sound when exhaling


1. The first reaction to an individual with difficulty breathing is to stop the exercise which will decrease the oxygen demand. Have the individual sit down or lie down with their shoulders and chest elevated. It may be helpful to have them lean against a wall when seated.
2. If they have constrictive clothing, loosen or remove the constrictive pieces.
3. Many asthmatics carry bronchodilator medications for inhalation during attacks-ask if they have this medication and help them administer it.
4. Observe them frequently for improvement or deterioration. If their condition continues to worsen, activate the EMS by calling 911 or get the individual to the hospital immediately if EMS is not readily available.


Two major signs of a serious epileptic attack are seizures and loss of consciousness. Attacks can be so mild they are not noticed by others or they may be so severe that, without medical intervention, they can be life threatening.

Most epileptic patients take medication to control attacks. The presence of epilepsy should be documented on their health history form. Seizures can also be associated with head injury, poisoning, infections, high fevers, toxemia in pregnancy, or conditions resulting in lack of oxygen supply to the brain (e.g., severe heart attack or arrest).


  • Drooling
  • Foaming at the mouth
  • Periods of unconsciousness
  • Rigid muscles
  • Seizures with uncontrollable shaking, jerking motions


1. Activate the EMS by calling 911.
2. Do not restrain seizure individuals. Protect them from injury by moving objects away from them. Never attempt to put anything into their mouths or force anything between their teeth. Never attempt to insert fingers in their mouth.
3. When the jerking movements stop, position the individual on one side to allow for drainage from the mouth. Keep their airway open and reassess frequently to make sure they are breathing.
4. Seizure attacks are generally followed by periods of rest or sleep.
Moving around can precipitate another attack. Provide for rest while immediate medical care is arranged for the individual.


Shock is a general term for the changes the body experiences with a serious injury or cardiac event. In any shock situation, blood pressure begins to drop depressing all body functions. If untreated, shock will result in death. There are three major types of shock.

Hypovolemic Shock-results from excessive loss of body fluids from hemorrhaging, profuse sweating, vomiting, or diarrhea.

Cardiogenic Shock-happens when the heart loses its ability to pump effectively. This can be as a result of a heart attack.

Anaphylactic Shock-results from a severe allergic reaction. The blood vessels lose their tone and a blood pressure cannot be maintained.


  • Anxious and fearful-feeling of impending doom Cool and clammy skin
  • Dizziness, confusion, or changes in level of consciousness Feeling of profound weakness
  • Heart rate and respiratory rate may be elevated
  • Numbness or tingling in the extremities


1. Comfort and calm the individual. Keep them lying down,
comfortable, and attempt to maintain a normal body temperature.
2. If the individual is hot or in the sun, provide shade.
3. If it is cool, keep the individual warm.
4. There are a variety of positions beneficial to the shock individual that the rescuer must be knowledgeable about.

Standard Position: Keep the feet up or the injury elevated. This aids circulation back to the heart. However, do not elevate any unsplinted fractures.

Head and Shoulder Positions: If the individual has ahead in jury or is having trouble breathing, elevate the head and shoulders. If the problem is respiratory, elevation of head and shoulders decreases pressure on the diaphragm and allows for greater chest expansion. Head and neck should not be elevated if a neck or back injury is suspected.

Flat Position: If a back injury or fractures arc suspected or if the responder is unsure of what position is correct, leave the individual lying flat.

Side-Lying Position: An individual who is bleeding from the mouth or may vomit needs to lie on one side. This prevents blood or stomach contents from flowing into the lungs and compromising breathing.


A stroke or Cerebral Vascular Accident (CVA) is a sudden, often severe impairment of body functions brought on by a disruption of blood flow to the brain. When blood flow fails to reach parts of the brain, the affected brain cells die and leave an infracted area. The location and magnitude of the injury determines the residual damage to the individual. There are three types of strokes.

Thrombotic Stroke-is a result of the atherosclerosis process as seen in CVD. The arteries are narrowed due to plaque deposits decreasing blood flow to vital tissues.


Embolic Stroke-is caused by a blood clot (embolus) that breaks loose and travels through the vascular system until it lodges in a smaller vessel. About 20% of all strokes are embolic.

Hemorrhagic Stroke-occurs when a blood vessel in or around the brain bursts, spilling blood into the surrounding brain tissue. This can be the result of an aneurysm which is weak, a ballooning spot in a vessel, or it may be from trauma to the head.

Transient Ischemic Attack
Sometimes called a mild stroke, Transient lschemic Attacks (TT As) manifest themselves with the same signs and symptoms of a stroke, but to a lesser degree and for a shorter time frame. Despite the fact a person has seemingly recovered from a TIA, it is necessary for them to seek medical help. TIAs are signs of underlying pathology and can be precursors to serious strokes.


  • An individual experiencing a stroke may have a number of neurological changes.
  • Change of mood or affect
  • Confusion, disorientation to self, time, or place. Difficulty speaking
  • Difficulty swallowing
  • Dizziness, loss of balance, unexplained fall
  • Headache, usually sudden and severe, or an unexplained headache pattern
  • Numbness, paralysis, or weakness of face, neck, or limbs occurring on one or both sides of the body
  • Persistent ringing in the ears
  • Sudden blurred vision or loss of vision in one or both eyes

1. Keep a stroke individual lying down and protected.
2. Attempt to maintain normal body temperature and activate the EMS by calling 911.
3. Do not give them anything to eat or drink.
4. If the individual is semi-conscious or unconscious, turn them to their side to prevent secretion from falling back into their lungs (aspiration). Due to the potential pressure in the brain, stroke individuals may vomit.
5. Reassess the person’s respiratory status in case their condition deteriorates and begin CPR if necessary.
6. In cases of a TIA, where the individual seems to regain all faculties, protect the individual from accidents and physical exertion. Suggest follow-up medical attention. It is also recommended to notify a family member of a suspected TIA to inform them of the incident, and to insure that someone is aware of the suggestion for medical follow-up.

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