When Exercise Apps Fall Short: Why Medical Conditions Require Professional Supervision

Jill is a 65-year-old woman with knee arthritis who followed a popular fitness app's program, resulting in severe knee pain and weeks of recovery. She didn't have the money to pay for a personal trainer so she tried an app a friend had recommended to her. She has had a total knee replacement on her left knee and severe arthritis in her right knee which will need a replacement in the near future. She has a fused left ankle, obesity, hypertension and is able to walk for short distances. She does no other forms of exercise such as flexibility, core, balance or strengthening. She has never had a postural stability assessment to determine posture and muscle imbalance which can contribute to dysfunctional movement while exercising, leading to injury.

Many exercises turn to exercise apps for convenience and affordability, but these apps lack the supervision and customization necessary for people with conditions like arthritis, hypertension, and post-rehabilitation needs. While apps may be adequate for some, they are best served by people who are already experienced exercisers and understand proper form as well as their own limitations and needs.

The fitness app market has experienced explosive growth, beginning with the COVID-19 pandemic and continuing to accelerate in popularity. Exercisers view these apps as convenient and less expensive than going to a gym and hiring a personal trainer to design and monitor a program tailored for them. While these apps may be both convenient and inexpensive, are they both safe and effective, especially for someone who has medical considerations?

Apps often lack evidence-based protocols (Only 0.5% of Apps Are Evidence-Based). A comprehensive systematic review examining 531 fitness apps found alarming deficiencies in scientific backing. Of 219 qualifying apps that met basic criteria, only one app (0.5%) was evidence-based. The research revealed that 99.6% of qualifying fitness apps provided no information regarding whether their programs were based on scientific evidence. In contrast, a certified personal trainer has been educated in exercise evidence-based best practices.

One important exclusion found in these apps is that there are typically no preparticipation health screening protocols (Only 3.7% Include Screening). This represents a critical safety gap, as preparticipation screening is considered essential for determining exercise safety and reducing the likelihood of adverse events. A personal trainer will require a preparticipation health screening, done prior to exercise, typically using a Physical Activity Readiness Questionnaire for Everyone (PAR-Q+), based on the American College of Sports Medicine (ACSM) guidelines.

This absence of screening is particularly problematic for individuals with medical conditions who may have absolute or relative contraindications to certain types of exercise.

Fitness apps typically employ a one-size-fits-all approach that fails to account for individual differences in fitness levels, medical conditions, physical limitations, and specific health goals. Generic programs are designed to cater to a broad audience, which means they don't account for individual differences in fitness levels, goals, and limitations.

Most fitness apps (64.8%) focused primarily on body image and athletic performance rather than health conditions. Only 4.3% of apps specifically addressed chronic diseases or health conditions, while the remainder (34.5%) did not disclose their focus area.

The inability to provide truly personalized programming means that individuals with medical conditions may receive exercise recommendations that are:

• Too challenging, leading to injury or symptom exacerbation

• Too conservative, limiting potential health benefits

• Inappropriate for their specific medical condition

• Potentially contraindicated given their health status

Perhaps the most critical limitation is fitness apps' complete inability to assess exercise contraindications—conditions or circumstances that make certain exercises inadvisable or dangerous. Apps cannot evaluate real-time postural dysfunction, exercise form, or recognize warning signs that would indicate the need to modify or cease exercise.

For individuals with medical conditions, exercise contraindications are numerous and serious. Those with hypertension should not exercise if their systolic blood pressure is >180mmHg or if their diastolic blood pressure is >100mmHg. It is important to monitor blood pressure prior to exercise in an exerciser with hypertension. If a person with cardiovascular disease develops symptoms during exercise, an app will not be able to detect this. There are smart watches and devices that can be employed for this use; however, they may not fully replicate trained human supervision.

Individuals with musculoskeletal conditions, such as joint inflammation or severe arthritis, require specifically designed exercise programs that minimize harmful joint stress. Consider the case of Jill, the 65-year-old female with knee arthritis who followed that popular beginner fitness app. She assumed the app's seated exercises appeared safe and accessible, but one exercise in particular proved problematic: sitting in a chair and lifting both legs simultaneously, repeatedly moving them outward and inward, first bending her knees and moving them towards her chest, then straightening her legs and moving them away from her chest. Despite seeming gentle, this exercise represents a classic open-chain movement, with her feet unsupported and moving freely through space, that generated significant shearing forces across her already vulnerable knee joints. The result was severe knee pain and weeks of recovery time.

A qualified exercise professional would have recognized that Jill's condition required closed-chain exercises instead. For example, a standing squat with both feet firmly planted on the ground would have been far more appropriate. This closed-chain movement provides joint stability through ground contact, engages multiple muscle groups for functional strength, and minimizes the harmful shearing forces that exacerbated her arthritis. The app's generic programming failed to account for these biomechanical principles that are essential for individuals with joint conditions.

Apps cannot coordinate with healthcare providers. A personal trainer will communicate with the client's healthcare providers and physical therapist to determine any recommendations or contraindications to exercise. The research emphasizes that "exercises without guidance or supervision could result in injuries (e.g., skeletal muscle damage), psychological issues such as overexercising, unhealthy diet habits, or compulsive behaviors." This risk is amplified for medical populations who may not recognize when symptoms indicate the need to stop or modify exercise.

This evidence clearly demonstrates that while fitness apps have gained tremendous market popularity, they remain fundamentally inadequate for individuals with medical conditions who require evidence-based, individually tailored, medically supervised exercise prescriptions. The 0.5% evidence-based rate and virtual absence of medical screening protocols highlight the urgent need for professional supervision when medical conditions are involved.

Research Articles:

1. Bartlett, C., et al. (2023). "Evaluation of Exercise Mobile Applications for Adults with Cardiovascular Disease Risk Factors: A Systematic Review." Digital Health, PMC10743387

2. Bittner, A.K., et al. (2024). "Efficacy of the mHealth-Based Exercise Intervention re.flex for Patients with Knee Osteoarthritis." JMIR mHealth and uHealth, 12:e54356

3. Chen, L., et al. (2025). "Effect of Digital Exercise Therapy on the Pain and Physical Function of Patients with Osteoarthritis." Journal of Medical Internet Research, e66037

4. Gavanda, S., et al. (2025). "Comparing supervised training, app-guided training, and self-directed programs." Journal of Strength and Conditioning Research

5. Liu, X., et al. (2024). "Comparing the impact of personal trainer guidance to exercising alone or with a partner." Frontiers in Psychology, PMC10828695

Exercise Guidelines:

1. American College of Sports Medicine (2018). "New Preparticipation Guidelines Remove Barriers to Exercise." ACE Fitness

2. Breeze Academy (2025). "What Are The Contraindications To Exercise?" Clinical Practice Guidelines

3. Exercise and Sports Science Australia (2018). "Exercise Professionals with Advanced Clinical Training Should be Part of the Solution." British Journal of Sports Medicine, PMC5948234

Industry Reports and Reviews:

1. Medical News Today (2024). "Exercises to avoid with hypertension"

2. Trustpilot Reviews (2025). "LazyFit Customer Service Reviews" - documenting user injury reports

3. Chrome Stats (2025). "LazyFit User Reviews and Ratings" - safety concerns documentation

Supporting Evidence:

1. VASA Fitness (2024). "The Benefits of Personal Training After an Injury"

2. First Class Personal Training (2023). "Fitness Apps vs. Personal Trainers"

3. NESTA (2024). "The Importance of a Prescreening Assessment by Personal Trainers"

Assessed and Endorsed by the MedReport Medical Review Board