Clients with sudden pain without source.

I train a predominantly older client population, with few under the age of 55-60. I work hard to follow the rules you espouse of first confirming self efficacy, and people are a resilient organism, etc., but I am struggling with what is starting to be a semi regular occurrence across my group. That is clients reporting serious pain, and seeking to stop working out over it.

More specifically a trainee will complain of sudden disfunction. The most recent for example is a woman about 50 years of age, who recently began training, three months ago. She has made solid progress across the board, and suddenly on a rest day stated “I can no longer lift my arm above my shoulder.” This example occurred when they were on a rest day. It has happened for others on a general GPP day, and even for people who are by all evidence following proper RPE based training. There are no catastrophic events, or moments of in the gym injury, simply a sudden disfunction. Similarly a few weeks ago a different client had a similar scenario but with hip abductor pain. This client is in their early sixties. A week before that a different client has sudden low back pain and “couldn’t even walk.” None of these are happening under the bar, or are under the trainers watch so to speak.

I understand this is a broad question, but what is the general advice for how to progress with these types of periodic incidents? I do not want to ask them about their pain, or bring focus to the pain, and I also do not want to downplay or appear to not be listening to them when they say they have pain. However, when they ask “Should I take this week off,” when I know more motion not less is usually good, I feel like I am ignoring their plea regarding pain. I have been following a general line of a single session break from that muscle group, pivoting to something different that day, then a less rigorous 2-4 week easing back into the motion, sometimes starting from empty bar so they do not have constant fear / pain associations. Is this a reasonable general approach? (summarize rehab and physical therapy in a single bolus right? :)…)

Equally importantly, as I am obviously not a medical practitioner, how do I know when it is time for me to say, stop, and see a clinician. They are saying there was no exercise related event, but they associate it with exercising, and are claiming dysfunctional range of motion or extreme pain.

I really enjoy and find fulfillment working with this age group, but I am feeling very I’ll equipped to deal with the surprisingly frequent occurrence of these non specific pain source events.

Help and advice would be appreciated.