I think the best approach to take when a client complains of injury as a result of a session would be to:
1) Pull out the session notes for that session.
2) Gather as much information from the client as you can about the nature and the extent of the injury.
3) Cross-reference what you know about the injury with the exercises performed during the session.
4) Advise the client on RICE and proper use of NSAIDs if applicable and appropriate for the client.
5) Advise that the client see a qualified health care professional *refer!* immediately if the injury appears to extend beyond DOMS, which is commonly confused as injury for some clients.
6) Write a letter to the client’s physician(s) outlining the situation and what you think may have caused the injury. Provide the physician with as much relevant information as possible and request recommendations.
7) DO NOT have another session with the client until the issue is resolved and the client has been cleared by his/her physician for exercise.
By taking these steps, you minimize the risk of legal action under malpractice or negligence. You will also show your client how much you care! Don’t be afraid of staying in contact with the client’s physician(s). It shows more professionalism to address the issue head-on and work as closely as you can with the physician(s) in the best interests of the client than it does to have a client just go to the doctor and say “I got hurt in a session with my personal trainer.” Get out in front of the situation as much as possible, stay in contact with the client, and make sure that the client knows you’re there to help out in any way that you can *within your scope of practice*.