Chest pain or fainting: call 999
Call 999 if:
- You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
- The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
- You have chest pain and feel sweaty, sick, light-headed or short of breath.
- Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.
Sources 66, 67
Chest pain that comes and goes
Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem. If you've been diagnosed with angina, get help from NHS 111 too if it feels worse than before, is happening more often, lasts longer or happens when you're resting.
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Before you play hard
The PAR-Q+ (Physical Activity Readiness Questionnaire for Everyone) asks about a heart condition or high blood pressure, chest pain, dizziness or losing consciousness, other long-term conditions and their medicines, a bone or joint problem that activity could make worse, and being told to exercise only under supervision. If you answer yes to any, check with your GP or a qualified exercise professional first. If you're over 45 and not used to hard exercise, ask a qualified exercise professional before the hardest sessions, and delay if you're ill.
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A snap at the back of the heel
Contact NHS 111 if you heard a snap, grinding or popping noise at the time of the injury, can't walk on tiptoe or up stairs, or have swelling and bruising in your calf and ankle. Our Achilles rupture guide says to get it checked the same day, at A&E (accident and emergency) or a minor injuries unit, or through NHS 111.
Same day: a sudden snap or pop at the back of the heel or calf, or a feeling of being kicked there, then walking flat-footed and being unable to push off, stand on tiptoe or climb stairs. It could be an Achilles tendon rupture or a broken heel bone. Go to A&E or a minor injuries unit, or contact NHS 111.
Sources 70, 71, 72
Achilles or calf pain, or coming back after a break
5 of 31 players who ruptured an Achilles had noticed symptoms first. Follow our Achilles tendinopathy guide's calf loading and pain rule before full play, rather than playing through it.
Ruptures cluster in recreational players in their mid-30s. Warm up every time, keep sessions shorter at first, and strengthen your calves on other days (our suggestion).
Sources 7, 50
An ankle or knee injury
Call 999 or go to A&E if you heard a crack, the joint has changed shape or is pointing at an odd angle, it's numb, tingling or has pins and needles, or the skin has changed colour or is cold. Get help from NHS 111 if it's very painful, badly swollen, or you can't put weight on it or walk more than a few steps, and for a knee that locks, gives way or painfully clicks.
Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.
Same day (NHS 111 or an urgent treatment centre): after an injury, you can't put weight on it or walk more than a few steps, the pain is very bad or getting worse, there is a lot of swelling or bruising or it is getting worse, it feels very stiff, or it's not feeling any better after treating it yourself. Get the same help if you also have a very high temperature, or feel hot, cold or shivery: this could be an infection. If you think it's broken, don't treat it yourself.
Go to A&E (accident and emergency) if you've injured your knee and it has changed shape, it becomes very swollen very quickly, you felt a pop or snap, you can see bone sticking out, or it's bleeding heavily. Don't drive yourself: ask someone to take you, or call 999 if the pain means you can't move your leg to get there.
Get advice from NHS 111 now: you cannot move the knee or put any weight on it, or it is very painful, badly swollen or has changed shape, or it locks, gives way or clicks painfully. A pop, quick swelling and a knee that gives way point to an ACL injury: our ACL injury guide says what to do.
Sources 72, 73, 71
A previous ankle sprain
Repeat sprains are common. Our ankle sprain guide: balance training 3 times a week for 8 weeks once you're back on court, and a brace for sport.
See a doctor or physiotherapist if:
- An ankle that keeps giving way months after a sprain.
Sources 5, 21, 71, 72
Knee pain when you play: the pain rule
Our knee guides use this rule: rate your knee pain from 0 to 10 during and after exercise; 0 to 2 counts as safe, up to 5 as acceptable and above 5 as too much, and your knee should be back to its usual level by the next morning.
Sources 74, 75
A shuttle in the eye
Go to A&E or call 999 if something hit your eye at high speed, your sight has changed, you have severe pain in the eye, a headache or sensitivity to light, you feel or are sick, you can't move your eye or keep it open, or blood or pus is coming from it. Ask for an urgent GP appointment or contact NHS 111 if it isn't getting better after 24 hours. Raised eye pressure can follow years later, so keep any follow-up appointments (our suggestion).
Sources 76, 77
The hitting shoulder
Ask for an urgent GP appointment or contact NHS 111 for sudden or very bad shoulder pain, an arm you can't move, a shoulder that has changed shape or is badly swollen, pins and needles that don't go away, or pain that started after a fall.
Same day (GP or NHS 111): sudden weakness lifting the arm after an injury or fall. A rotator cuff tear caused by an injury needs urgent referral to a shoulder specialist. After a dislocation in anyone over 40, the rotator cuff should be checked: about 40% have a tear.
See a GP or physiotherapist if:
- Your shoulder has partly or fully come out of joint, or you worry it might.
Sources 78, 79
Heat in a hot hall
Heat exhaustion should improve within 30 minutes of resting somewhere cool, cooling down and drinking. Call 999 if it doesn't, or for a very high temperature, hot skin that isn't sweating, a fast heartbeat, fast breathing, confusion, a fit or loss of consciousness.
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Pregnant
The NHS says it's usually fine to keep doing the activities you already do, but advises against sports with a risk of falling or bumping your tummy, and against starting a new vigorous activity. Talk to your midwife or GP; if you already play, gentle social doubles may suit (our suggestion).
Source 81
Back pain with numbness or bladder problems
Call 999 or go to A&E: loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
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Unusual breathlessness
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
Source 83
During a session
A joint pain that is sharp, gets worse during a session, lingers into the next day or changes how you move is a reason to use an easier version, and to see a GP or physiotherapist if it keeps happening (the rule in our plans).
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Stop the session if
You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
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Before you start
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
Source 85