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 75, 76
Dark urine and very sore muscles: get help the same day
Dark, red or cola-coloured urine, much less urine than usual, or very painful, weak or swollen muscles in the days after a session: get medical help the same day. Dark pee isn't always there, so muscles far sorer, more swollen or weaker than the session explains still need the same-day check.
The signs to act on, from our rhabdomyolysis guide:
- Dark pee: red, brown, tea or cola coloured, especially with very sore, swollen or weak muscles, in the hours or days after exercise.
- Muscle pain, cramps or aches far worse than the session explains, or muscles that are swollen.
- Feeling too weak or tired to finish a workout, or everyday tasks you could do before.
- Peeing much less than usual, feeling very thirsty, being sick, swollen feet or legs, or feeling very tired, dizzy, confused or sleepy: these can be signs of kidney injury.
- A high temperature along with the muscle pain.
Sources 77, 78, 10
Call 999 or go to A&E: a swollen, tight muscle or heatstroke
Don't drive yourself to A&E.
- Sudden, severe pain in a muscle, especially if it's very swollen and tight, or numb, weak or tingling: this can be compartment syndrome, which needs surgery as soon as possible.
- Signs of heatstroke: still unwell after 30 minutes of resting somewhere cool, being cooled and drinking; a very high temperature; hot skin that isn't sweating and might look red (harder to see on brown or black skin); a fast heartbeat; fast breathing or breathlessness; confusion and loss of coordination; a fit; or loss of consciousness.
Source 79
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.
Source 80
The shoulder
Call 999 or go to A&E: after a fall or injury, your shoulder looks out of place or has changed shape, you cannot move your arm, or your shoulder is painful, bruised or swollen. Do not drive yourself, and do not try to put it back in yourself.
Same day (GP or NHS 111): sudden or very bad shoulder pain; you cannot move your arm; the arm or shoulder is badly swollen or has changed shape; pins and needles that do not go away; no feeling in the arm; the arm is hot or cold to the touch; pain that started after an injury such as a fall; or severe pain in both shoulders.
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 73, 81
A joint that slips, locks or swells
A shoulder that slips out or looks out of place, a knee that gives way, locks or swells within hours, or a wrist that's swollen and can't take weight needs checking before you train it again. Our pain guides say what to do.
Sources 81, 82, 83
Leaking, pregnancy and after a baby
Don't start CrossFit new in pregnancy; if you already train, talk to your midwife, and see our pregnancy guide. After having a baby, or with leaking or a feeling of heaviness, our postpartum and pelvic floor guides help, and a pelvic health physiotherapist can assess you.
Source 84
Very flexible joints
Build strength and control before high-impact and gymnastics work, as our hypermobility guide explains.
If you're hypermobile, don't use mobility work to push further: the NHS says "do not overextend your joints just because you can". See a GP if you think you have joint hypermobility syndrome: for example, your joints keep dislocating, or you keep getting sprains, strains, pain or stiffness.
Sources 85, 86
Before the hardest sessions
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.
Source 87
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 88
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).
Source 89
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.
Source 90
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 90