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 76, 77
A head injury with red flags
The UK guidelines call these red flags, needing urgent assessment by a healthcare professional or at A&E (accident and emergency), by ambulance if necessary.
- Any loss of consciousness, or getting drowsier
- No memory of events before or after the injury
- Increasing confusion or irritability, or unusual behaviour
- New problems understanding, speaking, reading or writing, less feeling, loss of balance, weakness or double vision
- A seizure, twitching limbs, or lying rigid or motionless
- A severe or worsening headache, repeated vomiting or severe neck pain
- A suspected skull fracture: a cut, bruise, swelling or severe pain where they were hit
- Previous brain surgery, a bleeding disorder, blood-thinning medicine, or being drunk or on drugs at the time
Sources 16, 78
A suspected concussion
With a suspected concussion, if in doubt, sit them out. The UK's grassroots guidelines say no sport for at least 24 hours, get checked by a healthcare professional or NHS 111 within 24 hours, follow a staged return, and no competition before day 21; if symptoms last beyond 28 days, stay out of sport and see a doctor. Pilates waits too: gentle breathing and mobility fit the early, light-activity stages; bodyweight strength work can start in the light aerobic exercise stage, which allows "low intensity, body weight resistance training"; and springs, weights and harder trunk work come later (our reading). Our concussion guide has the stages.
Members of a governing body follow its current rules; everyone else follows these guidelines. Our concussion guide sets out each stage.
The NHS says to get help from NHS 111 if, after a head injury, you're being sick, feel dizzy, take medicine that thins your blood, were drinking alcohol or taking drugs at the time, or have any other symptoms you're worried about. See a GP if symptoms last more than 2 weeks, and don't play contact sports for at least 3 weeks.
Sources 16, 78, 13
After a choke: British Judo's warning signs
British Judo says any of these after a strangle needs immediate assessment by a healthcare professional, or A&E.
- Increasingly restless or agitated, or less and less alert
- New double vision
- Neck pain or tenderness
- A seizure
- Tingling, pins and needles, or weakness in the arms or legs
- Unconscious for more than a minute
- Persistent vomiting or a worsening headache
- More than one concussion or strangulation in 3 months, or a child
Source 65
A changed voice, noisy breathing or trouble swallowing after a choke
Go to A&E: British Judo lists voice box and airway injuries among the risks of strangulation.
Source 65
Signs of a stroke, even hours or days later: call 999
A face drooping on one side, an arm that can't be lifted and held, slurred or confused speech, sudden blurred or lost vision, sudden dizziness or a sudden, severe headache. The NHS says to call 999 even if the symptoms have stopped.
Source 79
Neck pain after a choke, a neck crank, a throw or a takedown
Call 999 or go to A&E: a headache that came on suddenly and is extremely painful; numbness or weakness in the face or body; a drooping face, or being unable to lift both arms and keep them up; difficulty speaking, swallowing, balancing, walking or remembering; double vision or loss of vision; drowsiness or confusion. A torn neck artery often starts with headache and neck pain, sometimes with dizziness or tingling, so head or neck pain unlike any you have had before needs checking.
Call 999 or go to A&E after a neck injury if the person is unresponsive, has severe neck pain or cannot move their head, has fallen from a height such as 5 or more stairs, or is drunk or has taken recreational drugs. Do not drive yourself. Being 65 or over, a dangerous fall or crash (from more than 1 metre or 5 stairs, diving, a high-speed or rollover crash, being thrown from a vehicle, a bicycle collision or an accident on a motorised recreational vehicle), or tingling in the arms or legs after an injury puts you at high risk of a broken neck: get checked.
Numbness, tingling, burning or weakness in both arms, in more than one limb, or in the legs: keep the player still and call 999. It can be an injury to the spinal cord, even if it passes in minutes.
Call 999 or go to A&E: new problems walking, loss of bladder or bowel control, or a sudden loss of coordination, such as difficulty doing up buttons. These can be signs of pressure on the spinal cord.
Sources 79, 80, 81
A joint that's out of place, locked or quickly swollen
An elbow that was forced straight and looks out of place, a shoulder that won't move, or a knee that locks or swells quickly needs A&E or urgent assessment. Don't try to put a joint back yourself.
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.
Source 82
A shoulder that comes out
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.
Your shoulder has partly or fully come out of joint, or you worry it might.
Source 83
Back pain that's worse arching
Back pain that is worse arching back and has lasted more than a couple of weeks can be a stress fracture of the spine (spondylolysis): get it checked.
Source 73
Very flexible joints
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 84, 72
During a weight cut, or in a hot room
Confusion, fainting, dark urine or passing very little urine: stop and get medical help.
Our editorial advice: don't use hot Pilates or hot yoga classes, saunas or sweat suits to make weight. In any hot class, drink before and during, and stop at the first sign of dizziness, a headache or feeling sick; our hot yoga guide gives the NHS signs of heat exhaustion and heatstroke.
Source 75
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 85
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).
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 86
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 86