Warning signs: when to get help
These are the warning signs of our hip, knee, thigh fat, legs and Pilates guides, word for word. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Call 999 or go to A&E
- Call 999 or go to A&E: severe hip pain after a fall or injury, or you cannot stand, walk or put weight on the leg. In an older adult this can be a broken hip; the leg may be at an odd angle or look shorter. Don't drive yourself.
- Call 999 or go to A&E: tingling or loss of feeling in the hip or leg after an injury.
- Leg pain or swelling with breathlessness or chest pain: call 999 or go to A&E, and do not drive yourself. It can be a blood clot that has reached the lungs.
Sources 87, 88
A clot that may have reached the lungs
If you have pain and swelling in a leg with shortness of breath or chest pain, or leg swelling with a tight, heavy or painful chest, coughing up blood, or feeling faint, confused or clammy: it could be a blood clot in the lungs. Don't drive yourself to A&E.
Sources 89, 90
The same day: a clot in the leg
Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. This can be a deep vein thrombosis (DVT). It is more likely after surgery, a hospital stay, 3 or more days in bed, a journey of over 4 hours, pregnancy or a recent birth, cancer, a previous clot, or contraception or hormone replacement therapy (HRT) that contains oestrogen.
Source 89
The same day: a hot, swollen or injured hip or knee
- Ask for an urgent GP appointment or get help from NHS 111 if you have severe hip pain that started suddenly but you've not had a fall or injured your hip, your hip is swollen and feels hot, the skin around your hip has changed colour, or you have hip pain, feel generally unwell and have a high temperature (or feel hot, cold or shivery). A hot, swollen hip with a high temperature can be a joint infection.
- Get advice from NHS 111 now: a hot, red or swollen knee with sudden severe pain, a very high temperature, or feeling hot, cold or shivery. This can be a joint infection.
- 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.
- You hurt your knee and cannot take 4 steps, or you are 55 or over and have injured it: get it checked the same day for a broken bone.
- Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin; or swollen veins; or sudden worse pain and swelling around a lump at the back of the knee (a possible clot or a burst Baker's cyst).
- Get advice from NHS 111 now: the knee locks, gives way or clicks painfully. Painless clicking is normal.
- Get advice from NHS 111 now: after a twist, your knee won't go fully straight, or something blocks the last part of straightening, even if you can still walk on it. A torn piece of meniscus caught in the joint can do this, and it needs checking promptly.
Sources 87, 88
A pulled muscle in the thigh or groin
Get help from NHS 111 if it's very painful or getting worse, there's a lot of swelling or bruising, you can't put weight on it or walk more than a few steps, it feels very stiff, or it isn't getting better with self-care. The NHS advises avoiding strenuous exercise for up to 8 weeks while it heals.
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See a GP or physiotherapist
- Hip pain that stops normal activities or disturbs sleep, keeps getting worse or keeps coming back, or has not improved after 2 weeks of looking after it at home.
- Stiffness lasting more than 30 minutes after waking.
- Knee pain doesn't improve within a few weeks. In many areas you can refer yourself to NHS musculoskeletal (MSK) services, such as physiotherapy.
Sources 87, 88
Gaining weight you can't explain, in the NHS's words
The NHS lists health conditions that cause weight gain, such as an underactive thyroid, Cushing's syndrome and PMOS (polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome), and "certain medicines including some steroids, antidepressants and beta blockers". It says: "Speak to a GP for advice if you have a condition that makes it harder to stay a healthy weight." Don't stop a medicine without talking to your doctor (our suggestion).
Source 92
Chest pain or fainting while exercising: 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 93, 94, 95
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.
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A heart condition
If you have a heart condition, follow your cardiac team's advice on how hard to work, and stop for the warning signs above. People with long-term conditions may wish to ask their specialist before starting. With uncontrolled high blood pressure, avoid straining against a held breath; the high blood pressure guide has more.
Older adults
See your GP first if you get chest pain, breathlessness or dizziness when you are active, if you have a heart condition and want to exercise harder, or if you have had a fall.
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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.
If you have a heart, lung or joint condition, are pregnant or have recently been unwell, start gently and read our guide for your condition. Muscle soreness for a day or two after a new exercise is common and fades as you repeat it.
Source 98