Stop and get medical help
If you get chest pain or pressure, feel faint or dizzy, are unusually breathless, or your heart races or beats irregularly during exercise, as our plans advise. The American Heart Association says these need immediate medical evaluation.
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Call 999 (911 in the US)
For chest pain that comes on suddenly and doesn't go away, feels tight or like squeezing, spreads to your arms, neck, jaw, stomach or back, or comes with sweating, feeling sick, light-headedness or breathlessness; arm pain that comes on suddenly with pressure, heaviness or squeezing across your chest; severe difficulty breathing, or a chest that feels tight or heavy; someone who faints while exercising; palpitations that don't go away, or come with chest pain, shortness of breath or feeling faint; or a headache that starts suddenly and is extremely painful, especially while lifting or straining. The NHS says a bleed on the brain may be more likely when lifting something heavy. Don't drive yourself to A&E.
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A headache with effort
Ask for an urgent GP appointment or get help from NHS 111 for a headache that's triggered or made worse by coughing, sneezing, bending down or exercising.
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Same day: a pop at the elbow or upper arm
A pop or snap with sudden pain during a hold, especially with bruising or a bulge in the upper arm, can be a torn biceps tendon. Go to an urgent treatment centre or A&E (in the US, urgent care) the same day, and don't wait for it to settle, as our biceps guides say: OrthoInfo says a repair is ideally done in the first 2 to 3 weeks.
A sudden, sharp pain at the shoulder or upper arm, sometimes with a pop, can be a torn long head of the biceps: see a GP or get help from NHS 111 the same day, as our biceps tendinitis guide says.
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A fall from the bar
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.
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A knock to the head
Call 999 if someone has hit their head and has been knocked out and not woken up, can't stay awake, has a fit, has fallen from a height of more than 1 metre or 5 stairs, has problems with their vision, hearing, balance, walking or speech, or has new numbness or weakness. Get help from NHS 111 after a head injury if you're being sick or feel dizzy. If you're told to go to A&E, don't drive yourself.
Train over a mat, with the bar or rings low enough to put your feet down (editorial).
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Urgent GP appointment or NHS 111: your shoulder
Ask for an urgent GP appointment or get help from NHS 111 for sudden or very bad shoulder pain; not being able to move your arm; a shoulder or arm that has changed shape or is badly swollen; pins and needles that don't go away; or pain that started after an injury or accident, like a fall. In the US, contact your doctor or urgent care. See a GP if shoulder pain is getting worse or hasn't improved after 2 weeks. While your shoulder is sore, the NHS says not to make up your own strenuous exercises or use heavy gym equipment.
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Your wrists
Get help from NHS 111 if you heard a snap, grinding or popping noise when you hurt your wrist, or you can't move it or hold things.
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Swollen muscles and dark urine
Very sore, swollen, tight muscles and dark urine after an unusually hard or high-rep session need medical help the same day: it could be rhabdomyolysis, as our elbow pain from pull-ups guide explains. Normal soreness peaks a day or two after a new exercise and fades.
A new lump or bulge in your groin or tummy
See a GP if you think you have a hernia, a bulge or lump that may get bigger when you strain and smaller when you lie down. Get help from NHS 111 if you have a hernia and pain in or around it, a bloated tummy, you feel or are sick, you're vomiting blood or your vomit looks like coffee grounds, you're constipated, you have a high temperature or feel hot, cold or shivery, or you've suddenly become confused. Call 999 or go to A&E for a femoral hernia (a small lump at the top of your thigh, in your groin) with very bad tummy pain, sickness, being unable to fart or poo, a high temperature or sudden confusion.
The NHS lists lifting heavy weights among the causes of a femoral hernia. After an inguinal hernia repair, avoid heavy lifting or strenuous activity for at least 4 to 6 weeks.
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Before you start
Speak to your GP first if you haven't exercised for some time or have medical conditions or concerns, as the NHS advises. Get advice before hard or straining work if your blood pressure is uncontrolled (140/90 or higher at a clinic, or 135/85 at home), or you have heart disease or chest pain when you're active, a pacemaker or defibrillator, diabetic eye disease, glaucoma, a hernia, recent eye or tummy surgery, or you're pregnant, as our breathing guide lists.
With controlled high blood pressure, the American Heart Association considers low- to moderate-intensity strength training with proper breathing safe: breathe out as you lift.
With a pacemaker or defibrillator, the American Heart Association asks you to check with your doctor before upper-body strength training, because repeated arm movements can damage or dislodge the leads.
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