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.
Arm pain that comes with pressure, heaviness or squeezing across your chest is a 999 call, not a rotator cuff problem.
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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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Your shoulder
Ask for an urgent GP appointment or get help from 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, no feeling in your arm or shoulder, an arm or shoulder that's hot or cold to touch, pain after an injury or a fall, severe pain in both shoulders, or feeling feverish or unwell. Go to A&E if, after an injury, you can't move your arm or your shoulder looks out of place or has changed shape. See a GP if shoulder pain is getting worse or hasn't improved after 2 weeks.
In the US, contact your doctor or urgent care. While your shoulder is sore, the NHS says not to make up your own strenuous exercises or use heavy gym equipment.
Keep shoulder pain to about 5 out of 10 or less during the exercise, back to its usual level by your next session, as our shoulder guides advise. A sharp pinch means lower, lighter or stop.
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Weakness after an injury
Sudden weakness lifting or turning your arm after a fall or a wrench needs prompt checking, as our external rotation guide says. See a GP promptly rather than trying to strengthen it.
An ache over the shoulder blade with weakness
Or a muscle that looks thinner: see a GP or physiotherapist, as our back of shoulder pain guide says, because a nerve can be involved.
Sore, or hurt?
Muscle soreness for a day or two after a new or harder session is common and fades. Sharp pain, or pain that builds during a set or lingers into the next day, isn't: swap to an easier version, and see a clinician if it persists, as our plans advise. The NHS says to stop exercising straight away if you feel any pain or become unwell, and to get help from 111 if symptoms worry you or don't go away.
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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, as our breathing guide advises.
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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