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.
Sources 43, 44, 45, 46, 47, 48, 49, 50
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.
Source 49
A pop in the chest or armpit
Same day (NHS 111 or an urgent treatment centre): a pop or tearing at the front of the armpit or chest during a lift, a dip or a tackle, followed by bruising into the chest or upper arm, a change in the shape of the chest or armpit (a thinner or lost armpit fold, or a chest or nipple that looks uneven), or weakness pushing. Don't wait for it to settle: it can be a torn pec tendon. In the US, go to urgent care.
Sources 51, 40
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.
Sources 52, 53
A dumbbell dropped on you
Call 999 or go to A&E if you heard a crack, the injured foot or hand has changed shape or points at an odd angle, it's numb, tingling or has pins and needles, or the skin has changed colour or is cold to touch, as the NHS sprains and strains page lists. A headache after a blow to the head in the last 3 months is also a 999 or A&E matter, as the NHS headaches page lists. Don't drive yourself.
Sources 54, 49
A pulled muscle
Get help from NHS 111, or go to an urgent treatment centre (in the US, urgent care), if it's very painful or the pain is getting worse, there's a large amount of swelling or bruising or it's getting worse, it feels very stiff or is difficult to move, it's not feeling any better after treating it yourself, or you also have a very high temperature or feel hot, cold or shivery.
Source 54
Contact NHS 111 for a wrist injury
For severe wrist pain; feeling faint, dizzy or sick from the pain; a snap, grinding or popping noise at the time of the injury; being unable to move your wrist or hold things; a wrist that has changed shape or colour; a very painful, hot or red lump; or lost feeling in your hand. In the US, use urgent care.
Source 55
A hernia
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.
Sources 56, 57
Pregnancy
The NHS says to avoid lying flat on your back for more than a few minutes in later pregnancy, and not to start new vigorous activity. After the first trimester, our incline bench press guide suggests swapping a flat press for an incline or standing press, at moderate weights.
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After heart, lung or breast surgery
After heart surgery through the breastbone, or a heart or lung transplant, follow your surgeon's advice before pushing, pulling or lifting with your arms.
After breast cancer surgery or reconstruction, follow your surgical team's advice on when you can lift your arm above shoulder height, or push, pull or lift with it.
After a recent shoulder dislocation, or shoulder or elbow surgery, follow your surgical team's limits first.
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 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.
Sources 59, 60, 37
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.
Source 61