Leave it out
With osteoporosis or a past spinal fracture: choose a dead bug, bird dog or plank, because the UK consensus advises modifying or avoiding repeated or end-range forward bending. In pregnancy after the first trimester, when the NHS advises against lying flat on your back for more than a few minutes. In the first weeks after a birth, when the NHS advises avoiding sit-ups and planks to start with, and whenever the middle of your tummy domes (bulges into a ridge). After tummy or bowel surgery or with a stoma, while your tummy heals, as our move page says.
Sources 8, 9, 10
Ask first
With a hernia, uncontrolled high blood pressure, glaucoma or diabetic eye disease, choose gentler core work or get advice first, and never hold your breath in the hold, as our breathing guide advises.
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.
Source 18
Call 999 (911 in the US)
For chest pain that feels tight, heavy or squeezing, or spreads to your arms, neck, jaw or back; a headache that starts suddenly and is extremely painful, especially while straining; someone who faints while exercising; palpitations that don't go away, or come with chest pain, breathlessness or feeling faint; severe difficulty breathing; or angina pain that doesn't stop after rest and your medicine. Don't drive yourself to A&E.
Sources 19, 20, 21, 22, 23, 24, 25, 26
A headache brought on by straining
A headache triggered or made worse by coughing, sneezing, bending down or exercising needs an urgent GP appointment or NHS 111 (in the US, your doctor or urgent care), as our dragon flag guide says.
Source 21
Check before hard straining work
If you haven't exercised for some time or have a medical condition, speak to your GP first, as the NHS advises. Get advice before hard straining work if your blood pressure is uncontrolled, 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.
Source 27
After a faint, or dizziness that keeps coming back
See a GP after any faint, and for dizziness that won't go away or keeps coming back.
Sources 23, 28
Your neck
Get a same-day GP appointment or contact NHS 111 for severe neck pain that starts suddenly or gets worse quickly, heaviness or weakness in your arms or legs, or pins and needles in an arm with neck or arm pain, as our neck pain guide says.
Source 16
Call 999 or go to A&E: back pain with these signs
Loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
Sources 15, 29
Back pain that needs a GP or NHS 111
Ask for an urgent GP appointment or contact NHS 111 (in the US, urgent care) with a high temperature, if you feel hot, cold, shivery or generally unwell, or if severe pain starts suddenly or gets worse quickly. See a GP for back pain that doesn't improve after a few weeks of treating it at home, stops your day-to-day activities, is worse at night or after resting, or comes with weight loss you can't explain or a lump or change in the shape of your back.
Source 15
A new lump or bulge
See a GP if you think you have a hernia: a bulge or lump in your groin, upper thigh or tummy that may get bigger when you cough, sneeze or cry 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, sickness, constipation, a high temperature or sudden confusion. Call 999 or go to A&E for a femoral hernia (a lump at the top of the thigh) with very bad tummy pain, sickness, being unable to fart or poo, a high temperature or sudden confusion.
Sources 30, 31