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 29
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 35, 36, 37, 38, 39, 40, 41, 42
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 41
Go to an urgent treatment centre or A&E
If you have severe pain in your arm and it's difficult to move; you've injured your arm and heard a snap, or it has changed shape; or your arm tingles or feels numb. A pop at the front of the elbow with bruising and a bulge in the upper arm needs checking the same day. In the US, go to urgent care or the emergency department.
Sources 37, 11, 34
Get help from NHS 111
If your arm hurts when you exercise but the pain goes when you rest, or it's swollen and you have a very high temperature or feel hot, cold or shivery. In the US, contact your doctor or urgent care.
Source 37
See a GP
If elbow or arm pain hasn't gone after a few weeks.
Source 37
Swollen arms and dark urine
Very painful, swollen, tight arms and dark urine after an unusually hard or high-rep session, such as drop sets or a curl challenge, need medical help the same day: it could be rhabdomyolysis, as our elbow pain from pull-ups guide explains. Dark urine isn't always there, so arms far sorer, more swollen or weaker than the session explains still need the same-day check.
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 43
See a GP for wrist pain
If wrist pain is no better after 2 weeks of home treatment, or comes with tingling, diabetes, or a hot, swollen, stiff wrist.
Some discomfort during these exercises is fine and doesn't mean you are doing damage. Keep it to about 5 out of 10 or less. It should settle within half an hour or so, and your hand should be no worse the next morning. If it is, do fewer, smaller or lighter next time, not nothing. That's our wrist pain guides' rule.
Source 43
Your back
Call 999 or go to A&E: 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.
See a GP if pain spreading down a leg hasn't improved after a few weeks of home treatment, is getting worse or stops your normal activities. Sciatica on both sides, or weakness or numbness in both legs that's severe or getting worse, is a 999 call or a trip to A&E.
Sources 44, 45
A cable or clip that fails
Check the cable, clips and pin before you start. A frayed cable or a clip that won't close means another station, as our cable machine guide says.
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 46, 29
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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