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 26
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 sudden, extremely painful headache, especially while straining; someone who faints while exercising; or palpitations that don't go away, or come with chest pain, breathlessness or feeling faint. Don't drive yourself to A&E.
Shoulder or arm pain with chest pain that feels tight or squeezing, especially with breathlessness, sweating or feeling sick, could be a heart attack, as our shoulder pain in lateral raises guide says: call 999.
Sources 27, 28, 29, 30, 31, 32
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 29
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 33, 34
Sudden weakness, or a pop in the upper arm
Sudden weakness lifting the arm after a jerking heavy rep or a fall, or a pop with a bulge low in the upper arm, needs checking the same day through a GP or NHS 111, as our shoulder pain in lateral raises guide explains.
Your neck
Pins and needles or a cold arm with neck pain, or neck pain that hasn't gone after a few weeks: see a GP.
Source 35
Muscles far sorer than the session explains
After a big or unusual session, such as drop sets or a raise challenge, muscle pain, swelling or weakness far worse than the session explains, with dark pee, needs the same-day check through NHS 111, or A&E if you feel very unwell: it can be rhabdomyolysis, as our shoulder pain in lateral raises guide explains.
After heart, lung or breast surgery, or a dislocation
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 36, 26
A cable or clip that fails
Check the cable, clips and pin before you start, and keep your face out of the cable's line. A frayed cable or a clip that won't close means another station.
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 37