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 52
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.
Sources 53, 54, 55, 56, 57, 58
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 55
Muscles far sorer than the session explains
Same day (call NHS 111, or go to A&E if you feel very unwell): after a big or unusual session, such as hundreds of pull-ups, push-ups, dips or curls, a challenge or a new class, muscle pain, swelling or weakness far worse than the session explains, and dark pee (red, brown, tea or cola coloured), sometimes starting hours or days later. Dark pee isn't always there, so muscles far sorer, more swollen or weaker than the session explains still need the same-day check. It can be rhabdomyolysis, a breakdown of muscle that can harm the kidneys.
Start with 2 or 3 sets of 3, and skip the "100 pull-ups" challenges while you're new.
Sources 12, 43, 44
Your shoulder
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.
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.
Call 999 or go to A&E: after a fall or injury, your shoulder looks out of place or has changed shape, you cannot move your arm, or your shoulder is painful, bruised or swollen. Do not drive yourself, and do not try to put it back in yourself.
Your shoulder has partly or fully come out of joint, or you worry it might, including a clunk, a dead arm or a feeling it will slip when you hang from the bar or at the bottom of a pull-up. Get it checked by a GP or physiotherapist soon (our suggestion).
Sources 59, 60, 61
Your elbow
Keep elbow discomfort to about 3 to 4 out of 10, settled within an hour and no worse the next morning, as our pull-up challenge says. With pain at the front of the elbow, use an overhand or neutral grip and leave chin-up negatives out.
A pop or snap with sudden pain at the front of the elbow, especially with bruising, a gap at the front of the elbow or a bulge in the upper arm, can be a torn biceps tendon. Go to an urgent treatment centre or A&E (in the US, urgent care) the same day, and don't wait for it to settle, as our biceps guides say.
A snap at the back of the elbow with sudden pain and weakness straightening the arm needs an urgent treatment centre or A&E.
Source 62
A pop at the shoulder, or sudden weakness
Same day (GP or NHS 111): a sudden pop or snap with pain at the shoulder or upper arm during a lift, with or without a bulge low in the upper arm. It's usually a torn long head of the biceps. Most need no operation, but the rotator cuff can tear at the same time.
Same day (GP or NHS 111): sudden weakness lifting the arm after an injury or fall. A rotator cuff tear caused by an injury needs urgent referral to a shoulder specialist. After a dislocation in anyone over 40, the rotator cuff should be checked: about 40% have a tear.
Falls from the bar
Pull-up bar injuries in US emergency departments, mostly at home, were most often falls, so step down rather than drop. Test a doorway bar before you trust it.
Source 9
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.
The NHS lists lifting heavy weights among the causes of a femoral hernia. After an inguinal hernia repair, avoid heavy lifting or strenuous activity for at least 4 to 6 weeks.
Sources 63, 64, 65
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.
Pregnancy
The NHS says strength training at a gym is fine if you already do it, but it isn't the time to start new vigorous training. Hanging gets harder as your weight changes: machine-assisted chin-ups or rows are easy swaps, and stop if you feel uncomfortable or unwell, as our chin-up guide says.
Source 66
Muscular dystrophy
With muscular dystrophy, leave out exercises that focus on lowering a heavy load or hard landings unless your neuromuscular team advises them, as our move page's caution says.
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.
Sources 67, 68, 52
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 69