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 36
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 37, 38, 39, 40, 41, 42, 43, 44
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 43
Go to an urgent treatment centre or A&E
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.
Also for severe arm pain that makes it hard to move your arm, a snap with your arm changing shape, or an arm that tingles or feels numb after an injury.
Source 39
Get help from NHS 111
If your arm hurts when you exercise but the pain goes away when you rest, if you think you've torn a tendon, or for severe wrist pain, a snap, grinding or popping, or lost feeling in your hand. In the US, your doctor or urgent care.
Sources 45, 39, 46
See a GP
If elbow or arm pain hasn't gone after a few weeks, or tennis elbow hasn't improved after 2 weeks of rest and self-care.
Sources 39, 33
Swollen muscles and dark urine
Very sore, swollen, tight muscles and dark urine after an unusually hard or high-rep session need medical help the same day: it could be rhabdomyolysis, as our elbow pain from pull-ups guide explains. Normal soreness peaks a day or two after a new exercise and fades.
A new lump or bulge in your groin or tummy
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 47, 48, 49
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.
After a recent shoulder dislocation, or shoulder or elbow surgery, follow your surgical team's limits first.
Sources 50, 51, 36