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 33
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 34, 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
The same day: a pop at the front of the knee
A pop or tearing feeling at the front of the knee, then you can't straighten it or lift the straight leg, there's a dent above or below the kneecap, or the kneecap sits higher or lower than the other: go to A&E or an urgent treatment centre, or get help from NHS 111. A torn quadriceps or patellar tendon does best repaired soon; our patellar tendon rupture guide explains.
Your knee
Get advice from NHS 111 if your knee is very painful, you can't move it or put weight on it, it's badly swollen or has changed shape, it locks, gives way or clicks painfully (painless clicking is normal), or it's hot and red and you have a high temperature. See a GP if knee pain doesn't improve within a few weeks.
Source 30
A pulled thigh muscle
A sudden sharp pain in the front of the thigh: stop. Get help from NHS 111 if it's very painful or getting worse, the swelling or bruising is large or growing, or you can't put weight on it or walk more than a few steps. Call 999 or go to A&E if you heard a crack, the leg has changed shape, or it's numb or tingling.
Sources 43, 32
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.
Sources 44, 10
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 45, 46, 47
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.
Sources 48, 49, 36, 33