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.
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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.
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A pop, or a knee that changes shape
Go to A&E if you've injured your knee and it has changed shape, it becomes very swollen very quickly, you felt a pop or snap, you can see bone sticking out, or it's bleeding heavily. Don't drive yourself: ask someone to take you, or call 999 if the pain means you can't move your leg to get there.
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Get help the same day for your knee (NHS 111; in the US, urgent care)
If your knee is very painful, you can't move it or put any weight on it, it's badly swollen or has changed shape, it locks, gives way or clicks painfully (painless clicking is normal), or you have a very high temperature with redness or heat around the knee. See a GP if knee pain doesn't improve within a few weeks.
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A turned ankle or a bad landing
Call 999 or go to A&E if you heard a crack, the injured part has changed shape or points at an odd angle, it's numb, tingling or has pins and needles, or the skin has changed colour or is cold to touch, as the NHS sprains and strains page lists.
Get help from NHS 111, or go to an urgent treatment centre (in the US, urgent care), if it's very painful or the pain is getting worse, there's a large amount of swelling or bruising or it's getting worse, you cannot put any weight on it or walk more than a few steps, it feels very stiff or is difficult to move, it's not feeling any better after treating it yourself, or you also have a very high temperature or feel hot, cold or shivery.
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Achilles, shins and one sore spot on a bone
A sudden snap or pop at the back of the ankle, or not being able to stand on tiptoe, is a same-day NHS 111 call: it can be a torn Achilles tendon. Get help from NHS 111 for severe shin pain or shin pain after an injury, and see a GP if shin splints are getting worse. Pain in one spot on a bone that's worse with jumping and hurts when you press it can be a stress fracture: stop jumping and see a GP, as our jumping jack guide says.
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Swollen, very sore legs and dark urine
Same day (call NHS 111, or go to A&E if you feel very unwell): after a big or unusual session, such as a first spin class, a workout of 100 back squats, or intervals of wall sits, squats, lunges and jumps, 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.
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.
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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.
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Children
Call 999 or go to A&E if your child gets sudden pain in their hip, knee or thigh (hip problems can sometimes be felt in the thigh or knee) or cannot put any weight on their leg. If your child is limping, ask for an urgent GP appointment or get help from NHS 111 the same day. This applies to teenagers too, and in some children knee pain is the only sign.
A child or teenager with pain at a bump just below the kneecap or at its lower tip, worse with squats, jumps and kneeling: see our Osgood-Schlatter and Sinding-Larsen-Johansson guides, and get it checked if it is getting worse.
Diabetic eye disease, numb feet and osteonecrosis
With proliferative or severe non-proliferative diabetic retinopathy, avoid jumping and jarring. With numb feet, choose low-impact options, wear well-fitting shoes and check your feet afterwards. With osteonecrosis (avascular necrosis) of the hip or knee, ask your specialist before impact exercise, as our jump squat guide 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.
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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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