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.
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; severe difficulty breathing; 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, or comes with numbness or weakness, difficulty speaking or loss of vision. The NHS says a bleed on the brain may be more likely when lifting something heavy. Don't drive yourself to A&E.
Sources 26, 27, 28, 29
Shoulder pain
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, or severe pain in both shoulders. 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.
Source 30
Keep pain in check
Pain during raises or presses should stay at about 5 out of 10 or less and settle by your next session, as our lateral raise guide says. If your shoulder is already sore, our bench press shoulder pain guide uses 4 out of 10, and the lower limit applies. See a GP if shoulder pain isn't improving after 2 weeks.
Source 30
A pop in the chest or at the elbow
A pop or tearing at the front of the armpit or chest during a lift, followed by bruising into the chest or upper arm, a change in the shape of the chest or armpit, or weakness pushing, can be a torn chest tendon. Don't wait for it to settle: get help the same day from NHS 111 or an urgent treatment centre, as our pec strain guide explains.
A sudden pop at the front of the elbow during a heavy pull, 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 or the emergency department), and don't wait for it to settle: repair is best done within the first 2 to 3 weeks.
Very sore after slow negatives
New pull-up sets, especially slow negatives, can leave you very sore. Muscle pain far worse than the session explains, with dark, red or cola-coloured urine, needs medical help the same day, as our rhabdomyolysis guide explains. Dark urine isn't always there, so muscles far sorer, more swollen or weaker than the session explains still need the same-day check.
Back pain that needs 999 or A&E
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.
Source 31
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 heavy lifting or hard straining work if your blood pressure is uncontrolled, 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. After a recent shoulder dislocation or shoulder surgery, follow our shoulder dislocation guide or your surgical team first.
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.
Wanting to be bigger
Beat says a drive to be more muscular, sometimes called muscle dysmorphia, can be part of an eating disorder, especially in men. The NHS lists exercising too much and very strict routines around food among the signs of an eating disorder, and says people with body dysmorphic disorder may take anabolic steroids because they don't see themselves as big or strong enough. See a GP; our eating disorders guide has Beat's helplines.
Sources 32, 33, 34, 35
When eating, training or your body becomes a worry
The NHS lists spending a lot of time worrying about your weight and body shape, eating very little food, exercising too much, and having very strict routines around food among the signs of an eating disorder, and says to see a GP as soon as you can. Worrying a lot about one area of your body can be body dysmorphic disorder. Beat's helpline in England is 0808 801 0677, and our eating disorders guide has the other numbers.
Sources 34, 33, 36