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; 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.
Call 999: arm pain that comes on suddenly with pressure, heaviness, tightness or squeezing across your chest, especially with shortness of breath, sweating or feeling sick. It could be a heart attack.
Sources 40, 41, 42, 43, 44
Arm pain that comes on with exercise
Same day (NHS 111): your arm hurts when you exercise, but the pain goes away when you rest.
Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem. If you've been diagnosed with angina, get help from NHS 111 too if it feels worse than before, is happening more often, lasts longer or happens when you're resting.
Source 41
A weak or numb arm with a drooping face
Call 999, even if it passes: sudden weakness or numbness in one arm, with a drooping face or slurred speech. These are signs of a stroke.
Ask for an urgent GP appointment or call NHS 111
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. In the US, contact your doctor or urgent care.
Source 45
A clot in the arm (our suggestion)
Our suggestion, from the NHS DVT page, which says DVT symptoms "can sometimes happen in your arm if that's where the blood clot is": for throbbing pain or swelling in one arm, red, blue or darkened skin around the painful area, or swollen veins, ask for an urgent GP appointment or get help from NHS 111, and call 999 or go to A&E if you also feel short of breath or have chest pain, as the NHS advises for DVT.
Source 46
A clot in the leg
Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. It could be a blood clot (deep vein thrombosis, DVT), which is more likely while you're moving about much less than usual or after a hospital stay.
Also call 999 for pain and swelling in one leg with breathlessness or chest pain: it can be a blood clot that has reached the lungs.
Source 46
A pop at the elbow
A sudden pop or snap with pain at the front of the elbow during a lift, then bruising, a bulge in your upper arm and weakness turning your palm up, can be a torn biceps tendon. Don't wait for it to settle: go to an urgent treatment centre or A&E, as our elbow pain guide explains, because a torn tendon is best repaired within the first 2 to 3 weeks. A sudden pop with weakness straightening your arm can be a torn triceps tendon and needs the same. In the US, go to urgent care or the emergency department.
Urgent treatment centre or A&E: a pop or snap at the back of the elbow during a push, a press or a dip, or after a fall onto an outstretched hand, then sudden pain and swelling, bruising at the back of the elbow or forearm, a gap above the point of the elbow, or weakness straightening the arm, especially overhead. Don't wait to see if it settles: a full tear in an active person is usually repaired, and expert guidance favours repairing it early.
A pop at the front of the armpit or chest
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.
After big or unusual sessions
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.
A hot, swollen elbow
Same day (urgent GP appointment or NHS 111): a swollen elbow with a very high temperature, or you feel hot, cold or shivery; or severe pain in one joint that started suddenly, swelling around a joint, the skin around a joint has changed colour, or difficulty moving a joint. It could be an infection in the joint or the bursa, or gout.
Shoulder symptoms
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.
During any session
Stop straight away if you feel any pain or become unwell, the NHS says, and contact 111 if your symptoms worry you or don't go away.
A dull ache in your muscles for a day or two after something new is normal. Joint pain that's sharp, gets worse during a set or lingers into the next day means switching to the easier option, and seeing a GP or physiotherapist if it carries on (our plans' rule). Our muscle soreness guide has more.
Source 47
See a GP
See a GP if:
- your arms or legs are out of proportion with the rest of your body, feel painful, tender or heavy, and bruise easily: it could be lipoedema
- you have swelling in all or part of an arm that doesn't go away: it could be lymphoedema
Source 48
Arm pain that won't settle
Elbow or arm pain that hasn't gone after a few weeks of looking after it yourself (for tennis elbow, the NHS says after at least 2 weeks of self-care). In many areas you can refer yourself to NHS physiotherapy.
After big weight loss
See your GP or surgical team if skin folds are sore, red or broken, or keep getting infected.
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.
Sources 49, 50
When exercise becomes harmful
The NHS lists exercising too much and spending a lot of time worrying about your weight and body shape among the signs of an eating disorder, and says to see a GP as soon as you can. Beat adds rigid or punishing exercise, exercising to make up for eating, and feeling guilty or anxious when you can't exercise. Beat's helpline in England is 0808 801 0677.
Sources 51, 52
Check first
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.
Speak to a GP first if you haven't exercised for some time, or if you have a medical condition or concerns. Get advice first, too, if you have a health problem, an injury or symptoms, have recently had a heart attack or an operation, or are pregnant or have recently given birth.
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