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 39, 40
Pain decides, not form
Stiff, achy legs for a day or two are normal at first and ease as you repeat the runs. Stop and rest if a pain is sharp, makes you limp or change how you run, or builds as you go, and skip your next run if it's worse the next morning. The NHS advises not running when you're in pain, and seeing a GP or physiotherapist if it doesn't go away; a very painful or swollen knee, or a sudden sharp pain at the back of the ankle, needs a GP straight away.
Source 41
Pain that comes on at the same point in every run
Tightness in the shin or calf, with tingling on the top of the foot or a foot that slaps down, that comes on at the same point in every run and eases within minutes of stopping: see a GP or sports physiotherapist. It can be exertional compartment syndrome.
A bone that hurts in one spot
Pain in one spot on the shin or a foot bone that you can point to with a fingertip, worse with impact and later present at rest or at night: a possible stress fracture. Stop running and jumping until it has been checked.
Back pain, and pain spreading down a leg
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.
Pain, tingling or numbness spreading below the knee that isn't settling after a few weeks, is getting worse or stops your normal activities: see a GP.
New pain after a change
If a new aching starts in your calf, Achilles, shin or foot after you change how you land or step, go back to your old running for a week or two and build the change in more slowly. Pain that doesn't settle needs its pain guide (our suggestion).
Sources 11, 13
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.
Check 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.
Answer the 7 questions of the Physical Activity Readiness Questionnaire (PAR-Q+) before you start. A yes to any (a heart condition or high blood pressure, chest pain, dizziness or fainting, another long-term condition or its medicines, a bone or joint problem, or being told to exercise only under medical supervision) means checking with your doctor or a qualified exercise professional first. It also asks people over 45 who aren't used to hard, all-out effort to check before exercising that hard: think races and time trials, not easy runs. The NHS suggests speaking to a GP first if you're worried about your health.
Source 42
A heart condition
If you have a heart condition, follow your cardiac team's advice on how hard to work, and stop for the warning signs above. People with long-term conditions may wish to ask their specialist before starting. With uncontrolled high blood pressure, avoid straining against a held breath; the high blood pressure guide has more.