Big sessions and muscle injury
Big, unaccustomed push-up sessions have been followed by serious muscle injury. A fit 36-year-old developed rhabdomyolysis, a breakdown of muscle that can harm the kidneys, in both triceps after a boot-camp session with a lot of push-ups, and a 34-year-old needed surgery for compartment syndrome in both arms after a push-up contest. Both are rare, and case reports can't say how often they happen.
Dark, red or cola-coloured urine, much less urine than usual, or very painful, swollen, weak arms in the days after a session: get medical help the same day. Call 999 (911 in the US) for sudden, severe pain in any part of your body, or for chest pain that doesn't go away, spreads to your arms, neck, jaw, stomach or back, or comes with sweating, feeling sick, light-headedness or breathlessness.
Get help the same day
Call NHS 111 (in the US, your doctor or urgent care) for severe muscle pain and weakness with dark (cola-coloured) or reduced urine after unusually hard training. This can be rhabdomyolysis, which can harm the kidneys and needs prompt care.
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.
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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.
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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.
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A pop in the chest or armpit while pressing
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.
Contact NHS 111 for a wrist injury
For severe wrist pain; feeling faint, dizzy or sick from the pain; a snap, grinding or popping noise at the time of the injury; being unable to move your wrist or hold things; a wrist that has changed shape or colour; a very painful, hot or red lump; or lost feeling in your hand. In the US, use urgent care.
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See a GP about your wrist
If wrist pain is no better after 2 weeks of home treatment, or comes with tingling, diabetes, or a hot, swollen, stiff wrist.
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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.
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Elbow pain
Our suggestion, from the NHS elbow and arm pain page: see a GP if elbow or arm pain doesn't go away after a few weeks; go to an urgent treatment centre or A&E if your arm tingles or feels numb, or after an injury with a snapping noise or a change in shape; and get help from NHS 111 if your arm hurts when you exercise but the pain goes away when you rest. Our elbow pain from push-ups guide has the detail.
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Heart failure
The British Heart Foundation advises avoiding exercises that use your whole body as the weight, such as press-ups and planks. Wall push-ups with steady breathing are gentler; ask your heart team.
Feet-raised push-ups and blood pressure
Raising your feet puts your head below your hips, as in a decline bench press: keep sets short, breathe out on each push and come up slowly, and while your blood pressure isn't under control, use a floor or incline push-up instead.
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.
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.
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