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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When it isn't ordinary soreness
After hard or unfamiliar exercise, these are not ordinary soreness. They can be signs of rhabdomyolysis, a breakdown of muscle that NHS clinical guidance describes as potentially life-threatening; its main danger is damage to the kidneys. Get urgent medical help if you have:
- Muscle cramps, severe pain or weakness, worse than you'd expect from the workout.
- Feeling so weak or tired that you can't finish a workout or everyday tasks you could do before.
- Red or brown pee, or dark pee that looks like tea or cola.
- A high temperature as well as the muscle pain.
- Peeing a lot less than usual, feeling very thirsty, being sick, or feeling confused or sleepy.
Why it happens
NHS clinical guidance links it to exercise that is unaccustomed (too much, too fast, too hard or too soon) or done when fasting, dehydrated or ill. Symptoms may not start until hours or days after the exercise, so don't ignore them. If you take a statin such as atorvastatin, the NHS says to call 111 if you think you might be having serious side effects, which include muscle cramps, severe pain and weakness.
Call 999 or go to A&E
- Sudden, severe pain in any part of your body.
- Pain and swelling in one leg (a possible blood clot) with shortness of breath or chest pain.
A possible clot, and rolling
Throbbing pain in one calf or thigh, with swelling and red, blue or darkened skin around it (a possible blood clot): the NHS says to ask for an urgent GP appointment or contact NHS 111. Don't roll it.
Never roll a calf that is swollen, red or darkened, or throbbing.
Don't roll over bruises, varicose veins, open wounds, recent surgery or a bone injury, and keep the pressure light if you bruise easily or take blood thinners.
A sudden pop during a lift is an injury, not slow recovery
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.
Soreness that lasts
Soreness that isn't better after a week, keeps coming back after normal sessions, or is in one spot (our suggestion).
Tiredness that rest doesn't fix
- Tiredness or falling performance that lasts for weeks despite rest, especially with low mood or poor sleep: other causes, such as anaemia, a thyroid problem or an infection, need ruling out.
- Sleep problems that have lasted months, or that changing your sleep habits hasn't helped.
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Eating too little
Training hard on too little food harms health and performance in women and men; experts call this relative energy deficiency in sport (REDs). If you're worried about your energy, your periods or repeated injuries, see a doctor.
When you're ill
Reduce or stop training when you have an infection, and allow time to recover. Avoid hard exercise if you have vomiting or diarrhoea, then ease back in with lighter sessions.
Cold water
Get into cold water slowly, never alone in open water, and leave cold baths out if you have a heart condition or high blood pressure unless your doctor agrees: sudden cold water makes you gasp and breathe fast, and cold water immersion has been linked with cardiac arrest and drowning (our suggestion).
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Painkillers
If a doctor has prescribed you an anti-inflammatory, keep taking it as prescribed, and ask your doctor or pharmacist before changing it (our suggestion).
If you feel faint after a hard effort
Lie down with your legs raised, or sit with your head lowered between your knees, and drink some water. Crossing your legs while standing, rocking up and down on your toes or clenching your fists can help. Call 999 if someone faints while exercising.
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.
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.
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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.