A snap at the back of the heel or calf
A sudden snap or pop at the back of the heel or calf, or a feeling of being kicked there, then walking flat-footed and being unable to push off, stand on tiptoe or climb stairs. It could be an Achilles tendon rupture or a broken heel bone: go to A&E or a minor injuries unit, or contact NHS 111, the same day, as our Achilles rupture guide explains. In the US, go to urgent care or the emergency department.
A suspected rupture that was never examined, or a weak push-off weeks after what seemed to be a sprain or calf strain: ask for an assessment. A rupture found late may need different treatment.
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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.
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Sudden, severe calf pain, or a cold, pale leg
Call 999 or go to A&E: sudden, severe pain in a muscle, which may be worse when you stretch it, with swelling, numbness, weakness or pins and needles, or tightness or difficulty moving the leg. This can be acute compartment syndrome, which needs surgery as soon as possible. It usually follows an injury or a bandage or cast that is too tight, but rarely it can follow very hard exercise. Do not drive yourself to A&E.
Call 999 or go to A&E: a leg that is suddenly cold, pale, numb, weak or very painful. A sudden loss of blood supply to a leg is a vascular emergency.
A calf strain
A sudden sharp pain in the calf as you push off can be a strain. Stop, and see our calf pain guide.
Calf pain on walking that eases with rest
Calf pain that comes on with walking and eases when you rest needs a GP check; our calf pain when walking guide explains why.
Pain that comes on when you walk a set distance and goes after a few minutes' rest, especially if you smoke or have diabetes. Exercise treats it well, but it needs a diagnosis first.
Cramps that need a GP
Cramps that disturb your sleep, last longer than 10 minutes, or come with numbness or swelling.
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Achilles pain that keeps getting worse
Pain that is getting worse week on week despite cutting back, or is stopping your normal activities.
Pain in one spot on a bone
Pain in one spot on a bone that's worse with jumping or running, eases with rest and hurts when you press it: stop jumping, as it can be a stress fracture, and see a GP. See a GP too for heel pain that hasn't improved after 2 weeks of looking after it yourself, or shin pain that's getting worse or isn't improving.
After unusually hard training
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.
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.
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 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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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.
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