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. The American Heart Association says these need immediate medical evaluation.
Source 41
Call 999 (911 in the US)
For chest pain that feels tight, heavy or squeezing, or spreads to your arms, neck, jaw or back; a sudden, extremely painful headache, especially while straining; someone who faints while exercising; or palpitations that don't go away, or come with chest pain, breathlessness or feeling faint. Don't drive yourself to A&E.
Call 999 too if you have pain or swelling in a leg and you're also breathless or have chest pain: it could be a clot that has reached your lungs.
Sources 42, 43, 44, 45, 46, 47, 48
Same day: a snap at the back of the heel or calf
A sudden snap, pop or grinding at the back of the heel or calf, often feeling as if you've been hit or kicked there, then not being able to push off, walk on tiptoe or climb stairs, with swelling and bruising: it can be a ruptured Achilles tendon or a broken heel bone. Contact NHS 111 or go to A&E or a minor injuries unit. In the US, go to urgent care or the emergency department.
Sources 49, 50
Ask for an urgent GP appointment or get help from NHS 111
For throbbing pain in one leg, usually the calf or thigh, with swelling, red, blue or darkened skin or swollen veins: it can be a deep vein thrombosis (DVT). It's more likely after surgery, bed rest or a long journey, in pregnancy or soon after a birth. In the US, contact your doctor or urgent care.
Source 48
See a GP
For cramps that disturb your sleep, last longer than 10 minutes or come with numbness or swelling; heel pain that hasn't improved after 2 weeks of looking after it, or comes with tingling or diabetes; or calf pain that comes on walking and eases with rest.
Sources 51, 49
Your back
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.
See a GP if pain spreading down a leg hasn't improved after a few weeks of home treatment, is getting worse or stops your normal activities. Sciatica on both sides, or weakness or numbness in both legs that's severe or getting worse, is a 999 call or a trip to A&E.
Sources 52, 53
A headache with effort
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.
Source 44
Calves far sorer than the session explains
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.
Source 54
The machine
On the leg press, keep the balls of your feet firmly on the platform and set the stops; on the Smith machine, set the safety stops just below your lowest point; on the standing machine, rest the weight before you step out. With numb feet, check them for marks afterwards, as our calf raise guide advises.
Before you start
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 hard or straining work if your blood pressure is uncontrolled (140/90 or higher at a clinic, or 135/85 at home), 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.
Sources 55, 56
Sore, or hurt?
Muscle soreness for a day or two after a new or harder session is common and fades. Sharp pain, or pain that builds during a set or lingers into the next day, isn't: swap to an easier version, and see a clinician if it persists, as our plans advise. The NHS says to stop exercising straight away if you feel any pain or become unwell, and to get help from 111 if symptoms worry you or don't go away.
Source 57