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 10
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.
Sources 27, 28, 29, 30, 31, 32
Other chest pain
Pain behind the breastbone during dips isn't normal: stop dips while it hurts. Contact NHS 111 (in the US, urgent care) for chest pain to rule out other causes, even if you think it's costochondritis.
Source 33
Your shoulder
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, severe pain in both shoulders, or feeling feverish or unwell. 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.
Call 999 or go to A&E: after a fall or injury, your shoulder looks out of place or has changed shape, you cannot move your arm, or your shoulder is painful, bruised or swollen. Do not drive yourself, and do not try to put it back in yourself.
Sources 34, 35
A pop in the chest or arm
Same day (NHS 111 or an urgent treatment centre): a pop or tearing at the front of the armpit or chest during a lift, a dip or a tackle, followed by bruising into the chest or upper arm, a change in the shape of the chest or armpit (a thinner or lost armpit fold, or a chest or nipple that looks uneven), or weakness pushing. Don't wait for it to settle: it can be a torn pec tendon. In the US, go to urgent care.
A snap at the back of the elbow with sudden pain and weakness straightening the arm needs an urgent treatment centre or A&E.
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 29
Muscles 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 36
A 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.
The NHS lists lifting heavy weights among the causes of a femoral hernia. After an inguinal hernia repair, avoid heavy lifting or strenuous activity for at least 4 to 6 weeks.
Sources 37, 38, 39
After surgery or a dislocation
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.
After breast cancer surgery or reconstruction, follow your surgical team's advice on when you can lift your arm above shoulder height, or push, pull or lift with it.
After a recent shoulder dislocation, or shoulder or elbow surgery, follow your surgical team's limits first.
Pregnancy
Dips you already do can carry on while they're comfortable, as our dips guide says; the NHS advises starting any new exercise gently in pregnancy. The seated machine keeps the platform and frame away from your bump (our suggestion).
Source 40
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.
With controlled high blood pressure, the American Heart Association considers low- to moderate-intensity strength training with proper breathing safe. Breathe out as you lift, as our breathing guide advises.
With a pacemaker or defibrillator, the American Heart Association asks you to check with your doctor before upper-body strength training, because repeated arm movements can damage or dislodge the leads.
Sources 41, 42, 10
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 43