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.
Source 36
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.
Sources 37, 38, 39, 40, 41, 42
Suddenly more breathless than usual
Call NHS 111 (in the US, your doctor or an urgent care centre) if you're suddenly more short of breath than usual, or have chest pain with feeling sick or a heartbeat that races, skips or flutters.
Sources 39, 41
A headache brought on by exercise
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.
Source 43
During a 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.
Source 36
Back pain: call 999 or go to A&E
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.
Source 44
Back pain: the same day
Same day (GP or NHS 111): back pain and you feel hot, cold, shivery or generally unwell, or severe pain that starts suddenly or is getting worse quickly.
Source 44
Pain spreading down a leg
Call 999 or go to A&E: leg pain with numbness around the genitals or bottom, new trouble starting or controlling peeing, not knowing when you need to poo or losing control of it, sciatica in both legs, or weakness or numbness in both legs that is severe or getting worse. These can be signs of cauda equina syndrome, which needs treating in hospital as soon as possible.
Pain, tingling or numbness spreading below the knee that isn't settling after a few weeks, is getting worse or stops your normal activities: see a GP.
Source 45
Exercising with back pain
Some discomfort during exercise is fine, and it does not mean you are doing damage. Aim for pain you would call mild to moderate, no more than about 5 out of 10. It should settle within an hour or so, and your back should be no worse the next morning. If it is worse, do less next time (fewer reps, a smaller range, a lighter load), not nothing.
New back pain if you're at risk of a spinal fracture
Sudden new back pain after a minor fall, lift, cough or sneeze, from 50 or past the menopause, or if you take long-term steroid tablets; or height loss, a curved spine or a change in posture: see a GP. It can be a spinal fracture.
Unexplained back pain with muscle spasms, loss of height, or a curved spine or change in posture: a possible osteoporotic spinal fracture, more likely with older age or long-term steroid tablets.
Pain in one spot on a bone
Pain in one spot on the shin or a foot bone that you can point to with a fingertip, worse with impact and later present at rest or at night: a possible stress fracture. Stop running and jumping until it has been checked.
One spot on a foot bone that hurts with every step and later at night: a possible stress fracture.
Go to A&E: severe pain after an injury, which can mean a broken bone, or you cannot put any weight on the leg. A stress fracture can become a complete break if you keep loading it.
Your knee
Go to A&E (accident and emergency) if you've injured your knee and it has changed shape, it becomes very swollen very quickly, you felt a pop or snap, you can see bone sticking out, or it's bleeding heavily. Don't drive yourself: ask someone to take you, or call 999 if the pain means you can't move your leg to get there.
Get advice from NHS 111 now: you cannot move the knee or put any weight on it, or it is very painful, badly swollen or has changed shape.
You hurt your knee and cannot take 4 steps, or you are 55 or over and have injured it: get it checked the same day for a broken bone.
Get advice from NHS 111 now: the knee locks, gives way or clicks painfully. Painless clicking is normal.
See a GP: If knee pain doesn't improve within a few weeks.
Source 46
Call 999 (911 in the US) after a fall
- After a fall: a possible injury to your head, neck, back or hip, or you cannot get up.
- Call 999 or go to A&E: severe hip pain after a fall or injury, or you cannot stand, walk or put weight on the leg. In an older adult this can be a broken hip; the leg may be at an odd angle or look shorter. Don't drive yourself.
Source 47
See your GP soon (or NHS 111 if you're worried)
- A fall, or a broken bone from a fall; or two or more falls in a year.
Source 47
A lump in the groin
A lump in the groin, or groin pain with coughing or straining (a possible hernia).
Get help from NHS 111 if you have a hernia (a lump in the groin or tummy) and pain in or around it, a bloated tummy, you feel sick or are being 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 now if you have a femoral hernia (a small lump at the top of the thigh, in the groin) and very bad tummy pain, you feel sick or are being sick, you cannot fart or poo, you have a high temperature or feel hot, cold or shivery, or you've suddenly become confused. It may be strangulated, which is an emergency. Don't drive yourself.
Sources 48, 49
Tingling or weakness in an arm
Our suggestion, from the military reviews, which list "rucksack palsy" and nerve injuries among load-carriage injuries: numbness, tingling or weakness in an arm or hand while carrying a pack means taking the pack off, loosening the shoulder straps and using the hip belt. If it hasn't gone by the next day, or you can't grip, see a GP.
With a vest, our suggestion is the same: loosen the shoulder straps or take weight out, and see a GP if it hasn't gone by the next day.
Heat
Heat exhaustion brings tiredness, dizziness, a headache, feeling or being sick, heavy sweating with pale, clammy skin, cramps, a high temperature and intense thirst. Move to a cool place, drink and cool your skin: you should start to feel better within 30 minutes. To prevent it, the NHS advises more cold drinks, especially when you're active, light, loose clothing, avoiding the sun between 11am and 3pm, and avoiding extreme exercise.
The NHS says to call 999 for signs of heatstroke: still being unwell after 30 minutes of resting somewhere cool, being cooled and drinking; a very high temperature; hot skin that isn't sweating; a fast heartbeat; fast breathing or breathlessness; confusion and lack of coordination; a seizure; or loss of consciousness.
A vest traps heat against your chest and back: on hot days, walk early or late, carry water and take the vest off (our suggestion).
Numb feet
With numb feet from diabetes or another cause, choose low-impact options, wear well-fitting shoes, and check your feet for redness or blisters afterwards; with an open sore or ulcer, do no weight-bearing exercise until your foot team says so.