Chest pain or fainting: call 999
Call 999 if:
- You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
- The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
- You have chest pain and feel sweaty, sick, light-headed or short of breath.
- Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.
Sources 63, 64
Unusual breathlessness
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
Source 65
Sudden weakness or paralysis: call 999
Case reports describe dangerously low potassium paralysing bodybuilders: one after a large binge in the days after a competition, and one after taking a diuretic while restricting fluids. Sudden muscle weakness or paralysis, especially around a show, is a 999 call (our suggestion, from these cases).
Sources 54, 17, 55
Dark urine or very painful muscles
Dark, red or cola-coloured urine, much less urine than usual, or very painful, weak or swollen muscles in the days after a session or a binge need medical help the same day, as our rhabdomyolysis guide explains.
Source 54
Dehydration
Ask for an urgent GP appointment or call NHS 111 if you feel unusually tired, dizzy when you stand up and it doesn't go away, or have dark yellow pee. Call 999 for confusion, cold or blotchy skin, or fast breathing.
Source 66
Heat in a hot class or gym
Move to a cool place, take off unnecessary clothing, drink plenty of water or an isotonic sports drink, and cool the skin with cool water and a fan. You should start to cool down and feel better within 30 minutes. If you're struggling to treat it, or need advice, get help from NHS 111.
If someone is still unwell after 30 minutes of resting in a cool place, being cooled and drinking fluids, or has a very high temperature, hot skin that isn't sweating, a fast heartbeat, fast breathing or shortness of breath, confusion and lack of coordination, a seizure or fit, or loses consciousness. Heatstroke is a medical emergency: while you wait, wrap them in a cool, wet sheet, or fan them or sponge them down with cold water.
Leave the heat at once if you feel dizzy, get a headache or feel sick, and cool down straight away if it doesn't pass. In a survey of 157 hot yoga practitioners, just over half had had a problem, most often dizziness, light-headedness, nausea or dehydration, and case reports describe a cardiac arrest from heatstroke and a heart attack during hot classes.
Sources 67, 58, 68
A pop with weakness
A sudden pop with weakness at the chest, upper arm, elbow or above the knee needs checking the same day. Call 999 or go to A&E (accident and emergency) if the injured part has changed shape or is pointing at an odd angle, or is numb or tingling.
Source 69
Very flexible joints
If you're hypermobile, don't use mobility work to push further: the NHS says "do not overextend your joints just because you can". See a GP if you think you have joint hypermobility syndrome: for example, your joints keep dislocating, or you keep getting sprains, strains, pain or stiffness.
Source 70
During yoga
A joint pain that is sharp, gets worse during a session, lingers into the next day or changes how you move is a reason to use an easier version, and to see a GP or physiotherapist if it keeps happening (the rule in our plans). Muscle soreness for a day or two after something new is normal. In a hot class, stop if you feel dizzy, sick or unwell; our hot yoga guide lists the signs of heat illness.
With glaucoma, or high blood pressure that isn't under control, skip headstands, shoulder stands and long head-down holds. With osteoporosis, swap deep forward folds for a flat-back hinge from the hips, and twist smoothly. In pregnancy, our yoga in pregnancy guide covers the changes. NCCIH advises beginners to avoid headstands, shoulder stands, the lotus position and forceful breathing.
You can say no to any hands-on adjustment, and a teacher registered with Yoga Alliance must get your explicit consent each time.
Source 31
Who should check first
The PAR-Q+ (Physical Activity Readiness Questionnaire for Everyone) asks about a heart condition or high blood pressure, chest pain, dizziness or losing consciousness, other long-term conditions and their medicines, a bone or joint problem that activity could make worse, and being told to exercise only under supervision. If you answer yes to any, check with your doctor or a qualified exercise professional first. The NHS asks you to speak to your GP first if you haven't exercised for some time or have a health condition.
Sources 71, 72
Before you start
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.