Dark pee or muscles far worse than the session explains
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. Get medical help the same day: call NHS 111, or go to A&E if you feel very unwell. Call 999 for sudden, severe pain in a swollen, tight muscle.
Sources 15, 65
A swollen, tight, very painful muscle
Call 999 (911 in the US) or go to A&E for:
- Sudden, severe pain in a muscle, especially if it's very swollen and tight, or numb, weak or tingling: this can be compartment syndrome, which needs surgery as soon as possible.
Source 67
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 68, 69
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 70
A joint that slips, locks or swells
A shoulder that slips out or looks out of place, a knee that gives way, locks or swells within hours, or a wrist that's swollen and can't take weight needs checking before you train it again. Our pain guides say what to do.
Sources 71, 72, 73
Back pain
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.
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.
Same day: leg weakness that is getting worse.
Source 49
A shoulder injury
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.
Same day (GP or NHS 111): sudden or very bad shoulder pain; you cannot move your arm; the arm or shoulder is badly swollen or has changed shape; pins and needles that do not go away; no feeling in the arm; the arm is hot or cold to the touch; pain that started after an injury such as a fall; or severe pain in both shoulders.
Same day (GP or NHS 111): sudden weakness lifting the arm after an injury or fall. A rotator cuff tear caused by an injury needs urgent referral to a shoulder specialist. After a dislocation in anyone over 40, the rotator cuff should be checked: about 40% have a tear.
Sources 71, 74
A knee injury
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: the knee locks, gives way or clicks painfully. Painless clicking is normal.
Source 72
A blow to the head (a fall from a box, a bar or rings)
Call 999 if someone has hit their head and has been knocked out and hasn't woken up, can't stay awake or keep their eyes open, has a fit, has fallen from a height of more than 1 metre or 5 stairs, has problems with their vision or hearing, has clear fluid coming from their ears or nose, has new numbness or weakness, has problems with walking, balance, understanding, speaking or writing, hit their head at high speed, or their behaviour has changed. Get help from NHS 111 if they're being sick, feel dizzy or take medicine that thins the blood. If you're told to go to A&E (accident and emergency), don't drive yourself there if you have hit your head.
With a suspected concussion, if in doubt, sit them out. The UK's grassroots guidelines say no sport for at least 24 hours, get checked by a healthcare professional or NHS 111 within 24 hours, follow a staged return, and no competition before day 21; if symptoms last beyond 28 days, stay out of sport and see a doctor. Yoga waits too: gentle breathing fits the early, light-activity stages, and no head-down poses or inversions until you're cleared (our reading). Our concussion guide has the stages.
Sources 75, 76
Heat: what to do
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.
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 77, 62
Call 999 (911 in the US): signs of heatstroke
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.
Source 77
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 47
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 78
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.