Cellulitis, clots and other warning signs
These are the warning signs from our exercise for lymphoedema, Pilates for lymphoedema and yoga for cancer guides, word for word. Use the numbers your team gave you. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999.
Call 999 or go to A&E: cellulitis with signs of sepsis
If you have cellulitis with any of these, which can be signs of sepsis:
- A very high temperature, or feeling hot, cold or shivery.
- A fast heartbeat or fast breathing.
- Purple patches on the skin (these may be harder to see on brown or black skin).
- Feeling dizzy or faint, or confused.
- Cold, clammy or pale skin, or not responding.
Sources 70, 71
Call 999: a clot in the lungs
Also call 999 for pain and swelling in a limb with breathlessness or chest pain, which can mean a blood clot has reached the lungs.
Call 999 or go to A&E if breathing suddenly becomes difficult, if pain in your chest or upper back comes on suddenly with breathlessness or a very fast heartbeat, or if someone passes out. Do not drive yourself. It can be a blood clot that has reached the lungs.
Source 72
Urgent GP appointment or NHS 111, the same day
- The skin of the swollen or at-risk area is painful, hot and swollen, perhaps red (harder to see on brown or black skin), or you feel unwell with flu-like symptoms: this can be cellulitis, and early antibiotics help.
- Throbbing pain and swelling in one limb with red, blue or darkened skin or swollen veins, which can be a DVT (it can happen in an arm too).
- Antibiotics for cellulitis aren't helping after 48 hours.
Sources 70, 72
A swollen, painful leg
Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. This can be a deep vein thrombosis (DVT). It is more likely after surgery, a hospital stay, 3 or more days in bed, a journey of over 4 hours, pregnancy or a recent birth, cancer, a previous clot, or contraception or hormone replacement therapy (HRT) that contains oestrogen.
Source 72
If you have cellulitis
Rest and raise the limb. If your compression garment hurts, take it off, and put it back on as soon as you can tolerate it. Go back to your normal activity once you feel better, and have your garment's fit checked, as the limb may be more swollen afterwards. If you've been given a "rescue pack" of antibiotics after a previous attack, start it at the first familiar symptoms and get medical advice as soon as you can.
The NHS calls cellulitis the most common complication of lymphoedema. In one specialist clinic, as reported in the BLS and LSN cellulitis guideline, 37.6% of people had had cellulitis at least once and 23.3% more than once. Keeping the swelling under control lowers the risk: in a trial of 84 people with long-term leg swelling and repeated cellulitis, wearing compression cut further attacks from 40% to 15%.
Sources 73, 71, 18
See a GP, or your cancer or lymphoedema team
- New swelling in an arm or leg, especially after cancer treatment: early swelling can come and go, and after breast cancer treatment Breast Cancer Now says to get advice as soon as you notice it. A GP can refer you to a specialist lymphoedema service. New swelling after cancer treatment needs checking for other causes first.
- Signs of a skin infection, such as redness or heat, as soon as possible.
- Swollen legs, ankles or feet that haven't improved after a few days, or symptoms of lipoedema.
Sources 5, 18
During and after yoga
If the swollen or at-risk arm or leg changes during or after yoga, stop and ask your lymphoedema specialist. Our exercises for lymphoedema guide lists the signs of infection that need urgent help.
If the swollen or at-risk area changes during or after exercise, stop and get in touch. Talk to them before you start a new activity, and after surgery, follow the exercises and limits your surgical team gives you. The ACSM roundtable recommends a medical check before exercise for people with lymphoedema after cancer, and medical clearance while lymphoedema is flaring.
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.
You can say no to any hands-on adjustment, and a teacher registered with Yoga Alliance must get your explicit consent each time.
Sources 16, 3, 34
During cancer treatment: call 999
- Chest pain that feels tight or like squeezing, or spreads to your arms, neck or jaw; severe difficulty breathing; or collapse.
- Difficulty breathing that comes on suddenly, or pain in your chest or upper back: these can be signs of a blood clot in the lungs (a pulmonary embolism). Don't drive yourself to A&E.
Sources 75, 76
During cancer treatment: stop exercising
Macmillan says stop exercising if you get any sudden symptoms, including:
- Feeling dizzy, chest pain, a racing heart, breathing problems or feeling sick.
- Unusual back or bone pain, or unusual muscle pain.
- A headache that doesn't go away.
Source 16
During cancer treatment: call your care team
Use the number you were given (or NHS 111 if you're not sure how to contact your care team) if, during treatment, you have:
- A temperature over 37.5°C or below 36°C, or you suddenly feel unwell even with a normal temperature.
- Signs of an infection, such as feeling shivery, a sore throat, a cough, diarrhoea, or needing to pee a lot or pain when peeing.
- Throbbing or cramping pain, swelling and warmth in a leg or arm, which can be signs of a blood clot. Sudden breathlessness or chest pain means 999.
Sources 77, 78
What's normal
Some soreness or stiffness for 2 to 3 days after exercise, and tiredness during it, is common. Go by how you feel on the day, not the class plan.
Source 16
Chest pain or fainting while exercising: 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 79, 80
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 81
Head-down poses, bones and pregnancy
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.
Sources 82, 83
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.