When to check first, and when to stop
These are the warning signs from our yoga, Pilates over 50, yoga for seniors and back pain guides, word for word, with one line of our own. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999.
See your GP first if
See your GP first if you get chest pain, breathlessness or dizziness when you are active, if you have a heart condition and want to exercise harder, or if you have had a fall.
Sources 6, 5
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 72, 73
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 74
Stop and rest if you feel
Dizzy, faint, unusually breathless, or sharp or increasing pain. Sit down until it passes, and see a GP if you keep getting dizzy or faint when you stand up.
Source 75
Falls
- After a fall, if someone may have injured their head, back, neck or hip, or can't get up.
- If you've had a fall or you're worried about your balance (you may be able to refer yourself to a falls service), if you've fainted, if dizziness worries you, or if you keep feeling dizzy or faint when you stand up. NICE offers a full falls assessment to people who have fallen in the last year and are frail, were hurt, blacked out, couldn't get up, or have fallen twice or more.
- If you fall repeatedly, or have started avoiding activity because you're worried about falling, ask your GP about a local falls service.
- If you have fallen, or are worried about falling, ask your GP about a falls assessment. The NHS says strength, balance and flexibility exercise will help make you stronger and feel more confident on your feet.
Sources 76, 41, 39, 6
Start supervised if
You're frail, have moderate to severe dementia, have had a spinal fracture or fall regularly: the UK guidelines suggest any new exercise is supervised by a trained professional at first.
Source 4
Osteoporosis and your spine
See your doctor about back pain, or a change in body shape such as losing height or a more curved back: these can be signs of a spinal fracture, though not all spinal fractures hurt.
Sudden mid or lower back pain after a minor fall, lift, cough or sneeze, especially from 50 or with long-term steroid tablets.
Modify or avoid exercises that round your back deeply or repeatedly, especially with a weight: sit-ups, toe touches, Pilates roll-downs and curl-ups, and extreme yoga forward folds. Bend from the hips instead. You do not need to avoid bending, twisting or lifting altogether: move smoothly and keep your upper back straight.
Twisting should be safe if you do it smoothly and comfortably. Slow down and shorten fast or forceful twists, and leave out the added weight.
Sources 43, 15
Eyes and blood pressure
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.
Glaucoma UK says: "Yoga is generally safe, but moves that involve the head being lower than the heart for an extended period of time" "can increase eye pressure and should be avoided."
With high blood pressure, keep breathing in every pose with no breath holds, and come up slowly from folds and the floor (our suggestion).
Sources 18, 77, 20
Back or tummy pain: call 999
Call 999: sudden, severe pain in the tummy or back, which can come with breathlessness, pale or grey skin, or collapse. It can be a burst abdominal aortic aneurysm, most common in men aged 65 or over and in people who smoke or used to smoke.
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 78
Back pain: see a GP
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.
Source 78
Bleeding after the menopause
See a GP about any bleeding from the vagina after your menopause, even if it's only a small amount or has only happened once. It's not usually serious, but it needs checking, and you shouldn't have to wait more than 2 weeks to see a specialist.
Source 79
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.
You can say no to any hands-on adjustment, and a teacher registered with Yoga Alliance must get your explicit consent each time.
Sources 20, 24
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.