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Gym-Goer’s Guide to Red Flag Symptoms


Guide to Red Flag Symptoms

Did you decide to go for a Personal Record or send it, then find yourself in some pain or discomfort shortly after? Do you have sudden numbness, tingling, loss of balance, or something else? How do you know whether the pain or symptom is something that can be managed or if you need to seek immediate medical attention? Strength training is one of the safest physical activities you can participate in [1][2], however, sh*t does indeed happen. Even if you do everything correctly from a technique, load management, and recovery perspective, the risk of injury is always greater than zero.


Whether you are new to the gym or a veteran, below are the Red Flag Symptoms you need to watch out for so you can triage yourself both in and out of the gym. These symptoms may be caused by your training or by an underlying condition that is unrelated. This is by no means a comprehensive list but should point you in the right direction. When in doubt, consult your doctor or medical professional. Each Red Flag symptom is denoted with a letter A, B, or C which corresponds to the level of urgency as well as recommended action(s) that should be taken:

  • [A] This is a Critical Red Flag symptom which requires immediate medical attention. Go to the Emergency Room.

  • [B] Consult your doctor. Do not train until cleared.

  • [C] Consult your doctor. Continue to train and monitor symptoms.

Disclaimer: I am not a medical professional or physical therapist, and I might not be YOUR coach or know YOUR specific circumstances. The following information is provided to give you broad concepts that you can hopefully apply to your specific situation.


RED FLAG SYMPTOMS


Unexplained Sharp or Shooting Pain - Acute and Chronic [A]

If unexplained sharp or shooting pain occurred directly after or during training, or has been occurring for some time outside of the gym setting, seek immediate medical attention. Potential causes include nerve damage, impingement, or spinal injury.


Sudden Incontinence [A]

Accidents do happen during training and are more likely to occur at maximal weights or when straining. This Red Flag refers to a sudden inability to control bowel movements or your bladder outside of executing a lift, movement, or while straining. Potential causes include spinal injury, seizure, or stroke. Seek immediate medical attention.


Widespread Numbness or Tingling - Acute [A]

If the onset of numbness or tingling occurred directly after or during training, seek immediate medical attention. Potential causes include neuropathy, impingement, or spinal injury.


Widespread Numbness or Tingling - Chronic [B]

If the onset of numbness or tingling is unexplained and chronic, consult your doctor and do not train until cleared. Potential causes include neuropathy, impingement, spinal injury, or vitamin deficiency.


Tingling or Burning Sensation in Hands and/or Feet [A]

If you experience a sudden onset of tingling or burning sensation in the hands and/or feet, seek immediate medical attention. Possible causes included spinal injury, neuropathy, metabolic disease, vitamin deficiency, or something else.


Unexplained Weight Loss [C]

Unexplained weight loss beyond normal daily fluctuation can be caused by anything from a tapeworm to cancer. Training can continue, but seek medical attention to determine the cause. Monitor and log caloric intake, sleep, and stress to help you and your doctor navigate possible causes.


Unexplained Fatigue, Nausea, or Vomiting [C]

There is a wide differential of possible causes. Training can continue, but seek medical attention to determine the cause. Monitor and log daily activities to help you and your doctor navigate possible causes.


Chronic Light Headedness or Dizziness [B]

If you are experiencing frequent light headedness or dizziness, consult your doctor and do not train until cleared.


Swelling of Limb [A]

Swelling of limb due to a non-obvious cause (like twisting an ankle) is associated with a pulmonary emergency, possible bone break/fracture, or infection. Seek immediate medical attention. Do not train until cleared.


Chest Pain + Nausea, Dizziness, or Shortness of Breath [A]

Chest pain of any kind with nausea, dizziness, or shortness of breath is associated with cardiopulmonary emergencies. Seek immediate medical attention. Do not train until cleared.


Sudden Numbness or Weakness in the face, Arm, or Leg [A]

Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body, is associated with a stroke or TIA. Seek immediate medical attention. Do not train until cleared.


Sudden Difficulty Speaking, Confusion, or Difficulty Understanding [A]

Sudden difficulty speaking, confusion, or difficulty understanding , is associated with a stroke or TIA. Seek immediate medical attention. Do not train until cleared.


Sudden Trouble Seeing [A]

Sudden trouble seeing in one or both eyes, is associated with a stroke or TIA. Seek immediate medical attention. Do not train until cleared.


Sudden Loss of Coordination [A]

Sudden trouble walking, dizziness, loss of balance, or lack of coordination, is associated with a stroke or TIA. Seek immediate medical attention. Do not train until cleared.


Sudden Severe Headache [A]

Sudden severe headache with no known cause, is associated with a stroke or TIA. Seek immediate medical attention. Do not train until cleared.


Chest, Abdominal, or Back Pain that Increases with Exertion [A]

Pain in these areas that increases with exertion and the sensation of a heavy hart beat is associated with cardiopulmonary emergencies. Seek immediate medical attention. Do not train until cleared.


NON-SPECIFIC PAIN


Pain of unknown cause or pathology can sometimes be attributed to inappropriate changes in programming intensity or volume. This can be self-managed by monitoring and logging daily activities to see what triggers the pain. If the pain occurs during a specific movement, determine if there is an intensity that can be used that does not cause pain and progress from there. If pain is experienced even during the lightest weights, reduce range of motion to see if a partial range of motion reduces pain symptoms. If there is no range of motion that is pain free, then consider an alternative exercise/movement altogether following the same approach.


REFERENCES

  1. Aasa U, Svartholm I, Andersson F, et al Injuries among weightlifters and powerlifters: a systematic review British Journal of Sports Medicine 2017;51:211-219.

  2. Keogh JW, Winwood PW. The Epidemiology of Injuries Across the Weight-Training Sports. Sports Med. 2017 Mar;47(3):479-501. doi: 10.1007/s40279-016-0575-0. PMID: 27328853.

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