Acute chest tightness on faster runs

I'll start by saying I've seen a doctor and been through all sorts of heart tests with all results coming back as normal.

I'm getting quite an acute pain around the left side of my chest when I'm pushing my pace on 5ks. I'm a fit 35 year old man, been running for years and normal training runs of greater distance are fine, it's just when I'm lifting my pace or more accurately, trying to maintain my pace over the course of a 5k Parkrun that I feel a tightness and pain around the left side of my chest around the 2 mile mark which is impossible to ignore and causes me to have to ease off to a stop or to what feels like a crawl where the tightness/pain lifts after 30 seconds or so and I'm able to get back to my previous speed again.

I've noticed recently that it feels like I've aggravated something during these Parkruns because then setting off on a long slow 10 miler the next day has the pain returning very soon into my run, even though I'm obviously going significantly slower than what brought the pain on in the first instance.

I saw a physio and she gave me side stretches and some exercises to build up or muscle around my back but this has yielded mixed results and doesn't feel like a solution.

Many thanks for your help on this,



  • chamolkchamolk ✭✭✭
    Hi Rob - are you still getting the problem? I had something similar myself a few months ago - didn't bother my at all at rest, but started getting sore in my left chest within a few minutes of starting a run. I'm fairly sure I just pulled a muscle one day on the rowing machine (possibly one of my intercostals), as I remember no pain one day, then did a row and the pain started in my next run. It seemed to be purely due to breathing heavily when running, which tends to use accessory muscles in the chest that aren't used at rest. 
  • Hi, thanks for your response. Yes it still bothers me and has been a problem which has been around for years so not sure it's a short term thing of pulling a muscle. I'm now trying 'belly breathing', i.e. breathing in deeply through my nose and inflating my stomach while my chest stays where it is, then breathing out through my mouth. I do this normally to a pattern of 2 sides in, 2 strides out. This is effective breathing for running anyway I think but also could place less load on the intercostals and has yielded mix results which doesn't sound good but it's a step up from bad results.

    There was one glorious parkrun recently where I was able to gas it the whole way around without the pain coming on after about 2 miles, that felt revelatory!

    Many years ago when this problem first surfaced I was doing more press ups which would obviously be strenuous so maybe I aggravated something then which has just never returned to the way it should?
  • chamolkchamolk ✭✭✭
    Yeah, present for that length of time would go against a muscle injury. Can I ask what heart tests you've had so far? You sound to me like you might need an echo and treadmill test, and to see a cardiologist. 
  • I had an ECG which was fine. Ive also been on a treadmill where I think my heart was photographed at rest before going on the treadmill where I took my heartbeat to 100% of capacity and having it photographed again. This sounds like the echo test? Frustratingly the time on the treadmill didn't bring on the pain as I wasn't running for long enough or the process is very slow and so it wasn't geared to bringing on the pain. The nurses were simply concerned with taking my heartbeat to 100% which is something like 220 minus your age? Asking to simply run to bring on my pain is probably what I should have done but I think that's out their remit, to alter their procedures to a patients request.

    No further action was taken on all counts.

    If you have ideas as to other things I could try I'd be very happy to hear.

    Thanks for your thoughts and help
  • Doesn't sound like an echo to me - it's an ultrasound (same sort of thing they do to look at babies in the womb) and isn't normally done on a treadmill. Your test sounds more like an exercise stress test /treadmill test which is basically trying to induce angina - you run on the treadmill to try and reproduce your pain, and they look for changes on an ecg tracing. There are other types of angiography done after a treadmill test, so I can't be sure.

    I'd maybe have a word with your gp, just to discuss that it's still going on. Chest pain on exertion COULD (emphasised, please don't be panicking about it) be a structural heart problem like aortic stenosis, though it's less common at your age. It would be worth mentioning that it's worrying you and affecting your ability to exercise, so they might consider an echo /discussion with a cardiologist.

    Some sort of musculo-skeketal thing is probably the most likely cause I suspect, especially if changing your breathing affects the level of pain
  • Thank you very much for all this, it's very interesting and thanks so much for making the time. I'm sorry for my late response, completely forget to check it.

    Might be a little while before I'm running again as I turned my knee really badly playing football last night and have strained all sort of ligaments there so I'm having to wait a bit. Ho-hum!
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