We all know that running is good for the heart and lungs. Within just the first minute or so of any run, you can start to feel your pulse increasing as your heart beats faster to pump enough oxygenated blood to your working muscles.
Some runners notice mild chest tightness or heaviness when they first head out for their run, but feeling chest pain when running can be quite concerning.
It’s normal to immediately worry that any amount of or type of chest pain when running or chest pain after workouts is indicative of a potentially fatal heart attack or another heart-related issue.
Fortunately, there are several less severe or alarming causes of chest pain when running or performing another type of physical activity that is not sudden cardiac arrest.
However, knowing the signs and symptoms of various causes of chest pain when running is essential to ensure you catch anything concerning before it becomes severe.
This guide will discuss the most common causes of chest pain when running and what to do about it.
Why Does My Chest Hurt When I Run?
There are quite a few potential causes of chest discomfort or chest pain when running, ranging in severity from mild or benign to life-threatening heart conditions.
Given the potential seriousness of chest pain during exercise, it’s imperative that you seek immediate medical attention or speak to your doctor as soon as possible if you have concerns about chest pain during your workout or experience lingering chest pain after workouts.
It’s important to be aware of the signs and symptoms of a heart attack so that you can differentiate less concerning causes of chest pain during exercise from this life-threatening situation.
Signs and Symptoms of a Heart Attack
A heart attack, also called a myocardial infarction, occurs when part of the heart muscle is deprived of oxygen because of a blockage in one of the coronary arteries that feed the heart.
Deprivation of oxygen to the heart tissue, referred to as ischemia, can cause the heart muscle to die.
Depending on the location and extent of the ischemia, the heart attack can be fatal because the damaged heart muscle is either no longer able to conduct the electrical signal to contract or has too much dead muscle tissue to be able to contract and pump blood through the body adequately.
There are early symptoms of a heart attack that may occur in 50 percent of all people who have heart attacks, according to the Society of Cardiovascular Patient Care.1Discover Accredited CPCs DID YOU KNOW? EHAC. (n.d.). Retrieved April 2, 2024, from https://deputyheartattack.acc.org/assets/pdf/EHAC-Brochure.pdf
Being cognizant of the early signs of a heart attack can help you recognize the condition before significant damage is done.
Early signs of a heart attack can include any or all of the following:
- “Stuttering” chest pain, which is essentially mild chest pain or discomfort that comes on, then dissipates one or multiple times
- Sweating
- Shoulder, neck, or jaw pain
- Feeling faint or dizzy
- Breathlessness
- Nausea or vomiting
- Anxiety, confusion, or fear
Symptoms of a heart attack once it’s past the early stages tend to vary based on your sex.
Men tend to display the more “classic” symptoms, such as chest pain, pressure, tightness, or discomfort, often described as a “piano fell on your chest”; rapid or irregular heart rate; breathlessness, left arm pain; a feeling of indigestion; lightheadedness; and breaking out in a cold sweat.
Women,2American Heart Association. (2015). Heart attack symptoms in women. Www.heart.org. https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack/heart-attack-symptoms-in-women on the other hand, might feel chest pain and some of these classic symptoms, or they might also experience extreme fatigue, nausea, jaw pain, upper back pain radiating down the arm or to the chest or abdomen, flu-like symptoms, indigestion, anxiety, dizziness, and throat pain.
When to Be Concerned About Chest Pain When Running
Knowing the signs and symptoms of a heart attack can help you know when your chest pain when running is potentially indicative of this severe condition.
Therefore, if you are experiencing any of the following signs and symptoms alongside your chest pain during or after running, call 911 immediately:
- A squeezing pressure in the chest, sharp pain in the chest, or uncomfortable fullness in the chest
- Abnormal or inconsistent heart rhythm or rate
- Shortness of breath
- Dizziness
- Excessive sweating
- Nausea
Additionally, if you have other risk factors for heart disease, cardiovascular disease, or any other heart problems, you should speak with your healthcare provider about any chest pain you feel during or after exercise.
Chest Pain When Running? Here Are 8 Potential Causes
Now that we have gone through the life-threatening heart health concerns, let’s address other potential causes of chest pain when running.
#1: Angina Pectoris
Angina pectoris, typically referred to as just angina, is a common cause of chest pain while exercising. It is caused by a lack of blood flow to the heart, resulting in tightness, pressure, or chest pain, particularly during physical exertion.
Unlike a heart attack, angina pain typically alleviates when you stop exercising, so if you still have chest pain after running, it’s more concerning.
#2: Asthma
Exercise-induced asthma is a condition marked by airway inflammation, which can cause breathlessness, pressure, coughing, and chest pain when running.
Exercise is often a trigger for bronchoconstriction with asthma.
#3: Muscle Strains
We often don’t think about the chest muscles involved in breathing, but it’s fairly common3Ayloo, A., Cvengros, T., & Marella, S. (2013). Evaluation and Treatment of Musculoskeletal Chest Pain. Primary Care: Clinics in Office Practice, 40(4), 863–887. https://doi.org/10.1016/j.pop.2013.08.007 to strain intercostal muscles in the chest. Intercostal strains or injuries can cause chest pain while breathing because the expansion of the chest stretches the muscle fibers.
#4: Heartburn
Heartburn, GERD, or indigestion can also cause chest pain when running, particularly if you run after eating as stomach acid flows back up through the esophagus.
Fried or fatty foods, caffeinated foods and drinks, and spicy foods are especially irritating to the stomach and can cause symptoms of burning and pain in the chest or abdomen.
#5: Pleurisy
Running outside in the cold or in poor air quality can cause pleurisy, an inflammation of the tissues lining the lungs and chest.
Runners with asthma or who have had a recent respiratory infection are at a greater risk of pleurisy if they run outside. Symptoms include chest pain when running, a painful cough, and difficulty breathing.
#6: Dehydration and Cramping
The intercostal muscles between the ribs can cramp up, particularly if you are dehydrated or have an electrolyte imbalance.
#7: Costochondritis
Costochondritis is an inflammation of the cartilage by the breastbone. It is more common among women and generally resolves on its own. It can cause chest pain with physical exertion4Schumann, J. A., & Parente, J. J. (2020, January 21). Costochondritis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532931/ and can be caused by repetitive, high-impact activities like running.
#8: COVID-19
The coronavirus can cause chest pain, tightness, and breathlessness when running even if you have minimal symptoms at rest.
What to Do About Chest Pain When Running
Given the range of potential causes of chest pain when running, it’s difficult to give advice on what to do to alleviate the problem. However, here are some tips that may be helpful, depending on your situation:
- Consult your healthcare provider or cardiologist
- Examine your hydration strategy
- Wait longer after eating before running if you deal with heartburn, and cut back on trigger foods
- Take an inhaler if you have asthma, or consider getting a consultation if you think you might
- Rest if you have a muscle strain, pleurisy, costochondritis, or COVID-19
- Warm-up instead of jumping right into your workout
Remember, if you have any concerns about the health of your heart or a potential heart attack, seek emergency medical care.
It’s always better to err on the side of caution.
Your doctor can get to the root of your specific case and rule out any serious conditions such as myocarditis, hypertrophic cardiomyopathy (HCM), coronary artery disease, heart failure, among others.
As runners, we can experience many discomforts throughout our running careers, but there exist ways in which we can treat and hopefully even prevent them from occurring in the first place.
For more guidance to those discomforts, check out our injury guide section:
