Chest pain, defined as any discomfort between the neck and upper abdomen, can manifest as sharpness, dullness, tightness, or a crushing feeling. Pushups, a common exercise, can lead to chest pain. While often not serious, this symptom warrants careful attention.
Common Causes of Chest Pain from Pushups
Muscular strain is a frequent cause of chest pain during or after pushups. Overexertion or incorrect form can strain the pectoralis major and minor muscles in the chest, as well as shoulder muscles. The intercostal muscles, located between the ribs, can also be strained by repetitive pushup movements.
Another potential cause is costochondritis, an inflammation of the cartilage connecting the ribs to the breastbone. This condition presents as sharp, aching, or pressure-like pain, often affecting the second to fifth ribs on one side of the chest. The pain often intensifies with movement, deep breathing, or coughing. While the exact cause is often unclear, it can be linked to repetitive trauma, heavy lifting, strenuous exercise, or severe coughing.
Tietze syndrome is a less common condition involving inflammation of the rib cartilage, similar to costochondritis, but characterized by noticeable swelling in the affected area, usually around the second or third rib. This inflammatory disorder can cause pain that spreads to the arms and shoulders. Though painful, Tietze syndrome is not serious and often resolves within a few weeks or months.
Chest pain can also originate from issues beyond the musculoskeletal system. Gastroesophageal Reflux Disease (GERD), for example, is a common cause of non-cardiac chest pain. This discomfort may feel like heartburn or indigestion. Additionally, anxiety can manifest as chest discomfort, which may be accompanied by a rapid heartbeat, sweating, or dizziness.
When to Seek Medical Attention
While many instances of pushup-related chest pain are due to muscle strain, it is important to recognize when symptoms might indicate a more serious underlying condition. Any new or unexplained chest pain should be evaluated by a healthcare professional.
Immediate medical evaluation is necessary if chest pain is accompanied by certain symptoms, including:
Shortness of breath
Dizziness
Excessive sweating
Nausea
Pressure, squeezing, or crushing in the chest
Pain that radiates to an arm (especially the left), jaw, neck, back, or stomach
Pain that does not subside with rest or persists for more than a few minutes
Preventing Chest Pain During Pushups
Adopting proper technique minimizes the risk of chest pain during pushups. Position hands slightly wider than shoulder-width apart and directly beneath the shoulders. Keep elbows at an angle of approximately 45 degrees relative to the body, rather than allowing them to flare out, which can place undue stress on joints. Engage core muscles by pulling the belly button towards the spine and squeezing the glutes to maintain a straight back, moving the body as a single unit.
Beginning any exercise session with a thorough warm-up is beneficial for preventing muscle strain. Preparing the muscles and joints helps improve flexibility and readiness for physical activity. Specific stretches for the chest, shoulders, and upper back, such as doorway stretches or chest openers, can be included in a warm-up routine.
Employing progressive overload principles can help prevent injuries by gradually conditioning the body. This involves slowly increasing repetitions, sets, or pushup difficulty, rather than attempting too much too quickly. For those new to pushups or recovering from injury, starting with modified versions like knee or incline pushups provides a safer introduction. Pay attention to any discomfort and modify or stop the exercise if pain occurs.
Managing Mild Pushup-Related Chest Pain
If mild, non-serious chest pain occurs after pushups, rest is a simple yet effective first step. Avoid activities that worsen the pain, allowing affected muscles time to recover. This initial rest period prevents further irritation and supports healing.
Applying ice therapy to the affected area can help manage acute pain and inflammation. For new aches or swelling, apply an ice pack for about 20 minutes at a time, especially within the first 24 to 72 hours. Once acute inflammation subsides, heat therapy can address muscle soreness and stiffness by increasing blood flow.
Over-the-counter pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can help reduce pain and inflammation. Always follow dosage instructions. Once the acute pain begins to subside, incorporating gentle, non-painful stretches for the chest and shoulders, such as doorway stretches, can help restore flexibility. When the pain has fully resolved, gradually returning to pushups or similar exercises, while reinforcing proper form and a slow progression, can help prevent recurrence.