What could be causing my running funk?

August 24, 2014 9:17 AM

YANMD. I am seeing a doctor, but don't have an appointment for a follow up until Wednesday. I can't figure out why I'm feeling so ill.

Last Sunday, on a planned 16 mile run, I bonked after four miles. I was running very close to a full minute slower per mile than normal. My chest hurt. I wasn't breathing correctly. I chalked it up to a bad run, and took a day off. (I had run 10 miles on Saturday, at a decent clip, without issue.) Then, Tuesday, same issue, after three miles I stopped because I was moving so slowly it wasn't worth it.

I took a full four days off to recover. When I went to the doctor on Thursday, she said that my vitals were normal, even though I told her I was still having problems taking a full breath in. She said I could have possibly fractured a rib (?!) or something, and scheduled me for an X-ray and ultrasound of the muscles under my rib cage for this coming Wednesday.

Honestly, I don't remember doing anything that could have fractured my rib. I have been consistently running 40-50 miles per week since last summer with no issue whatsoever, and am still planning to run a November marathon.

I was able to run 6 miles today, but again, my pace has slowed drastically from last week, and it feels like I can't breathe correctly. I do have some early fall allergies, but they have never affected my lungs before in years past. The pain had sort of been localized to my left side but is now more general. It's not bad pain (I would have gone to the ER), and I can breathe okay sitting down, but I can't take a deep breath without feeling pressure.

Other possibly relevant factors... we went on a long car trip about a week and a half ago, and I spent about 10 hours in the car last week in one day. The doctor said she was ruling out any sort of blood clot because she found my vitals to be normal, and I wasn't having leg pain. I do not smoke, am not on birth control pills (I have a Mirena), and the weather here has been beautiful and cool. My family has no history of asthma.

I'm not looking for an AskMe diagnosis. But are there questions I'm missing that I should be asking my doctors?

posted by roomthreeseventeen to Health & Fitness (15 answers total)

You might want to ask whether you need to lay off the running (or anything else strenuous) until you're checked out, anyway.
posted by dilettante at 9:27 AM on August 24, 2014

Any reason your doctor has ruled out asthma as the issue? It's a simple test to administer to see if you're having it. But even if it doesn't manifest while in the doctor's office, there's such a thing as exercise-induced asthma. A few puffs on an albuterol inhaler could eliminate such a problem.

If I were you, I would ask whether this could be the problem, and if there would be any harm in using an inhaler before your run?

I have had exercise-induced asthma in the past, but it seems to have just faded after a while. When it was bothering me, without an inhaler, I would feel uncomfortable during exercise and during the next day after. With the inhaler, not much problem... I never had an asthma issues outside of exercise, but I did have some gnarly hayfever allergies that I have had shots for.
posted by Tandem Affinity at 9:29 AM on August 24, 2014 [1 favorite]

Response by poster: Sorry, not to babysit. Doctor said to lay off the running if it was going to make it worse. I took four days off and ran today for the first time since then. It did not make anything worse, but I don't feel better, either.
posted by roomthreeseventeen at 9:30 AM on August 24, 2014

I imagine you'd have mentioned it if you had, but have you made any diet changes recently? This sounds like how I felt the entire month of my paleo experiment.
posted by obfuscation at 9:39 AM on August 24, 2014

Response by poster: OK, one more response. And then no babysitting. No diet changes. Doctor ruled out asthma because of my vitals, lack of history in family, and that I've been running for almost five years with no asthma.
posted by roomthreeseventeen at 9:43 AM on August 24, 2014

So just to be clear, you're experiencing shortness of breath (pain/difficulty taking deep breaths) even when you're not exercising?

IANAD, etc., but I am a survivor of pulmonary embolism. In my case, the more severe incident--the one where my dr. sent me to the ER and I got a proper diagnosis--was almost surely preceded about a month prior by a milder incident, where my doctor sent me to get x-rays (was not a broken rib) and never really figured out what the problem was until it cleared up on its own. During that episode my vitals were normal and on both occasions I didn't experience any leg pain.

According to this article, normal vital signs is not reason to rule out the possibility of blood clots/PE.
posted by drlith at 9:44 AM on August 24, 2014 [1 favorite]

Response by poster: So just to be clear, you're experiencing shortness of breath (pain/difficulty taking deep breaths) even when you're not exercising?

Yes, shortness of breath, and some chest pain.
posted by roomthreeseventeen at 11:24 AM on August 24, 2014

Is it possible that you are dealing with a collapsed or partially collapsed lung? The symptoms sound about right, and sometimes it can happen spontaneously without direct trauma. Also, sometimes it's caused by altitude changes. During your car trip, did you experience anything like that?
posted by SpacemanStix at 11:42 AM on August 24, 2014 [1 favorite]

This is a very, very long shot, but the time this happened to me it was because I was pregnant. There's no chance you are pregnant or have an ectopic pregnancy, is there?
posted by redfoxtail at 12:18 PM on August 24, 2014

Yeah I was also going to say... that's exactly how I felt when I was pregnant. Constant exhaustion, trouble breathing, no stamina, and it was virtually my only symptom. Probably worth checking...
posted by brainmouse at 12:42 PM on August 24, 2014

Best answer: I have broken ribs a few times and you probably didn't run 6 miles with a broken rib unless you are really tough. You can irritate/ damage the cartilage in between the ribs, which is also painful but less sharp but I don't think you'd be running with that either without being miserable.
posted by fshgrl at 12:43 PM on August 24, 2014

I'd like to second the encouragement to check out the pulmonary embolism. I'm also a survivor and actually didn't experience any shortness of breath in daily life, just pains on my left side that felt like indigestion. I never experienced leg pain. My vitals were normal (not an "unusual" decrease in blood oxygen).

And I'm also a runner. I mention it because there are a whole lot of ways in which generally healthy bodies (and our low heart rates) can mask issues like pulmonary embolisms. Have them do the blood test.
posted by correcaminos at 1:18 PM on August 24, 2014

we went on a long car trip about a week and a half ago, and I spent about 10 hours in the car last week in one day

I often get pinched nerves and/or muscle spasms from long car and plane trips and it could explain all your symptoms except shortness of breath (although if it's just pressure when you fill your lungs and not gaspy wheeziness, that could be from tight chest muscles). For me, when one muscle knots up it gradually pulls on all the others until half my body is fucked up and I'm completely miserable. And a pinched nerve in your spine can refer pain to elsewhere.

So, you might try a long, hot bath or shower followed by thorough stretching a few times per day. Get a professional massage if you can afford it. And try sleeping flat on your back with good neck support (a cervical support pillow if you have one or a rolled-up hand towel if you don't) for a few days and see if that helps.
posted by Jacqueline at 1:56 PM on August 24, 2014

I'd also make sure they do a full blood workup to rule out anemia since that's also what these symptoms sound like, especially the inability to complete runs no matter how slowly you're going.

I have an extreme case of anemia right now that crept up on me so gradually I never saw it coming and these were my exact symptoms. One day I was out running my daily ten miler like I've done for years and the next day I couldn't even get through a few miles no matter how slow I jogged. I'd be surprised if the doctor didn't check for this, but in the event they didn't it's the first thing to rule out.
posted by stagewhisper at 2:43 PM on August 24, 2014

Response by poster: Resolved! I finally was feeling so ill I went for a second opinion. It turns out that I had finally progressed enough for my symptoms to present correctly. I have an inflammation of the cartilage in my chest, as well as a sinus infection. Am already on meds to get this cleared up. Thanks everyone for the help.
posted by roomthreeseventeen at 7:25 PM on August 24, 2014 [3 favorites]