Chest Pain

[Radial_Deviation]

Hi all,

I recently saw a client who has chest pain with no particular pathology, an dvery erratic?

He c/o pain and discomfort over the chest whenever running, especially on the treadmill. All other exercises are fine, but running often gives him chest pain which subsides almost immediately once he stopped running.

He is very fit and healthy...no recent trauma or injury. Had a minor shoulder injury whilst skiing a 2yrs back. But the chest pain was already experienced prior to this injury. His Chiro did pointed out that he has a slightly raised pelvis to the Rt. However, my objective observation does not show this to be a significant issue. He has had ECG and the whole cardiac test...but nothing was detected.

Any suggestion on the causative factors?

Thanks Guys

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[physiobob]

Sounds like referred rib pain, common in running. If he has been cleared via ECG then I would work on his thoracic mobility especially in rotational movements.

Perhaps he can also do us a favor and also monitor his HR when he gets the pain. If there is a consistency to that then if he can try and achieve the same levels on cross trainer and/or stationary bike and let us know if he exhibits any symptoms with that exercise.

[ginger]

The most likely explanation is that this guy has an intervertebral facet joint inflammatory event , which is giving him referred pain to the chest. Spinal joints will become inflamed for long periods at the effect of a protective response , probably initiated by his fall. Mobilising the relevant facet joints will quickly eliminate both the protective response and referred pain associated with nerves irritated by close proximity to those joints. Continuous Mobilisation is the method most likely to bring about resolution , other methods like Maitland and Mulligan have some value also.