Acute Chest Pain

Acute chest pain is sudden onset or particularly painful. It can range from cardiac chest pain or heart attack to a torn muscle or bruised rib. If you suspect cardiac chest pain then seek urgent medical attention immediately. Do not take chances. Many cases of acute chest pain have musculoskeletal causes for example from a hard impact to the rib cage.

Cardiac Chest Pain

Chest pain in athletes can be from a number of causes, although cardiac or heart problems should always be considered. The chest pain could originate from the muscles, but it could also signify a more serious cardiac problem, even in young athletes. We describe some of the cardiac causes of chest pain and what you should do about them.

Side Stitch

A stitch can usually be felt to one side of the abdomen, more often the right side, around the area of the lower ribs. Many people suffer from stitches when doing sport, particularly running based activities. We examine the possible causes and what you may be able to do about it.

Rib Fracture

A rib fracture is common in contact sports and usually occurs following a hard impact to the chest by an elbow or similar. Breathing will often be painful and there will normally be a particular point on the ribs that will be especially tender. It is possible that the fracture may cause internal damage so seeking medical advice is recommended, especially if the pain is severe.

Pec Strain

The pectoralis major muscle is a large powerful muscle at the front of the chest. It is used to rotate the arm inwards. Its weak point is at the tendon where it attaches to the arm bone. The front of the shoulder will be painful and swell up, and the muscle may have visibly changed. Read more on the symptoms and treatment for this injury.

Costochondral Separation

A Costochondral separation, sometimes known as a rib separation, usually occurs after a direct impact. This injury occurs when a rib becomes separated from the costochondral joint (made from cartilage) which is also attached to the breastbone. The area will be very painful, especially when breathing deeply, and it can take several months to fully recover.

Breast Contusion

A breast contusion is bruising of the breast tissue, caused by a direct impact to the area. Common examples of this are being hit by a ball such as in hockey or cricket or being elbowed in contact sports. Pain, tenderness and bruising are the main symptoms and these can be helped by icing the area and supporting the breast.

Bruised Sternum

A bruised sternum, or sternum contusion as it is also known, occurs after an impact to the sternum or breastbone. This most frequently occurs after road traffic accidents, although collision sports and those with hard balls or rackets etc can also impact the sternum. From this injury the front of the chest will be painful and there may be difficulty breathing.

Sternum Fracture

A sternum fracture is a break to the breastbone. A sternal fracture is most often caused by a direct impact to the bone, at the front of the chest. This is most frequent in road traffic accidents. There will be sharp chest pain at the front of the body and bruising may appear. The injury will need to be assessed and monitored to ensure no further damage is made.

Jogger's Nipple

This is a painful condition more common in men than women. It is in effect a friction burn, known as chafing, caused by constant rubbing of a T-shirt on the nipple. It is often more likely in cold and wet weather, particularly when running or exercising for long periods of time. There are simple ways you can prevent this chafing, which we describe below.

Jogger's Breast

Repetitive trauma or bouncing up and down from jogging can cause permanent damage resulting in breasts dropping. Not wearing a supportive bra when exercising can cause pain in the breast and lead to other related issues in the upper back and neck. It is much easier to prevent this condition than to cure it as all you need is a good sports bra!

Bruised Ribs

Bruised ribs or a rib contusion occurs following a direct impact to the chest. This may be because of a fall or direct impact from a hard object, but the most common cause is a car accident. Chest pain and difficulty breathing are two main symptoms that can be helped with rest and ice. The injury should be assessed to confirm it is not a more serious condition.


A pneumothorax or collapsed lung occurs when there is a build-up of air in the space between the lungs and the rib cage - known as the pleural space. Symptoms include a sharp chest pain and shortness of breath. This condition can be caused by a specific injury like broken ribs, or just happen for seemingly no reason. Read more on the causes, symptoms, and treatment of a collapsed lung.

Sternoclavicular Sprain

The collarbone connects to the sternum or breastbone in the middle of the chest at the top. If the shoulder is subjected to a hard impact, this joint (known as the sternoclavicular joint), can become injured. There will be pain located on the joint which may spread into the shoulder. Medical help should be consulted to check there is no further damage to blood vessels in the area.