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Help: Sternum Pain While Swimming
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Hello,

I apologize as this post will be relatively long, but I want to provide as much information as possible to see if anyone can help diagnose me or relate to the issue and let me know what if anything they did to solve the problem for themselves.

Last year, I did my first triathlon at Mont Tremblant, Quebec (olympic distance), but was forced to stop after a very intense pain in my sternum that began during the swim. I completed the bike and walked half of the run, before the pain became too intense and the medical staff saw me pawing at my chest and sent me to the hospital as they were concerned it was my heart based on the fact that the pain was in my chest. Afterwards, I consulted a cardiologist who confirmed my heart is just fine, so that's been ruled out. The best way to describe the pain is as though you had eaten a piece of food that's a bit too big and gets stuck in your digestive tract behind the sternum. Usually with a bit of water the food goes down and you move on with your life, but the pain I experienced did not go away for hours after I stopped the race and after much flatulence.

After failing to complete the race last year, I signed up again for 2019 and trained well in the pool without ever experiencing the pain again. On race day this year (2 days ago), the water temperature was about 17 degrees Celcius or about 63 Farenheit (about the same as last year). I was wearing a wetsuit both this year and last year as is manadatory based on the water temperature, and once again this year after about 10 minutes in the water the pain started up. Since I knew that the pain wasn't related to my heart, I completed the bike with much discomfort, but had to walk most of the run because the pain was too intense and crossed the finish line in just under 4 hours. So I finished, but didn't really do the full distance as it is meant to be done.

A little more information on the swim itself. As I mentioned the water was pretty cold and this year, the current was actually quite strong resulting in me not being able to get into a good breathing rhythm, having to do a lot of sighting and often gasping for air after just a few strokes. Last year, the conditions were much calmer, but it was my first open water swim which I think led to a bit of a panic until I was able to get my brain to tell my body to calm down and just swim normally. Once I did that, I swam well, but the pain had already set in.

Drinking water while on the bike or on the run actually made the pain worse and the only relief came when I lay down on the grass after the race ended.

With resepct to nutrition, I ate 2 scrambled eggs and a couple of slices of buttered toast, a small amount of mixed berries, a small glass of orange juice and a big glass of water about 3 hours before diving in.

I'm not a big guy by any stretch of the imagination... about 5'10 and weigh about 135 pounds.

I've done some reasearch online and I have a feeling it's some sort of reflux condition, but haven't been able to find anything conclusive (pain is described in point 2 at the bottom of the first page of this article https://www.usms.org/articles/gerd.pdf).

At this point, I will not be racing Mont Tremblant again, but would really like to try another race, though am a reluctant to do so until I get some sort of clarity and treatment for the chest pain I seem to get during the swim.

Any help or advise would be greatly appreciated.

Thanks and again apologies for the length of this post.
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Re: Help: Sternum Pain While Swimming [Moose&Squirrel] [ In reply to ]
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Not a doctor, but was going to guess reflux, too. Although it's strange that it doesn't happen during training and got better after lying down. Perhaps the lack of stress and pool walls, such that you're not remaining horizontal the whole time, preclude the condition during training. Could you try a long practice open water swim to see if you can make it happen, then try again after taking some OTC antacid beforehand. I have GERD and occasionally experience a bit of reflux running or swimming, especially if I've recently had coffee. I would say orange juice is a no no.

Strava
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Re: Help: Sternum Pain While Swimming [Moose&Squirrel] [ In reply to ]
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Moose&Squirrel wrote:
Hello,

I apologize as this post will be relatively long, but I want to provide as much information as possible to see if anyone can help diagnose me or relate to the issue and let me know what if anything they did to solve the problem for themselves.

Last year, I did my first triathlon at Mont Tremblant, Quebec (olympic distance), but was forced to stop after a very intense pain in my sternum that began during the swim. I completed the bike and walked half of the run, before the pain became too intense and the medical staff saw me pawing at my chest and sent me to the hospital as they were concerned it was my heart based on the fact that the pain was in my chest. Afterwards, I consulted a cardiologist who confirmed my heart is just fine, so that's been ruled out. The best way to describe the pain is as though you had eaten a piece of food that's a bit too big and gets stuck in your digestive tract behind the sternum. Usually with a bit of water the food goes down and you move on with your life, but the pain I experienced did not go away for hours after I stopped the race and after much flatulence.

After failing to complete the race last year, I signed up again for 2019 and trained well in the pool without ever experiencing the pain again. On race day this year (2 days ago), the water temperature was about 17 degrees Celcius or about 63 Farenheit (about the same as last year). I was wearing a wetsuit both this year and last year as is manadatory based on the water temperature, and once again this year after about 10 minutes in the water the pain started up. Since I knew that the pain wasn't related to my heart, I completed the bike with much discomfort, but had to walk most of the run because the pain was too intense and crossed the finish line in just under 4 hours. So I finished, but didn't really do the full distance as it is meant to be done.

A little more information on the swim itself. As I mentioned the water was pretty cold and this year, the current was actually quite strong resulting in me not being able to get into a good breathing rhythm, having to do a lot of sighting and often gasping for air after just a few strokes. Last year, the conditions were much calmer, but it was my first open water swim which I think led to a bit of a panic until I was able to get my brain to tell my body to calm down and just swim normally. Once I did that, I swam well, but the pain had already set in.

Drinking water while on the bike or on the run actually made the pain worse and the only relief came when I lay down on the grass after the race ended.

With resepct to nutrition, I ate 2 scrambled eggs and a couple of slices of buttered toast, a small amount of mixed berries, a small glass of orange juice and a big glass of water about 3 hours before diving in.

I'm not a big guy by any stretch of the imagination... about 5'10 and weigh about 135 pounds.

I've done some reasearch online and I have a feeling it's some sort of reflux condition, but haven't been able to find anything conclusive (pain is described in point 2 at the bottom of the first page of this article https://www.usms.org/articles/gerd.pdf).

At this point, I will not be racing Mont Tremblant again, but would really like to try another race, though am a reluctant to do so until I get some sort of clarity and treatment for the chest pain I seem to get during the swim.

Any help or advise would be greatly appreciated.

Thanks and again apologies for the length of this post.

Sounds like a Gastrointestinal issue, like esophageal spasms...
Stress/anxiety, very hot or cold liquids and even very tight clothing like a wetsuit, theoretically can cause those. Talk to your GP about it just to be on the safe side.

"Discipline is the highest of all virtues. Only so may strength and desire be counterbalanced and the endeavors of man bear fruit."
Nikos Kazantzakis, The Rock Garden
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Re: Help: Sternum Pain While Swimming [Moose&Squirrel] [ In reply to ]
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What is your sports history? Are you coming off other hi-energy sports or the couch?

IMO Blood supply/circulation issue cause by being overloaded in execution (too much too soon).

What does your training look like?

Training Tweets: https://twitter.com/Jagersport_com
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Re: Help: Sternum Pain While Swimming [SharkFM] [ In reply to ]
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Hi SharkFM,

Definitely not coming off the couch. Prior to getting into the sport, I was playing soccer twice per week which is by no means comparable to training for triathlon, but not a couch potato either.

As far as training goes, this year, I did one swim per week (2000-3000m with drills, pyramids, IMs etc...), 2-3 bike workouts on the trainer of about an hour each with a focus on hill sprints and neuromuscular training and then 2-3 runs per week between 5km and 12 km. I still play soccer once per week.

Last year I did 2 swims per week, but much less on the bike and I found the bike the toughest part last year, so I switched my focus to be able to improve on the hills and still have legs enough to handle the run.
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