Experts Explain Why Running in Cold Weather Can Cause Chest Pain

Chest pain in cold weather is usually linked to cold air, said Jason Womack, MD, chief of the division of sports medicine at Rutgers University, Robert Wood Johnson Medical School. "Cold air in particular can cause inflammation in the airways and cause hyperreactivity", he said. Meaning, your airways can spasm, making it hard to breathe normally.

Not only does cold air cause inflammation and irritation of the airways, it also causes them to narrow, which then leads to chest pain, said Glenn VanOtteren, MD, division chief of pulmonology at Spectrum Health. "It's sort of like an asthma attack in someone who might not otherwise have asthma", he said.

Womack also noted that cold weather can exacerbate or spark symptoms in people who have asthma. To make things worse, cold air is often dry, which can cause heightened irritation and inflammation, VanOtteren said.

"Any exercise that exposes you to cold or dry air is more likely to cause the asthma-type constriction", said Tracy Zaslow, MD, primary care sports medicine specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles.

It's important to point out that cold weather is also a risk factor for heart attack—it causes your blood vessels to tighten, decreasing the amount of blood flow to your heart and increasing your risk of heart attack, said Nicholas Anastasio, MD, a board-certified physician at Mercy Medical Center in Baltimore. If you develop symptoms such as shortness of breath, dizziness, lightheadedness or pain radiating down your arm, along with your chest pain (and especially if it gets worse with exercise) it's crucial to immediately go to the nearest emergency room.

To stay comfortable when running in cold weather, it's important to try to keep the air you breathe warm, Womack added. "Make sure you're breathing through your nose", he said. "That will naturally warm the air coming in". Wearing a mask, scarf or gaiter can also warm up the air you breathe before it hits your lungs, he said.

VanOtteren suggested warming up indoors—doing drills, yoga-style stretching or even star jumps—before you head out on your run to lessen the shock the cold weather can put on your lungs. If temperatures are more severe, though, "dial back on how aggressive you are" when exercising, he said.

"It's definitely better to run a longer, easier run in colder temperatures versus HIIT training and speed workouts", Zaslow said.

(Related: What Is a HIIT Workout, Anyway?)

The experts said it's hard to put an exact temperature on when it's too cold to run, given that factors such as wind chill and humidity can impact how your lungs feel in the cold. In general, though, it's recommended to avoid outdoor running when it's -7ºC or below, Anastasio said.

But, again, wind chill is a factor. "Running is not recommended if the temperature is 0ºC and there is high wind or a strong wind-chill factor", he said.

If you have chest pain when you exercise in the cold, Womack recommended that you try to decrease the level of intensity of your exercise and get to a warmer area. That, he said, "should help to settle it down".

If you have asthma, it's also a good idea to use your inhaler as prescribed by your doctor, Womack said.

Taking a warm or hot shower after your run may also help you feel more comfortable, due to the humidity and warmth, VanOtteren said. If the pain is still there after all of that, he suggested considering that your pain could be due to something more serious, like a cardiac or vascular issue. "You just can't always assume it's your lungs", he said.

If you live in a colder environment, you may build up a tolerance for exercising in colder weather, Zaslow said. "Otherwise, don't expect your very best when it's really cold", she said.

If you develop chest pain when you run in the cold and it doesn't go away after scaling back or going inside, you need to be seen by a doctor quickly. It could be a sign of a cardiac issue like a heart attack—and that's an emergency.

If you're fairly certain that the pain is partially due to the impact of the cold weather on your lungs, just know that it's normal to have some level of chest discomfort when you're exercising in cold weather. You don't want to push it, though. It may even be a good idea to check in with your doctor before running in the cold, especially if you have a health condition.

If this keeps happening to you, and it's not something you've experienced in the past, you'll want to get it checked out by a doctor. "Anybody that has a new onset of chest pain with exercising should be evaluated", Womack said. "You could have underlying asthma that could warrant treatment".

Words by Korin Miller