A Runner’s Guide To All the Tell-Tale Signs That You Need To See a Doctor

Bad runs happen. But if they start piling up, accompanied by shortness of breath and/or light-headedness, it’s definitely time to seek out a good ol’ MD.

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When the pandemic hit, John, an avid runner in his mid-40s, saw an opportunity to avoid using public transit by running home instead, thus knocking out his daily 10K run in the process. For nearly four months, he carried on this new tradition with ease — until, that is, late June when he felt his heart “do a quick flutter, almost like a reboot.”

“It was a weird feeling, but it didn’t hinder my run,” John tells me. “During my next few runs, though, I found myself having to stop every couple of kilometers to catch my breath and continue on, as if I’d lost all my fitness overnight.”

As a non-smoker who’s run multiple marathons and maintained a healthy Mediterranean diet throughout his life, it seemed odd to have quickly fallen out of shape. So he called his doctor.

After a few diagnostic tests, John underwent a stress test where he ran for 15 minutes on a treadmill while hooked up to heart monitors. “I felt great during the test, but after seeing the nurse looking quizzically at my charts, I noticed my heart starting to burn, kind of like indigestion.”

It turns out, he had significant blockage in his arteries, which led to him suffering a heart attack during the test. “I was then booked overnight and had an angiogram and two stents put in,” he tells me. “Had I not been a runner, I most likely would have never listened to my body and gone in, and things would be drastically different for me right now. But I knew how my body should react to workouts, and I could tell something was off.”

“If you suddenly go from an 8-minute mile to an 11-minute mile and you’re not hot or dehydrated, you probably should talk to your doctor just to get screened,” recommends John Martinez, a former team physician with USA Triathlon who used to give an annual speech to runners on this topic. “Beyond pace, anytime there’s an increase in shortness of breath, decrease in exercise tolerance or increase in perceived exertion from the same effort, outside of it being hot and humid, call your doctor.”

Yes, athletes tend to have stronger cardiovascular systems that can handle stress, but per Martinez, this leads many of them to ignore early warning signs. “Athletic people are used to feeling uncomfortable, so they tend to minimize their symptoms and say, ‘Oh well, I’m supposed to be short of breath because I’m running really hard,’ but in reality, they have 90 percent blockage,” he says.

In addition to shortness of breath, he says other vitals to keep an eye on include “feeling really light-headed like you’re going to pass out, or a heart rate that’s very elevated or irregular.” “Not that they need to run off to the doctor for every little symptom,” he continues, “but heart disease is out there, not to mention pulmonary embolisms, or blood clots in the lungs. All of these things can pop up, and athletic people are by no means immune.”

So what’s the difference between a crappy run due to lack of sleep or the laundry list of other things that can impede a good workout?

“If it happens once, you can chalk it up to not eating or sleeping right, or it being hot out. But if it’s two, three, four workouts in a row, that’s when, as a doctor, I’d start being suspicious,” Martinez tells me. “We had a professional triathlete ignore symptoms because she figured it was her asthma and that she was just having trouble getting back into shape. When she finally came to us, though, it turned out she had blood clots in her lungs.”

Swap out lung pain for chest pain, and that’s exactly what happened to John. “Any runner will tell you that sometimes you just have bad runs, even if you felt great beforehand, which is why I initially chalked it up to a bad run,” he says. “But after it happened again on my next two runs, I knew something was up. A key factor as well is even during my worst ones — lack of sleep, hungover, hot out, etc. — I’d be able to slog it out. This time, however, I just couldn’t.”

Almost two months later, John is mostly feeling back to normal. “But it’s still an adjustment,” he tells me. “I have to consciously think, ‘I probably shouldn’t carry the heavy groceries up the flight of stairs in one go’ — things that you normally wouldn’t even consider. Sometimes I almost wish there was something I could do to feel a little more in control like quitting smoking or losing weight, but my family has a strong history of heart disease and that seems to be the link.”

With that in mind, John is adamant that his fellow runners keep their baseline health top of mind: “I’m exceptionally fortunate, and encourage anyone who doesn’t feel quite ‘right’ to get themselves checked out.”

He’s living proof that it could very well save your life.