If you’ve never experienced lower abdominal pain while running, consider yourself fortunate.
For many runners, stomach cramps, side stitches, or sudden digestive issues can put a damper on their runs.
The pain can come on unexpectedly and may last for just a few minutes or the entire run. This can be both frustrating and demotivating!
As a coach, I’ve seen this happen to runners of all levels. The good news is that with a little understanding and preparation, you can not only manage the pain but also prevent it from happening in the first place.
In this guide, I’ll cover the primary culprits behind abdominal pain while running and, most importantly, how to treat and prevent them.
Top 4 Causes of Lower Abdominal Pain While Running
When I first started running, I never thought abdominal pain would be an issue.
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I remember my first bout with a side stitch vividly. It was a crisp morning, and I was feeling strong… until I wasn’t. A sharp pain hit my side, forcing me to slow down. I was frustrated, confused, and, honestly, a little embarrassed. But that experience taught me a valuable lesson: running isn’t just about your legs—it’s a full-body sport, and everything from your breathing to your posture matters.
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But one morning, as I was pushing through my usual route, a sudden, sharp pain hit my right side.
It felt like a knife stabbing under my ribs—a classic side stitch. I slowed my pace, pressing my fingers into the pain and breathing deeply, just like I had read somewhere.
The pain subsided after a minute, but it was a wake-up call.
Here are the main culprits behind lower abdominal pain when running, along with some practical strategies to manage and prevent them.
- Side Stitches (Exercise-Related Transient Abdominal Pain)
Side stitches are a familiar enemy for most runners. Also known as exercise-related transient abdominal pain (ETAP), side stitches refer to a sharp, stabbing pain that typically occurs on one side of the abdomen, just below the ribs.
In some cases, this pain can also manifest in the lower abdominal area. It often comes on suddenly, without warning, and can range from dull and achy to sharp and stabbing.
How Common Are Side Stitches?
Research conducted by Australian scientists in 2015 revealed that approximately 70% of runners experienced a side stitch at least once in the past year. This shows just how common this issue is in the running community.
Why Do Side Stitches Happen?
The exact cause of side stitches isn’t fully understood, but here are some likely triggers:
- Pulling or irritation of the abdominal ligaments connected to your diaphragm.
- The bouncing motion of running, which stresses your diaphragm and internal organs.
- Running too soon after eating or drinking a lot of fluids.
- Shallow or irregular breathing patterns.
- Poor posture or form while running.
How to Manage Side Stitches While Running:
- Slow Down: If you feel a side stitch during a run, slow your pace to give your body a chance to recover. If the pain persists, stop and stretch.
- Engage Your Core: Bend forward slightly at the waist and engage your core muscles to stretch the diaphragm. Deep breathing can also help alleviate the pain.
- Apply Pressure: Use your fingers to apply pressure to the affected area while inhaling deeply. On each exhale, push a little deeper until the pain subsides.
- Stretch Up and Over: Extend the arm on the side where the stitch is located above your head and lean to the opposite side. Hold the stretch for 15-25 seconds before repeating on the other side.
Prevention Tips:
- Avoid Running on a Full Stomach: Space meals and runs by at least 3-4 hours, especially if you have a slower digestive system or a history of side stitches.
- Hydration: Drink small amounts of water consistently before and during your run and stay well-hydrated post-run.
- Improve Breathing Technique: Practice a 3:2 breathing pattern (inhaling for three steps, exhaling for two). Adjust to a 2:1 ratio for faster paces if needed.
- Heartburn
Ever feel a burning sensation in your chest or throat while running? That’s heartburn, and it’s a common issue for runners, especially after eating certain foods.
This condition can cause a burning feeling in the upper abdomen and chest, accompanied by burping or belching.
If you frequently experience these symptoms (more than twice a week), it could indicate gastroesophageal reflux disease (GERD).
Why Does Running Trigger Heartburn?
Running’s impact causes your stomach contents to bounce around, and if the muscle that keeps stomach acid in check (the lower esophageal sphincter) is relaxed or weak, acid can creep up into your esophagus.
Contributing Factors:
- Foods high in acidity or spiciness.
- Carbonated beverages.
- Running too soon after consuming large meals.
- Wearing tight clothing that compresses the stomach.
Managing Heartburn During Runs:
- Adjust Your Diet: Avoid typical triggers such as chocolate, tomato-based foods, spicy dishes, and citrus juices.
- Time Your Meals: Wait at least 3-4 hours after eating before running to ensure your stomach is empty.
- Loosen Your Gear: Wear loose-fitting shorts and tops that don’t put pressure on your stomach. If you wear a belt or compression garment, make sure it’s not too tight.
- Consider Medication: Over-the-counter antacids can neutralize stomach acid quickly. For stronger solutions, H2 blockers or proton pump inhibitors may be considered under a doctor’s guidance.
- Stomach Muscle Cramps
Sometimes mistaken for side stitches, these cramps originate from the stomach or intestinal
While these cramps can strike without warning, they often stem from specific triggers.
Common Causes of Stomach Muscle Cramps:
- Running in hot weather, which increases dehydration and electrolyte loss.
- Skipping a proper warm-up, leaving your muscles cold and more prone to cramping.
- Dehydration or an imbalance in electrolytes like sodium, potassium, and magnesium.
- Overexertion, especially if you’re pushing your limits without adequate recovery.
How to Manage and Prevent Stomach Muscle Cramps While Running:
- Stop and Stretch: If a cramp hits mid-run, stop running and gently stretch and massage the muscle with your fingertips. This can often provide quick relief. Applying ice to the area can help soothe soreness, while heat pads can loosen tight muscles.
- Stay Hydrated: Hydration is key for preventing muscle cramps. Drink water consistently throughout the day and ensure you’re hydrated before, during, and after your runs. About 12-16 ounces of water an hour before running is a good benchmark. During runs longer than 45 minutes, sip 2-4 ounces every 10-15 minutes.
- Warm-Up Properly: Always dedicate 5-10 minutes to dynamic stretches and light jogging before your run to warm up your muscles and prepare them for exertion.
- If cramps are frequent, consider electrolyte-enhanced water or sports drinks to maintain sodium, potassium, and magnesium levels during long or intense training sessions.
- Abdominal Strains
An abdominal strain is a more severe and less common reason for abdominal pain during running.
It occurs when one or more muscles in the abdominal wall are stretched or torn. This type of injury can cause intense pain, particularly during core movements and deep breathing.
Symptoms of an Abdominal Strain:
- Sharp pain that worsens with movement or certain positions.
- Swelling, bruising, or tenderness in the abdominal region.
- Weakness in the core muscles or a reduced range of motion.
Common Causes:
- Sudden, Intense Movements: Sprinting or abrupt twisting movements can strain the abdominal muscles.
- Overuse: Excessive training without adequate rest can lead to muscle fatigue and strain.
- Improper Form: Poor running posture or incorrect lifting techniques during cross-training can also contribute to abdominal strain.
How to Manage Abdominal Strains While Running:
- Rest and Recovery: Stop running and any other activity that aggravates the pain. Rest is crucial to allow the muscles to heal.
- Ice Therapy: Apply an ice pack to the strained area for 10-15 minutes, three to four times a day, to reduce swelling and pain.
- Over-the-Counter Pain Relief: Medications like ibuprofen or naproxen can help relieve pain and inflammation.
- Compression: Wrap an elastic bandage around your midsection to provide support and limit movement that might exacerbate the pain.
When to See a Doctor for Abdominal Pain While Running
While most cases of lower abdominal pain can be managed with the right techniques and adjustments, there are times when medical attention is necessary.
Chronic or severe pain could indicate an underlying issue that goes beyond typical running-related discomfort.
When to Seek Medical Help:
- Persistent Pain: If your abdominal pain does not subside after rest, stretching, or hydration, it’s time to seek medical advice.
- Disruption of Daily Activities: Pain that affects your ability to sit, walk, or sleep should be evaluated by a healthcare professional.
- Accompanying Symptoms:
- Shortness of breath or difficulty breathing.
- A burning sensation or severe stabbing pain.
- Tenderness in the abdominal region coupled with excessive sweating.
- Frequent constipation or diarrhea.
- Blood in the stool, severe bloating, or nausea even when not exercising.
Potential Serious Conditions:
Sometimes, abdominal pain could be a sign of a more serious medical condition, such as an ulcer, hernia, or even a heart condition.
If you or your family have a history of heart issues and you experience chest pain or other concerning symptoms, seek medical attention immediately.
Key Takeaways:
- Identify potential triggers based on your symptoms and make gradual adjustments.
- Practice deep breathing and core exercises to strengthen your abdominal muscles.
- Adjust your pre-run meals and clothing to reduce heartburn and other discomforts.
- Stay aware of how your body feels during runs and take action at the first sign of pain.
Stay Safe and Run Smart
By understanding the causes of abdominal pain and taking preventative measures, you’ll be better equipped to handle any discomfort that comes your way.
Running should be an enjoyable and fulfilling experience, so prioritize your well-being and make adjustments as needed.
Thank you for reading, and remember: keep training strong and listen to your body!
Got questions or personal experiences with abdominal pain while running? Share them in the comments below. I’d love to hear from you and help you stay on the right path.