About Abdominal Cramps With Exercise

Exercise-related transient abdominal pain, more commonly known as a side stitch, is a localized stabbing abdominal pain underneath the rib cage experienced during exercise. The pain can interfere with the performance of the athlete or stop it altogether. According to a study published in the British Journal of Sports Medicine, it is a common complaint among participants in endurance sports such as marathon running, cycling or distance swimming.

Significance

Many athletes have experienced side stitches. A study published in Medicine and Science in Sports and Exercise in 2000 looked at 965 athletes in six different sports over the course of a year of training and competition. Of those athletes, 75 percent of swimmers, 69 percent of runners, 62 percent of horse riders, 52 percent of aerobics participants, 47 percent of basketball players and 32 percent of cyclists were affected by side stitches.

Theories/Speculation

Although researchers have yet confirmed the direct evidence of the cause of exercise-related transient abdominal pain, most believe this phenomenon is due to problems with the gastrointestinal tract and/or the abdominal wall muscles.

If the gastrointestinal tract is the reason for the pain, it has to do with the food and beverages you consume before and during the exercise, as well as your hydration level. In a study published in the International Journal of Sports Nutrition in 1992, researchers noted that athletes who ate their meals within 30 minutes before a race were more likely to experience gastrointestinal discomfort. In the same study, researchers also found that athletes who consumed a pre-race meal that was high in fiber were more likely to experience gastrointestinal distress during the race. This study implies that the timing and quality of the meal before exercise is related to abdominal cramps. Moreover, dehydration causes osmolality imbalance and contributes significantly to gastrointestinal tract distress.

Cramps from the abdominal wall muscles are the result of vigorous breathing during exercise and decreased oxygen supply to these muscles, specifically the diaphragm and the liver. Since the liver is the heaviest organ in the abdomen, it creates the greatest downward force on the diaphragm, generating the greatest amount of friction in between, causing the pain. The fact that the most often reported occurrence is on the right lower abdomen supports this theory, since the liver is located on the right side. In addition, during strenuous exercise, oxygen supply to these muscles is decreased. The body naturally produces lactic acid in response. The buildup of lactic acid in the muscle is another factor responsible for muscle cramps.

Prevention

Avoid eating 30 minutes before you begin exercising. Avoid fiber-rich foods before you exercise.

Hyper-hydrate by drinking 13 to 20 ounces of cold water 10 to 20 minutes before exercise to help delay dehydration, since cold liquids are emptied from the stomach faster than those at room temperature.

Hypertonic beverages--those with a higher carbohydrate electrolyte concentration than body fluid--are loaded with simple sugars. Since simple sugars delay gastric emptying, avoid those beverages. Choose iso- and hypo- tonic beverages instead, which contain the same and lower concentration of carbohydrate electrolyte, respectively, and are therefore good for hydration.

A low level of calcium is responsible for muscle cramps. Increase intake of dietary calcium or take calcium supplements.

Solution

When you experience an abdominal cramp, slow down or stop exercising. Massage the area by gently pressing against it with your hands while inhaling and exhaling evenly. Also try to take even and deep breaths, which allow the diaphragm to relax.

Warning

If you experience gastrointestinal symptoms that are not exclusively exercise-related and increase in severity, it may be a sign of a more serious gastrointestinal problem. Consult with your doctor immediately.