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What Are Common Causes of Side Cramps?

Kerrie Main
Kerrie Main

Typically characterized by sharp, stabbing pains on either side of the abdomen, side cramps can affect all types of people. There are several types of these cramps, and the most common ones are running cramps or running stitches and menstrual cramps. The symptoms of side cramps are very similar, but their root causes might be very different. The most common causes of side cramps from exercise include food and drinks consumed before a workout, breathing patterns during exercise and overall workout intensity.

Side stitches or running cramps most commonly affect runners and swimmers. There are many theories behind this pain, though most experts agree that it is caused by a spasm of the diaphragm muscle. The reasons for this type of occurrence are numerous. Some exercisers might experience this pain from consuming drinks high in carbohydrates, such as concentrated fruit juices, right before a workout. Others might suffer from side cramps because they exercised too soon after eating a heavy meal or because they have intolerance to dairy or wheat products.

Intense workouts may cause abdominal contractions and side cramps.
Intense workouts may cause abdominal contractions and side cramps.

Another theory behind the main cause of side cramps is that running stitches are the result of poorly coordinated breaths with movement. For example, most runners exhale when their left feet touch the ground, and they inhale when their right feet touch the ground. When a man who is running exhales as his right foot hits the ground, he forces his liver to drop down on top of his diaphragm. The diaphragm typically lifts up during the exhalation motion, which means the two organs are not working in conjunction. The additional stress makes the diaphragm stretch more, which might lead to spasms and pain.

Menstrual cramps are one common cause of side cramps.
Menstrual cramps are one common cause of side cramps.

People who participate in high-intensity workouts might also be more susceptible to side cramps. Workouts that require the exerciser to raise his or her knees repeatedly can create abdominal contractions. This might cause the stomach to press down on the diaphragm. Intense exercise might also decrease blood flow to the diaphragm, which could cause it to spasm.

A person not properly conditioned may get side cramps when running.
A person not properly conditioned may get side cramps when running.

There are many ways to help prevent and treat side cramps. Some doctors recommend waiting an hour after eating before working out. Runners who spend time stretching their sides and abdominal areas might also prevent side stitches. If they do occur, experts recommend that the exerciser should try to slow down his or her breathing and incorporate longer, deeper breaths. Massaging the affected area might also help to increase blood flow to the diaphragm and relieve the pain.

Why Do I Get Side Cramps When I Run?

Indigestion from food can cause side cramps.
Indigestion from food can cause side cramps.

No matter your level of running experience, the unfortunate side cramp is inevitable. This muscle stitch is typically described as a sudden, painful sensation that occurs near your rib cage and can occur at any point in time during a running workout. Health experts refer to this type of muscle cramp as “exercise-related transient abdominal pain.” While side stitches are certainly uncomfortable, the good news is that the pain fades away shortly after you stop running.

While a definite cause has not been determined, several factors have a positive correlation with the onset of side cramps, including:

  • Eating shortly before running: If you eat immediately before running, your body does not have enough time to digest your meal. A side cramp can occur since more blood flows toward your stomach for digestion and less blood flows toward your diaphragm to help with proper breathing during exercise.
  • Breathing rapidly during running: The constant pulling of ligaments in combination with frequent breaths during running may stress the diaphragm. Moreover, increased oxygen intake causes the lungs to overextend, contributing to side stitch pain.
  • Having an electrolyte imbalance: Dehydration or high salt intake can irritate the abdominal lining.

To Get Rid of Side Cramps

There are a few ways to fight the dreaded side cramp, especially if you are in the middle of a long run.

  • Slow down to walking speed: If a side cramp occurs during your run, go on a walk break for a few minutes. Attempting to run through this stabbing pain may worsen the cramp. During this break, gauge your level of pain and determine whether or not you can continue your run with reasonable effort.
  • Drink water: You may be simply dehydrated. Drinking small sips of water may help to alleviate your side stitch.
  • Relax and stretch: Raise the arm on the side where the pain is. Stretch your arm high above your head to help relax your irritated abdominal muscles.
  • Take deep breaths: Focus on slowly breathing in and out until the side cramp resolves. You can also massage the area while taking deep breathes to further help relieve the muscle tension.
Staying hydrated can prevent cramps.
Staying hydrated can prevent cramps.

These simple tricks usually relieve side stitch pain. While side cramps are mostly mild and temporary, it is important to know when to go to a doctor for a side stitch. If the following occur, seek medical advice and/or attention from a healthcare professional:

  • Pain occurring in the absence of exercise 
  • Pain that does not resolve after several hours 
  • Tender sensation in your abdominal area

These situations may be indicative of underlying health conditions unrelated to plain running cramps.

How To Prevent Side Cramps When Running

There are several ways to avoid the pain of side cramps when running.

  • Improve by inches, not by miles: If you are planning to start running or if you want to increase the intensity of your workouts, do so conservatively. Build up the distance and speed of your runs slowly over time. 
  • Eat two to three hours prior to running: Give your body time to properly digest your pre-workout meal. More blood will be directed to your diaphragm while running if you do not have any food in your stomach. Also, do not go overboard with fluid intake immediately before running as this will contribute to abdominal irritation.
  • Avoid foods with high amounts of sugar or salt: Foods with too much sugar or salt can irritate the abdominal lining. Foods high in fat and fiber should also be avoided immediately before your run.
  • Avoid mouth breathing: Deep nasal breathing helps to decrease excessive abdominal breathing, causing less stress to the diaphragm. Practicing slow, measured breaths through your nose also helps to strengthen your lung and diaphragm muscles. 
  • Improve your posture: Throughout the day, make a conscious effort to keep your spine upright and shoulders held back. Performing exercises geared towards strengthening your back muscles will also help to improve your posture.
  • Dedicate time to warming up: Attempting to sprint right out of the gate will prompt shallow breathing and stress to your diaphragm. Incorporating a proper warm-up before you run can also decrease the chance of muscle cramps in other parts of your body. Dynamic movements also direct blood flow to your muscles to prepare them for strenuous exercise.
  • Strengthen your core muscles: Stronger core muscles have been associated with less pain from side stitches. Try incorporating glute bridges into your daily workout rotation to build your core.

Sources:

https://uthealthaustin.org/blog/the-cause-of-a-stitch

https://marathonhandbook.com/side-stitch-when-running/

https://www.healthline.com/health/stitch-when-running#prevention

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Discussion Comments

anon155121

I'm not a professional athlete but i hadn't gotten cramps in gym class for two years and no I suddenly got it so I was really curious to why i was getting them. Now I know!

thank you so much for this article!

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    • Intense workouts may cause abdominal contractions and side cramps.
      By: Kitty
      Intense workouts may cause abdominal contractions and side cramps.
    • Menstrual cramps are one common cause of side cramps.
      By: Ana Blazic Pavlovic
      Menstrual cramps are one common cause of side cramps.
    • A person not properly conditioned may get side cramps when running.
      By: Deklofenak
      A person not properly conditioned may get side cramps when running.
    • Indigestion from food can cause side cramps.
      By: sattriani
      Indigestion from food can cause side cramps.
    • Staying hydrated can prevent cramps.
      By: DragonImages
      Staying hydrated can prevent cramps.
    • Side cramps can be caused by abdominal exercises.
      By: michaeljung
      Side cramps can be caused by abdominal exercises.
    • Practicing yoga may help alleviate side cramps.
      By: magann
      Practicing yoga may help alleviate side cramps.
    • Running cramps may be caused by a spasm of the diaphragm muscle.
      By: snapgalleria
      Running cramps may be caused by a spasm of the diaphragm muscle.