Stomach pain, manifesting as sharp cramps, side stitches, or general abdominal discomfort, is a common physiological reaction to physical activity. This issue can abruptly halt a workout, whether you are a seasoned athlete or new to exercise. The pain is often a direct result of how the body manages blood flow and organ movement during exertion. Most exercise-related stomach pain is temporary and can be managed with immediate action and avoided with simple preparation strategies.
Common Physiological Causes of Exercise-Related Stomach Pain
During intense physical activity, the body redirects a significant volume of blood away from the digestive tract and toward the working skeletal muscles. This process, known as visceral ischemia, deprives the stomach and intestines of the necessary blood flow to function optimally. This can lead to generalized symptoms like nausea, cramping, and diarrhea. Strenuous exercise, particularly when dehydrated, exacerbates this issue because reduced blood volume hinders the gut’s ability to receive adequate perfusion.
A specific and widespread cause is the sharp, jabbing sensation known as a side stitch, or Exercise-Related Transient Abdominal Pain (ETAP). While the exact mechanism is debated, one theory suggests the pain originates from spasms in the diaphragm muscle, which is heavily involved in breathing. Alternatively, the repetitive jarring motion of activities like running can irritate the parietal peritoneum, the membrane lining the abdominal cavity, or place stress on the ligaments connecting internal organs to the diaphragm.
Improper pre-workout fueling contributes to stomach pain by delaying gastric emptying. Consuming large meals, or foods high in fat, fiber, or protein, too close to exercise means the stomach is still actively digesting when the workout begins. This competition for blood flow between the digestive system and the muscles increases the likelihood of cramping. Highly concentrated sugary beverages can also draw water into the intestines, increasing the osmotic load and potentially leading to GI upset.
Immediate Actions for Relief
The most immediate and effective action when stomach pain begins is to slow down the pace or stop the activity entirely. Reducing intensity helps re-establish normal blood flow patterns, quickly alleviating pain caused by visceral ischemia. For a painful side stitch, taking a moment to walk and focus on breathing is often enough to resolve the spasm.
Implementing deep, rhythmic breathing can help relax the diaphragm muscle. Try to breathe slowly and deeply into the belly, rather than shallowly into the chest, which can intensify the cramp. Exhaling with force, or using a pursed-lip technique, can also engage the diaphragm more completely to help break the spasm cycle.
Gentle stretching of the torso can directly target the affected area. If the stitch is on your right side, raise your right arm overhead and bend your body gently toward the left side, stretching the abdominal wall. You can also apply direct pressure by pressing two fingers firmly into the painful spot while bending forward slightly until the pain subsides. If dehydration is suspected, slowly sip a small amount of water or a low-concentration sports drink to restore fluid balance without overloading the stomach.
Prevention Strategies for Future Workouts
Planning your pre-exercise nutrition is one of the most effective ways to prevent future stomach pain. Athletes should aim to eat a main meal approximately two to three hours before a workout to ensure the stomach has largely emptied its contents. If you need a small snack closer to the session, choose easily digestible, low-fiber, and low-fat carbohydrates, like a banana or a small piece of toast.
A consistent hydration plan is paramount, as dehydration lowers blood volume and exacerbates many GI issues. Focus on drinking fluids steadily throughout the day rather than chugging large amounts immediately before exercising. During prolonged activity, aim to consume four to six ounces of fluid every 15 to 20 minutes to maintain balance.
Always begin your exercise with a proper warm-up to allow the body’s systems to gradually adjust to the demands of activity. Starting a workout at a high intensity without acclimatization increases the sudden demand for blood by the muscles, potentially triggering visceral ischemia. Incorporating core-strengthening exercises into your routine may also help. Developing stronger abdominal musculature can stabilize the torso, reducing strain on the abdominal ligaments and the diaphragm during high-impact activities.