What’s Causing My Sudden Abdominal Pain?

Side cramps, or stitches, can be a perplexing issue. The cause is not always clear, though there are some ways to address it.

What's Causing My Sudden Abdominal Pain?
Ariana asks: I have been experiencing extreme abdominal cramping when I run, also an unusual shortness of breath and an inability to move my legs. [I run] a 5k distance and usually the first kilometre or so feels great and my split time is right where it is supposed to be, but then my legs start to burn, my chest hurts, and I can’t push myself any farther. The rest of the race usually results in abnormally painful cramps all throughout my abdomen that last even after the race.

I also experience the feeling that I have to vomit. Slowing down usually helps, but when I speed up again, it comes back. 

I have been running for years and this has never happened until the last week or so. Both my coach and athletic trainer are confused. The athletic trainer first believed it to be an uneven pelvis, but the symptoms have remained the same after treatment.

This is a perplexing problem. We really do not know what causes abdominal cramps, or why runners get side stitches.

I am going to assume that you eat well, and drink enough fluid to keep hydrated (but are not taking in too much fluid). If you are someone who pushes fluids all the time, you might try cutting your intake in half and see how you feel.

Pelvic alignment is a good thought, but if resolving the pelvis issue has not cured the problem, ask your trainer to check for a sublimated – or misaligned – rib. This is another musculoskeletal problem that can affect the abdomen and cause cramping. It happens when your rib head junction experiences movement.

Most often abdominal cramping or side stitches have to do with pace and oxygen supply to the muscle, especially the diaphragm. Most abdominal cramps clear up when you slow your pace and breathe more deeply. Practice breathing with your diaphragm (abdominal breathing) so you fill your entire lung. If you are not using your diaphragm, you will limit your oxygen supply, and this may be the cause of your cramping and your heavy legs.

You and your coach should also discuss where you are in your training compared to your race pace. Maybe a slower start and a faster finish will help you get through the race more comfortably. I remember a young runner on my daughters’ team who had a breakthrough race and said to the coach, “It hurts to go fast.” Part of learning to run well is balancing pace with your capacity.

Nerves and stress can also play a role in some cases of cramping. You may need to assess the “stress” level of your racing and work with your coach and athletic trainer to reduce stresses you may have from races.
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