Ever felt a sharp jabbing pain below your right ribs while you are halfway through your run? You might be experiencing side cramps/ stitch or the more scientific term, “exercise-related transient abdominal pain” (ETAP). It’s really common among runners, but sometimes you might also get side cramps while swimming and doing other sports.
Why do side cramps happen?
There is no solid evidence on why you get side cramps but researchers have found a few theories on what causes them. Sometimes it is because of what you ate before you start your run, or it could be the speed.
Theory 1: Diaphragmatic ischemia
Diaphragmatic ischemia happens when there is a decrease in blood flow to the diaphragm, causing you to have cramps. In a study done by two researchers at Avondale College in Australia on the breathing patterns of 28 athletes after a workout on the treadmill, 14 of them experienced a side cramp, while the others managed to complete the course without any pain [1].
The researchers found that the athletes who experienced a side stitch only had a small decrease in lung power when exhaling exhalation which does not affect their performance. Also, there wasn’t any difference in inhalation strength which is usually controlled by the diaphragm so diaphragmatic ischemia might not be the main cause after all.
Theory 2: Irritation on the ligaments and abdominal pain
Another theory is that side cramps come from irritated ligaments and membrane that connects the muscles, bones, and organs inside the abdomen. The impact of running and other activities might pull the organs in your abdomen down, tugging on the ligaments in the upper abdomen and ultimately causing irritation [2]. This is why when you eat right before your run, you might get side cramps. If you drink sugary drinks before your run, the chances of side cramps will also be higher.
Theory 3: Irritation of the spinal column
In a report written by researchers, D. P. Morton and T. Aune in 2004, they found that the side cramps you get during a workout could be caused by the pressure that you put on the vertebrae of your upper spine. They have also found that athletes with kyphosis (or “roundback”), a condition where the upper spine is more sharply curved than normal, could have a higher risk of getting side cramps.
Sometimes you might feel a slight pain at the tip of your shoulder too when you get side cramps. How come? Well, the nerve that links to the diaphragm and the tip of your shoulder are connected to the same vertebrae.
This theory might explain why most runners, horse riders, and swimmers experience side cramps more often than cyclists. Activities like running and horse riding can cause jolts to the spine, while swimming causes rotational twisting to your spine so these activities can put stress on your upper spine. As for cyclists, they get less side cramps because cycling puts very little pressure to your spine [3].
5 ways to prevent or ease side cramps
1. Eat the right meal at the right timing
Always have your meal an hour to 3 hours before you start your run. Go for light meals with a good amount of carbs like sandwiches.
[Also Read: What You Should Eat Before a Marathon]
2. Hydrate (but avoid sugary drinks)
Water is the best running elixir before your run. If plain water is boring try making some fruit-infused water the night before so you get some naturally-flavoured water to perk you up.
3. Do proper warm-ups
Warm-ups are crucial before every workout because it will regulate your heartbeat, make your workouts more effective and lessen side cramps. Do some stretches and brisk walking until you get to your usual running pace. Starting fast the moment the gun goes off without warming-up properly will cause side cramps really fast.
4. Slow down & massage the cramp
Slow your pace until you get to gentle walking speed to lessen the pain. Then, bend your body forward while massaging or pressing on the area until the cramp goes away.
5. Stop and breathe
If slowing down doesn’t help to lessen the pain, just stop at a safe spot and take deep breaths into your lungs then to your belly. Sometimes, you get side cramps because of your nervousness which can cause you to take rapid shallow breaths. To know if you are breathing deeply, put your hand on your stomach, take a deep breath and you should feel your stomach rise and fall.
Always remember to drink enough water and eat the right meal before you start your run. Learn to breath deeply. Practise earlier to prepare your body for the 10km run. Preparing your body is the most important step to avoid cramps that could sabotage your run. If your side cramp still persists even after you have finished your run and activities, do seek a doctor immediately.
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