Common Causes of Stomach Pain During Exercise

Updated June 2, 2022
woman with stomach cramp while exercising

Do you experience abdominal pain when exercising? Perhaps you have stomach pain after working out. If these issues sound familiar, you're not alone. Studies suggest that 30% to 70% of athletes experience some type of gastrointestinal problems during or after their workouts and that endurance athletes (like runners and cyclists) are at higher risk.

But you don't need to throw in the towel if tummy problems attack. Depending on the cause of your stomach pain, there are different ways to approach the problem to keep your fitness training on track.

Abdominal Pain During Exercise

There are different causes of stomach pain during your workouts. Depending on the root cause, there are different ways to prevent or manage the stomach pain when it hits.

Side Stitch

Stomach pain that occurs on the sides of your torso is often referred to as a side stitch or a side cramp. It is often described as a sudden, sharp, or pulling pain. Exercise physiologists call it "exercise-induced abdominal pain" and research suggests that it occurs most often in endurance athletes, such as marathon runners or cyclists. Studies also suggest that it is more likely to occur in new runners or when experienced runners increase the intensity of their workouts.

Cause

There are several reasons why you might get a side stitch, but the most commonly cited cause is lack of oxygen. When you exercise, blood flow is directed to your working muscles. Blood flow is directed away from your stomach. As a result, your stomach gets less oxygen and may cramp up as a result. Dehydration can also cause side stitches or make them worse when they occur.

Prevention and Management

Make sure to stay properly hydrated on a daily basis. Dehydration can lead to muscle tension. When the muscles aren't properly lubricated, they aren't as pliable. This is true during exercise and throughout regular activity as well.

Also, whether you are a new runner or a seasoned athlete, always increase your intensity gradually so that your body can adjust to the oxygen demands of your muscles. Warm up slowly for at least five minutes with a brisk walk or a slow jog. If you still get side cramps, increase the warm-up duration to 10 minutes and see if that helps.

If you still get a side cramp, one of the first things you can do is to slow down your pace, relax your breathing and reduce discomfort. Running pros also suggest that you focus on deep diaphragmatic breathing, also known as belly breathing. Try to take deep breaths into the belly rather than shallow breaths into the chest area.

Lastly, some runners find that stretching can help. Stop briefly and reach one arm over the head while taking deep breaths. Repeat on the opposite side and then start running again at a slower pace.

Food-Related Stomach Pain

Gastrointestinal problems like gas or constipation, nausea, cramping, or acid reflux can occur in runners, cyclists, weight lifters, and other athletes. Studies suggest that this type of stomach pain during exercise is more likely in athletes who participate in vigorous activities, especially those that increase intra-abdominal pressure, like weight lifting. In severe cases, this type of stomach pain during exercise can lead to vomiting.

Cause

The cause of this type of stomach pain may be as simple as working out too soon after eating or eating the wrong type of food. Decreased blood flow may also contribute to the problem because it can contribute to a delay in gastric emptying.

Prevention and Management

The easiest way to avoid the condition is to avoid eating for three hours prior to exercise. Experts specifically advise limiting fat and protein before working out because those foods take longer to digest. For endurance athletes (like runners, swimmers, or cyclists) the International Society of Sports Nutrition recommends high glycemic foods, such as those that have a glycemic index of over 70. Foods like white bread, rice, and watermelon are examples of high glycemic foods. In some cases, antacids or other medications for acid reflux may be helpful.

Gastritis

Gastritis is an inflammation of the lining of the stomach. Over time the irritation can lead to erosion of the stomach lining. Symptoms can vary from one person to the next, but the Mayo Clinic says that it can feel like a burning or gnawing feeling or a feeling of fullness in your upper abdomen. You might also experience nausea or vomiting.

Causes

Researchers believe that this type of stomach pain is caused by exercise-related motion, lack of blood flow, or the use of non-steroidal anti-inflammatory drugs (NSAIDs).

NSAIDs include medications such as aspirin, ibuprofen (like Motrin or Aleve), and naproxen sodium (such as Aleve). According to the Cleveland Clinic, they are usually taken to relieve body aches and pains, headaches, or fever.

Prevention and Management

If you experience stomach pain after taking NSAIDs, experts advise avoiding them, especially before exercise. If you regularly experience stomach pain and suspect gastritis, talk to your healthcare provider to get a complete diagnosis. An antacid may help. Proton pump inhibitors (PPIs) and histamine H2 antagonists (H2 blockers) are also used to manage the condition.

Stomach Pain After Working Out

If your abdomen feels fine during most of your workout but you experience stomach pain after working out, there may be other issues at play. You might also feel pain momentarily during your workout and then find that the discomfort persists or comes back after your workout is complete.

Muscle Strain or Soreness

If your abdominal muscles are tight, you may experience pulling, a sharp pinch during movement (especially in the lower stomach area), or a gripping sensation. Many people refer to this type of pain as a "pulled muscle" because of the way it feels. The muscle damage may be severe enough that it becomes a muscle strain.

You might experience stomach pain or strain, but it can also occur in the psoas muscles that connect the lower abdominal area (pelvis) to the top of the thigh (femur). After the workout, you might experience soreness when you move the torso or lower abdominal area.

Causes

Muscle strains occur because of overexertion. Simply put, your muscles are not adequately prepared for the movement or the level of resistance that you subject them to. Pulled muscles or muscle strains often occur during explosive movements.

Prevention and Management

Warm up before you work out. Cold muscles are easy to over-stretch and pull. A proper warm-up will increase circulation and warm them so that they become flexible and better prepared for hard work.

A routine of light self-massage with a foam roller followed by five to 10 minutes of walking, cycling, or dynamic stretching should do the trick. Here is a video with a few quick ways you can foam roll your psoas, a hip flexor that extends from your abdominal region to your lower back.

If the abdominal pain persists, consider checking with a sports chiropractor. Muscle strains are a common cause of tightness. A professional can help with the process of healing through soft tissue work and exercise suggestions.

Hernia

If you experience stomach pain that persists after exercise, probably the biggest cause for concern is the potential of a hernia, particularly a sports hernia. This condition, also called athletic pubalgia, occurs when there is a tear in any soft tissue in the lower belly or groin area. A sports hernia can turn into a groin hernia where abdominal tissue bulges through an opening in the lower abdominal wall.

Causes

Experts at Johns Hopkins Medicine explain that sports hernias often happen as the result of explosive movements that involve twisting through the torso and pelvis area. They say that athletes who participate in sports such as football, hockey, soccer, rugby, skiing, running, or hurdling may be at higher risk because their sports involve this type of movement.

Prevention and Management

If you have a sports hernia, you'll feel pain in the groin area when you initially injure the area. It might go away with rest, but it will return when you start playing your sport again. If you suspect a hernia, seek the guidance of your healthcare provider who can provide you with a proper diagnosis and treatment. Left untreated, a sports hernia can become more serious and may prevent you from participating in workouts.

The Best Approach to Exercise-Related Stomach Pain

When it comes to figuring out what is causing your abdominal pain during exercise, it's best to look at the entire picture. The experience itself, along with your lifestyle habits and health history can provide clues. Check in with your doctor every year or two for physicals and current blood work. Express any concerns you have so that you can start taking measures to avoid injury before it arises. Also, be sure to stay hydrated, eat a healthy diet, and maintain a balanced exercise routine to keep your body fit and strong.

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Common Causes of Stomach Pain During Exercise