SparkPeople Blogs  •  running  •  safety

Running Inconveniences Part 2

By , SparkPeople Blogger
Before I begin my blog, I noticed in the news that much of the country is experiencing unseasonably warm temperatures. I wanted to link you to another blog I wrote last summer titled, The Heat is On: Taking Precautions When Exercising Outdoors. Because many of us seemed to have skipped right over spring and quickly into summer, it is very important that you allow time for your body to acclimate to the heat, including cutting your pace and mileage for a few weeks. This includes runners, walkers, cyclists and anyone else who spends time exercising outdoors. I want to keep you all safe so that you can continue on the path to healthy living.

This is the second in a series of blogs regarding those somewhat annoying running inconveniences that don’t necessarily keep us from running, but can turn an enjoyable experience into a little less enjoyable one unless you know what to do when the problem arises.

Gastrointestinal Issues

One of the most embarrassing running inconveniences known to many seasoned runners is runner’s diarrhea or more commonly known as ‘runner’s trots.’ The symptoms can range from mild cramping, to nausea, to full-fledged diarrhea. It has been reported that as many as 20-50% of all runners will experience at least one episode of runner's trots in their running careers. Although this condition is more commonly experienced in the beginner runner, it isn’t unusual to have a seasoned runner experience this problem when training for an endurance event, such as a full marathon.

  • Low Blood Flow to the GI tract- While we don’t fully understand why some runners experience this condition while others don’t, one theory is that as blood flow is diverted from the gastrointestinal tract to the working muscles of the legs, this leads to an irritation of the intestinal lining hence leading to cramps, gas, nausea and diarrhea.
  • Movement During Running- Another theory is that the constant jarring of the gastrointestinal tract during a run can stimulate bowel function, consequently speeding up bowel activity.
  • Diet- Consuming food or drinks containing sugar alcohols or high fiber can lead to GI issues.
  • Dehydration
Preventive Measures
  • Eat no sooner than two hours before your run.
  • Avoid caffeine or other warm fluids before your runs as this can actually stimulate the bowels.
  • Make sure you stay well hydrated before, during and after your runs.
  • Be mindful of high fiber foods before a long, slow distance run or before a race.
  • Avoid drinks or foods high in sugar or sugar substitutes, especially sugar alcohols found in sugar free gum and candies.
  • If you are lactose intolerant, avoid dairy products before your run.
  • For some runners, wearing a fuel belt or constricting clothing around the waist can lead to this issue.
  • Avoid eating foods high in fat and protein too closely to your run as these nutrients take more time to digest than carbohydrates.
  • Avoid taking Ibuprofen or a non-steroidal anti-inflammatory medications, such as Aleve, as these can lead to GI disturbances.
  • Start a running journal to help you determine if there is a pattern with the food/drinks you are consuming.

Most runners have experienced at least one side stitch in their running career; however the occurrence is more prevalent in the beginner runner. The reason--many new runners have not developed a suitable pace for running so they run too fast and too intensely.

A stitch can be quite painful and can literally stop a runner in his/her tracks. And while some runners may experience a stitch on the left side or under the shoulder blade, the majority of runners will experience this annoyance on the right side just under the ribs.

  • Side stitches are believed to be caused when the diaphragm goes into a spasm or when there is cramping or straining of the ligaments supporting the diaphragm.
  • Side stitches are usually related to our breathing. In other words the harder we breathe the greater the stress is placed on the muscles and ligaments.
  • Downhill running can lead to a greater incidence of developing a stitch as the impact to the body is much greater due to the gravitational pull.
  • Shallow, quick breathing is believed to be one of the biggest factors leading to a side stitch.
  • Side stitches may be more prevalent when running in colder temperatures as runners tend to do less deep belly breathing.
  • Runners who complain more often of side stitches tend to exhale when their right foot strikes the ground versus those who exhale when their left foot strikes. The reason is landing on the right foot while exhaling places a greater force on the liver which lies on the right side in proximity of the diaphragm.
  • Avoid eating within an hour or two of your run. When the contents in the stomach push on the diaphragm it begins to push on the other internal organs, especially the liver--the largest internal organ--causing the diaphragm to go into a spasm.
  • Breathe through pursed lips.Try forcefully exhaling through pursed lips as if you are blowing out candles on a birthday cake.
  • Bend into the stitch.Some runners find bending into the stitch and lifting the rib cage can help release the spasm.
  • Try alternating your breathing pattern. In other words, if you always exhale when landing on your right foot, try exhaling on your left foot.
  • Practice deep belly breathing when you are not running. Lie flat on your back (no pillow) and place a book on your lower abdomen, then practice breathing deeply by raising and lowering the book with each breath.
  • Mouth breathing allows for greater lung expansion and deep belly breathing which can help offset the dreaded side stitch.
  • Try stretching out the stitch.Some runners have found relief by raising their right arm and leaning toward the left and holding this stretch for 30 seconds, then repeating the stretch on the other side.
  • Stop or walk when all else fails. Slow down or stop until the pain subsides and then slowly resume running.
As you can see, many of these so-called running inconveniences will resolve over time as you develop from a beginner runner to a seasoned runner if you allow time for your body to adapt to the demands running places on your body.

Next week I will discuss shin splints and knee issues.

Have you ever suffered from runner’s diarrhea or side stitches? What measures did you take to resolve these inconveniences? Have you experienced unseasonably warm temperatures and if so, have you taken measures to allow your body time to adapt?

Click here to to redeem your SparkPoints
  You will earn 5 SparkPoints
See more: running safety


RCLYKE 3/6/2021
Thanks Report
I have a stitch once in a rare while, usually not a problem.

I get runner's trots if I run more than an hour and have learned to manage them. If I am training, I just find a washroom. If I am running a race, I eat less fibre for 2 days before and the day of the race and I hydrate for 3-4 days before and don't drink too much on race day before the race, but do have energy drinks after 45 minutes of running until the end of the race. I bring a complete change of clothes for right after the race in case I have an incident during the race. Report
Thanks Report
Great article! Thanks! Report
Great information. Report
Whew...I'm not alone. The "trots" situation has happened to me a few times since started running a few years ago. I was starting to get scared. Thanks so much for explaining what happens to me! Report
Great blog. Thank you. I can't say that I have experienced stiches or trots, but I didn't know it mattered what foot you land on when you exhale. I'll try exhaling when landing on my left foot now. Report
i'm planning to start running and this is good information to remember. Report
I am a beginner runner and experienced the 'runner trots' the first time this past Saturday. I blame it on a restaurant meal the night before with waaaaaaay too much sodium. My body was out-of-whack.

I used to experience stitches in my side whenever I ran when I was younger. Now, with a comfortable pace, and concentrating on exhaling through pursed lips I do not experience them any more.

cj Report
by the way, I thought my city was going to be in an unseasonable heat wave for the next week after looking at weatherbug on my ipod - then i realized i was looking at the forecast for my parents' town in New Mexico, not mine in Michigan. :^) Report
Once or twice I've been in the "end this run and head home!" situation. I figured it was related to whatever I'd snacked on that morning.

Can you write a blog about that other leakage some of us women runners face? I like to blame the grouchy male doctor at my 2nd birth who cut a probably unnecessary episiotomy... Report
The only time I've had indigestion while running was the one time I decided to skimp on cleaning the hydration pack I was using for the marathon training - on the theory that "it's only WATER in there"! Learned my lesson, remembered to clean it THOROUGHLY every single time after that, never have had problems again! Report
I practice breathing like for labor it seems to work me thru. Report
Great article! Looking forward to your next one! Report
I frequently get the "trots" when I drink too much Gatoraide or the like. I have learned not to drink it before or during the run, but to load up afterward when I am closer to the bathroom :~). Report
Unfortunately, the Pacific "NorthWET" has been nothing but rainy and cool / cold for the past 3 months. We have been making records for the lowest "high" for the day.

Yes, with regards to stitches... I have found that my breathing (how) really does make a difference in recovering from the difficulty. And yes, the breathing form that is practiced in Pilates has assisted me in keeping going instead of having to stop due to pain.

Yep... regular exercise will assist a well-functioning GI tract and contributes to regularity! My system was most consistent during my long walks in training for the Portland, OR marathon.

I used to participate in a local half marathon, but they moved it to the end of July in the midst of summer heat. It just is not conducive to health and well being for me. So, I have had to let it go, even though I have always enjoyed the outlet. Report
Thanks for sharing all the great tips. Report
For sidestitches, if I breathe in hard and fill my lungs as completely as possible, then breath out quickly and forcefully, it helps relieve the pain of the sidestitch... Hope it works for you... Report
Okay, I'll fess up. YES, I have had some bouts with LOWER GI issues to the point of embarassment. I am still in the process of tweaking my eating because of this. Another problem I have had with running is getting my child-bearing hemorrhoids all fired up to the point of bleeding. i refuse to let these annoyances stop me from doing what I love though. I just learn to work around them. Report
I've also had side stitches since I was a kid. Back then I didn't let it bother me and I try not to let it get to me now either. I haven't found anything that helps to prevent or get rid of them. And I not only get them from running, but from anything where I am really working hard. Never had any problems with the "runner's trots" thank God! It's very warm in Ohio now too, and the gym I go to doesn't have a/c, just big fans blowing hot air around. The last couple of times I was there, I had to cut my workout short; I just got too overheated and almost sick from the heat. I guess it will take some getting used to. Thanks for another great blog, Nancy. I really look forward to reading yours. Report
I wish it were unseasonably warm right now. It is FREEZING here!!

Great blog; I learned a lot! Report
I have IBS and have been running all of my life. I have always suffered from GI problems when I run. I have noticed it is worse in hot weather and if I am pushing myself to run faster. I recently ran a marathon in cold weather and had no problems due to my slower pace!
Also, for the lady with the plantar fascitis- I had the same condition about 5 years ago and it took a year of walking and then slow running, but I did recover from it. Now I can run just fine as long as I don't try to sprint for too long! Report
I've experienced the runner's diarrhea and severe cramping. It's awful. I found out that my body cannot handle running/exercising in the morning. As much as I want to, my body isn't ready early in the day. Running in the evening helped with that problem. I find that for side stitches stopping to walk and forcing breath through pursed lips really helps. I usually can start back up again in a few minutes. Report
I am an occasional runner and have been diagnosed with plantar fasciitis. I have stopped walking and running for over a month and am itching get back on track. Could you please write a post on this issue or let me know if people suffering from this issue can ever run again. Thanks in advance. Report
Thank you so much for posting about the diarrhea...I am currently in the process of tracking what I eat the night before my long runs on Saturdays to try and determine which foods are causing the diarrhea I have during those runs. It is not every Saturday, so I'm making a list of "no no" foods to eat the day before a long run. This was very helpful in solidifying some of what I have found and answering other questions.

And yes, it was 93 today! So, what I did was got up early and ran outside when there was no humidity (still was 72 at 5AM, but a nice 72!) and that way, I had extra time after work today to do more things around the house! Report
Thanks for the helpful information! I just started running this year and I love seeing articles like this. Report
I hear ya sister! I have been running 4/ever and currently am trying to qualify for Boston. GI issues are a big issue for me! I notice my pace determines the pain. When I start running faster or longer that is when it begins. However, I also have issues outside of running.
I have learned to. Cup sugar and fat to help with this. Report
Awesome blog! My who has just started running avidly, has been suffering from terrible side stitches (and actually went to the doctor's last week for them). She's also on Sparkpeople, so I will ensure she reads this! Thank you! And thank you for the link to the bog on running in the heat. We've really had an issue with that here - especially in the past week or so. It was 70 when I went for my run at 6:00 a.m. this morning. Expected high will be in the 90's by this afternoon. Very timely! Report
As a menopausal woman, I've learned to plan my walks around restrooms - I make sure there are adequate stops for frequent visits, especially since I drink so much water. Makes a huge difference in where I walk now! Report
This was great info for me as I want to start running with the c25k program. Thanks for sharing the great tips on how to avoid certain issues. Report
I used to get side stitches ALL the time when I ran! At the time, I never could understand why anybody would subject themselves to this torture and enjoy it.

Never even heard of runner's trots, didn't know there was such a thing - yikes! Report
great blog. i would like to start running consistently but there are obstacles. all the tips are much appreciated!!!! Report
I do not run but do want to start thank you for this informative article. Report
LOL. runner's trots. I have suffered from this constantly for years. Well, at least running has always stimulated certain bodily functions for me. When I first started running, I was afraid I would never be able to run long distances because of this. But I've learned several strategies to help. Last year I completed my first half marathon with no problems and without the need to take a bathroom break.

If you have constipation issues, there's nothing like running to get things going! Report
Side stitches essentially made me stop running. I would get them really bad, and even with all of the tricks I looked up, they never went away, even after running for several months. I used to get them a lot as a kid too. For some reason, I only really get them while running and not with other exercise. Report
I find I get GI issues/side stiches when progressing my training for a race. I usually don't get them when I'm just maintaining my usual distance. I definitely have had bad side stiches while running in the cold weather which stretching helped but they just went away as I got more used to running in the cold weather. I cannot run in the hot weather outside, I will either get up very early or go to the gym and run on the treadmill. I get very sensitive to the heat and have passed out before while running in too hot weather. Be careful out there! Report
Thanks for the great tips
Yes the weather has been CRAZY -
93 @ 4:00 pm and 63 @ 7:00 pm today!
I have experienced severe cramping, bloating and nausea toward the end of my run and up to 12 hours after my run. I also have IBS, so it makes it harder for me to begin with. I have been analyzing, experimenting, documenting and adjusting, to reduce these incidents. I have determined that I cannot drink coffee 4 hours before I run. I CANNOT use a fuel belt, so I have devised straps for my hands to carry smaller water bottles in each hand and map my route around places I can stop to refill (especially in hot weather). I cannot eat fiber the day before and the day of my long run. I have to drink, drink, drink, the day before, the day of a run, and the immediately after. And, absolutely no NSAIDS before my run. So, basically, I discovered most of my problems and they happen to coincide with most of the info from this article. The key is to experiment and listen to your body! Don't give up! Thanks, Nancy. Report
Thanks for the great article. I had constant GI problems while training for my first marathon last year and one sparker gave me the best advice - Immodium! I think mine were due to some of the causes you mentioned - sugar & sugar alcohols, ibuprofen, and high fiber. Since I was not able to get it totally under control before the marathon I took two immodium tables before the race and did not have one GI problem :) Since then I have cut out the source of sugar alcohols and cut down on my overall sugar intake which seems to have helped the problem. I also no longer take Aleve and I closely watch my fiber intake up to two days before a long run. I love running and GI problems while training made it very uncomfortable and almost caused me to quit. It is not fun to have to hide in the bushes while the rest of your running group passes by!

Thanks again for the great article. Report
Very helpful post. Thank you! Report
Oh wow, I finally found the reason for side stitches (not that I've tried googling yet), anyways, great article!!! Report
I have developed the stitch and the diarrhea due in part to not breathing right. I've learned to exhale while exerting and inhale through the nose while going back to the beginning. Partly I've learned this from Pulmanary Rehab. Report
I definitely get side stitches when I run outdoors, since I've only done that a very few times and running on a treadmill gives a lot more cushioning. My sister told me the breathing pattern trick when we went on a run together last week, and it 100% worked -- what a relief!!

As for the warm weather, while I did commute on my bike yesterday (20 miles total!), the hard uphill trek TO work was in 70 degree heat. The 92 degree heat on the way back wasn't so bad, since it's an easier, downhill ride home. I was planning on running tuesday with my sister again, but we both felt nauseous just sitting in the heat, so running was NOT an option!!! Report
When I get bad stitches, I squeeze my hand aroung my water bottle or if running without one I pick up a stone and use that - always squeeze using the hand on the side of the stitch - works for me. Report
The only time I get side stitches is when I run in the evening. I have learned not to eat too close to running time; my body needs at least two hours to process what I've eaten and then I can run. Report
Interesting article, very informative too.
I have had GI issues on occasion and what i found helps me a lot is eating a piece of extra dark chocolate before my run (but i rarely run more than an hour, hour twenty max, so if i ran for longer that probably wouldnt help much either).
As for the side stitches, i do get those...i used to think it was my stomach acting up or sth, but i get them at the exact spot you mentioned (on the right below the ribs) + i usually get them when i try running at a faster pace or for longer, so i do feel better now that i know what it is. And i actually tried the stretching thing today when i got that pain and it helped some, so thanks for the info:) Report
Not only with running, but just with high heat in general, I tend to have "gastrointestinal issues." It always seemed so counter-intuitive to me - it's hot and you might even be dehydrated, so, "quick! jettison any water you do have!", you know? Report
so that is what it is called a side stitch.. I got one on the right side but I swim and tread water and water jog and aqua fit for exercise mostly. Report
This is indeed useful information. I've been trying to do the couch 2 5k program but yesterday my upper right quadrant of my midsection hurt too much to do all the jogs. It sometimes hurts during zumba as well. Having read this, it might be a stitch. Good to know. Report
Great information. A good reminder to stay hydrated by getting my 8 cups of water a day. Report