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home > training > aches & pains > belly and chest discomfort

Belly and Chest Discomfort
From the common side stitch to more indelicate gastrointestinal discomfort to the dreaded runner's nipple, these tips will help you prevent and overcome pain 'round your middle.

  
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By Josh Clark
Posted Monday, 29 September, 1997

The Stitch
"Runner's Trots" (loose bowels)
Runner's Nipple


The Stitch

Description:
We've all had this one, a sudden sharp pain in the side of the upper abdomen at the base of the ribs. The side stitch typically strikes when you're really pushing yourself and fades quickly when you slow down or stop. The stitch is particularly common for new runners still adjusting to the rigors of running.

Likely causes:
The pain is caused by a spasm of the diaphragm, the muscle that controls your breathing. There are a number of possible reasons for this. If your breathing isn't controlled and disciplined, the diaphragm may be complaining. If you are running too soon after eating, your heavy stomach may literally be tugging at the ligaments connected to the diaphragm. Or you may simply be running too fast for your body's breathing machinery to keep up.

Remedy:
A stitch will usually go away quickly after just slowing down or stopping. If you're in a race or you just don't want to stop, however, you can often make it go away by bringing your breathing into careful control. Concentrate on belly breathing, pushing your belly out when you breathe in and relaxing it as you breathe out. Take deep breaths on the intake, and exhale suddenly, even noisily. To get the diaphragm to contract in rhythm with your steps, try to inhale and exhale as you land on your left foot. Strange but true, this can help prevent spasms by encouraging the diaphragm to bounce along in sync with your stride.

If the pain is just too much and you have to stop, try bending over and raising your knee on the stitch side while pressing your fingers deep into the painful area and tightening your stomach muscles. Or just walk while belly breathing.

 
Runner's Trots
(Loose bowels)

Description:
Painful and potentially embarassing, the runner's trots are marked by the urge to head for the bushes mid-run. You may experience abdominal cramps, gas or diarrhea during or immediately after long or particularly strenuous runs and races.

Likely causes:
It's not entirely clear why this happens, but 20 to 40 percent of runners are troubled by this from one time to another. It's something that seems quite specific to runners and probably has something to do with the inevitable bouncing and jarring and sloshing that goes on. At the same time, running boosts the hormones that get things moving in your intestines. Dehydration, too, can contribute to the problem. Some runners, though, are more likely than others to have the trots. It's possible that this has to do with milk (lactose) intolerance. Even a mild intolerance that would otherwise go unnoticed may cause gas and diarrhea during a strenuous run within 24 hours of eating a dairy product. This is caused by the body's inability to metabolize milk and dairy products; gas in the large bowel is the result.

Remedy:
Be sure to drink plenty of water before, during and after your run. Experiment with reducing or cutting out all dairy products at least 24 hours before a race or long run. Try using lactose-free milk, available in most stores. Finally, try to clear your system with a bowel movement before you run.

 
Runner's Nipple

Description:
When you have runner's nipple, you know it. Raw, painful, even bloody nipples are tough to miss, though sometimes you won't notice it until you get into the shower only to be treated to a decidedly unpleasant stinging sensation.

Likely causes:
Chafing with a wet shirt or running singlet. Particularly during long summer runs, the constant friction of a sweaty, salty shirt can quickly rub your nipples raw. Cotton is particularly villainous here, since it tends to hold water and become heavy.

Remedy:
Before especially long runs and on hot days, smear a little petroleum jelly on the nipples (or really anywhere there might be some chafing). Wear softer, looser clothes, and avoid screen-printed designs on your shirts and singlets. Especially avoid cotton and instead seek out lighter wicking fabrics like CoolMax.

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