When it comes to belly cramps, cyclists are different from runners. The most common cause of belly camps in a cyclist is stool in the colon. In runners, it is a stretching of the ligaments from the diaphragm that holds up the liver. Fit athletes rarely suffer discomfort from small amounts of food in the stomach.
Belly Pain in Cyclists
Did you know that when your colon is empty, it rarely contracts during exercise. However if there is stool in the last 6 feet of your colon, exercise can bring on giant contractions that can push stool towards the outside to cause discomfort, and, worse than that, catastrophic results. You will know that this is happening to you because you will feel these contractions in your lower belly and an urge to defecate.
Everyone should always try to empty their colons before they exercise. If you are often constipated:
- Eat plenty of vegetables, fruits, whole grains and nuts. These are rich sources of fiber that keep food moving along your intestinal tract.
- Eat dried fruits such as dried apples, prunes and apricots. Dried skins of fruits contain lots of soluble fiber that binds to sugar in the fruit to prevent the absorption of these sugars in your upper intestinal tract. When soluble fiber reaches your colon, bacteria break it down to release the sugars so they are fermented immediately, drawing large amounts of fluid that dilates the colon and pushes stool toward the outside.
- Restrict constipating foods made from flour, such as bakery products, pasta and many dry breakfast cereals.
- Try to have a bowel movement half an hour after you eat a meal to take advantage of the gastro-colic reflex. When food reaches your stomach, the stomach is stretched, sending a message along nerves from the stomach to cause the colon to contract and push foods forward. The longer stool remains in your colon, the drier and harder it becomes and the more likely you are to have something in your colon when you start to exercise.
Belly Pain in Runners
For runners, the most common cause of belly pain during running is a side stitch, a sharp stabbing pain usually in the right upper part of the belly just underneath the right lower ribs. With continued running, the pain worsens, but it goes away as soon as you stop running.
Dr. Tim Noakes, a medical school professor from South Africa, offered the first reasonable explanation and successful treatment. Thick, fibrous bands called ligaments extend downward from your diaphragm to hold your liver in place. When you run, your liver drops down at the same time that your diaphragm goes up from breathing out, stretching the ligaments to cause the pain.
However, when riding, you cycle in a smooth rotary motion with no sudden jarring. On the other hand, when you run, your foot hits the ground with a tremendous force. Your foot hits the ground at more than 3 times body weight when you run at six-minute-mile pace. So when your foot hits the ground, your body suddenly stops moving down , but your liver keeps on going down and stretches the ligaments that hold it up (which are are attached to your diaphragm). You develop a pain from the over-stretched ligaments from your diaphragm to your liver.
Humans have a fixed pattern of breathing when they run. When you run slowly, you usually breathe out once for every four strides. When you run fast, you can breathe once for every two strides. When you breathe out, your diaphragm goes up, and at the same time, the force of your foot strike causes your liver to go down. Most people breathe out when their right foot hits the ground, so the cause of a side stitch during hard running is a stretching of the ligaments that hold the liver to the diaphragm on the right side. The cure is to relieve the stretching of the ligaments.
When you get a side stitch, stop running and press your hand deep into your liver to raise it up toward your diaphragm. At the same time, purse your lips tightly and blow out. Pushing the liver up stops stretching the ligaments. Breathing against pursed lips retards fully emptying your lungs and doesn’t let your diaphragm rise too high. The pain is relieved immediately and you can resume running as soon as the pain disappears. The pain usually will not go away unless you stop running long enough to raise your liver.
If You Get Frequent Side Stitches When You Run:
- Breathe deeply when you run. The deeper you breathe, the more air you take in and the lower you push your diaphragm to decrease the stretching of the ligaments. Shallow breathing keeps the diaphragm in a high position, which stretches the ligaments further.
- Breathe through pursed lips. This keeps your diaphragm high and allows you to relax your diaphragm.
- Try to breathe out when your left foot strikes the ground. Avoiding breathing on your right foot strikes will help to prevent maximum stretching of the ligaments when your diaphragm goes up as you breathe out.
Food in the Stomach
Most cyclists should eat something when they ride for more than an hour. Eating does not cause discomfort unless you go so slowly that you spend more effort eating than pedaling. A stomach cramp is caused by inadequate blood flow to the stomach during exercise. Then the stomach muscles can suffer from lack pf oxygen and cramp.
During exercise, your exercising skeletal muscles need huge amounts of blood flowing to them to bring them the oxygen they need to convert food to energy. So your body protects the stomach muscles by shutting down the circulation to the stomach and intestines, and they move far less than they normally do. Eating small amounts of food frequently does not significantly increase stomach contractions.
Gabe Mirkin, M.D., is a sports medicine doctor and fitness guru. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin has run more than 40 marathons and is now a serious tandem bike rider with his wife, Diana. His website is http://drmirkin.com/. Click to read Gabe’s full bio.