Muscle Cramps and Stitches

At one point or other you may experience a cramp while running. This page will discuss what we know about muscle cramps, and how they differ from abdominal or side stitches.

Muscle Cramping

Cramps are sudden, involuntary contractions of muscles that last various lengths of time. They rarely result in injury, but can be very painful. Despite adequate preparation, you may experience a muscle cramp while running.

We breathe in oxygen to generate energy for our muscles to move. Our bodies accomplish this by using energy to both contract and relax muscles. This process involves several chemicals (oxygen, sodium, potassium, calcium, and water, to name a few) that work in a production line to continuously supply our muscles with energy. When depleted of one or more of these chemicals, our bodies may be unable to generate the energy needed to relax our muscles, and we CRAMP! Any one of these chemicals can stop energy production, which is why so many factors can lead to cramping during exercise. For example, our muscles may run out of much needed water during a long run in severe heat. These muscles need time to recover and generate energy before they can relax again[1].

Causes of Cramping

  • Dehydration
  • Electrolyte imbalance
  • Exercising in heat
  • Insufficient stretching
  • Malfunctioning nerves
  • Medical conditions
  • Medication side effects
  • Muscle fatigue
  • Poor Circulation
  • Overexertion [1, 2]


Ensure that your body is supplied with the chemicals needed to generate running energy without cramping. This includes eating foods with enough vitamins and nutrients before running. Leading up to and during a run, you should maintain/replace appropriate water and electrolytes. Other ways to prevent cramping include stretching, and conditioning your muscles by training regularly.


If you do experience a cramp, temporarily rest or walk until it subsides. This is a great opportunity to drink fluids, preferably something containing electrolytes. This is paramount because, as discussed above, our muscles have likely run out of certain chemicals in the production line of energy that are needed for our muscles to relax. The loss of electrolytes and water in our sweat, are most often the culprit. Try to stretch and massage the area. Cramps are common for all levels of runners, and usually subside quickly. If cramping becomes chronic and severe consult your physician.

The Sitch on the “Stitch”

When runners experience cramp-like discomfort along one or both sides of their abdomen, they may be experiencing a “stitch”, medically referred to as Exercise-Related Transient Abdominal Pain (ETAP). Unlike cramps, stitches are very localized areas of discomfort underneath the ribcage. Stitches are different from muscle cramps and are still not completely understood. Recently, sport medicine researchers Morton and Callister[3] argued that the best theory explaining the stitch is irritation of the parietal peritoneum, the outer lining of the sac that holds organs like our stomach inside of our abdomen. The stitch pain is thought to occur because the repetitive torso movements of running cause inflammation of this abdominal sac.

While these experts acknowledged that it is not always practical or desirable to stop running, they did suggest some strategies to manage a stitch. Strategies such as breathing exercises do not have evidence to support them, but controlling your breathing may be beneficial for other reasons. One example might be to mitigate an abdominal cramp rather than an abdominal stitch[3].

Avoid the Stitch

  • Avoid large volumes of food or beverages > 2 hours prior to running, especially those high in salt.
  • Maintain good running posture, consider wearing a broad supportive belt if this is a regular problem.
  • Practice drinking fluids while running. Find what works best for you[3].


  1. Ratini, M. (2015, July 21). Muscle Spasms, Cramps, and Charley Horse. Retrieved April 18, 2016, from
  2. (2016, April 9). In Wikipedia, The Free Encyclopedia. Retrieved April 18, 2016, from
  3. Morton, D., & Callister, R. (2015). Exercise-Related Transient Abdominal Pain (ETAP). Sports Medicine (Auckland, N.z.), 45, 23–35.


Aspiring runner, triathlete, and exercise junkie for more than a decade. Chris mostly provides technical writing for Aspiring Runner by examining evidence-informed running practices.

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