Posted by: Joe English | January 29, 2008

Training: why do I get side-aches when I run?

Coach Joe English

Coach Joe English

Boy we get this question a lot: why do I get a side-ache or pain in the right side of the abdomen when running?

I’ll start by noting that this is a very common issue and it can be a real downer. Side aches almost always occur on the right side, just below the point where your rib-cage meets the side of your body, but they can in fact happen on the left side at times as well.

There’s a lot of debate over the cause of side-aches, but the best guess is that the ache comes from the up and down motion of running putting stress on the diaphragm. What we see with runners is that there may be some combination of things that makes side-aches worse for them as individuals, such as eating or drinking before running – or not eating or drinking before running. The problem can be highly dependent on the person.

Side-aches are caused by the up and down motion of running putting stress on your internal organs, most especially when you’re breathing out. When breathing out, there is an increase in the tension on the ligaments holding your organs in place, in particular the liver (which is a big and heavy organ), as the diaphragm comes upward. If you also happen to be hitting the ground with your foot at the same time, this banging can cause your side to ache.

Here are a couple of things that you can do to help:
First, become a belly breather – concentrate on taking deep breaths and expanding your belly when you breathe. You can practice this by laying on the couch with a book or magazine on your stomach and lifting it up and down as you breathe. If you breathe shallowly with just your lungs, you won’t see your belly moving in and out as much. Belly breathing not only helps with side-aches, but also puts more air in your lungs, giving you more oxygen with each breath.

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  1. Thanks Coach Joe
    I thought I’d throw in my own experience with food contribution to side aches. I’ve found that having dairy the morning of or even evening before my long runs correlated with getting side aches. No milk, no ache. I’m not lactose intolerant, but found that it does affect my running.

  2. Ah milk rears its face once again.

    It’s interesting to hear you say that milk may give you side-aches. Milk gets blamed for all kinds of ailments and I’m not sure which are real and which coincidental.

    Some people do suggest cutting out dairy before running, but I’ve eaten dairy products for years and have never had trouble. I think this is truly an individual issue based on your diet and tolerance for milk products.

    Coach Joe

  3. Joe

    Interesting note..I went to the Reebok Indoor games this past weekend and witnessed a world class athlete having side stitch pains. Read the recap below. apparently she has had this problem for awhile and cant solve it. We watched her hold her side for 2 laps ( at a very fast pace) and still win.
    Im sure she has some of the best trainers and doctors trying to solve her problem..with no answers yet

    Women’s 3000m: Tirunesh Dibaba Wins but Is Upset Afterwards
    It was disappointing to see Tirunesh Dibaba basically race the same race as Meseret Defar (Dibaba the 3000m, Defar the 2 mile) and not have them in the same race, but there is no way these two will race each other without a lot of money or prestige on the line. The best solution would have been for one of them to run either the 1500 or the 5k.

    Nonetheless, Dibaba opted for the 3000m and ran before Defar. The women’s 3000m was the Dibaba show as Tirunesh and her sister, Ejegayehu, dominated from gun to finish. As would be expected Tirunesh got the win (she overshadows her sister so much we think most people don’t realize how good Ejegayehu is. Ejegayehu ran 30:24 for silver at the 2004 Olympics in the 10k and has 2 World Championship track medals as well)

    The 1600 was reached in 4:36.1 and Tirunesh would actually pick things up the 2nd half to finish in 8:33.37. Nonetheless, her expectations are high and after having set 2 world records at this meet (in the 5k in 2005 and 2007) she was disappointed afterwards. She had a sullen look on her face as she addressed the press afterwards through her translator. She said she was inflicted by the same stomach pains that hampered her run at the World Championships last year (she still won the gold). “It’s a very serious problem, and I think it’s getting worse. We have seen so many doctors and they told me I have nothing,” her translator told the press as quoted by David Monti (the translator was very hard to hear).

    A rare site was what was going on in the back of the women’s 3000m. Sally Kipyego the NCAA star who just dominates the NCAA ranks was almost lapped and finished in last place in 9:05.45. It just shows you how great the top pros are as Kipyego’s time was still a collegiate leader.

    Event 13 Women 3000 Meter Run
    Name Year Team Finals
    1 Tirunesh Dibaba ETH 8:33.37
    2 Ejegayehu Dibaba ETH 8:36.59
    3 Megan Metcalfe CAN 8:52.85
    4 Christin Wurth-Thomas USA 8:54.97
    5 Sally Kipyego KEN 9:05.45
    — Miesha Marzell USADNF

  4. Fascinating stuff Jim!!!

  5. As far a side aches go the only times I get them is when I am running on a decline, usually a steep one. I’ve noticed that it wont subside until I hit an incline. It’s very frustrating, especially when your running in a race.

  6. wow cool this is so cool is there a pose that u can run in to prevent side aches ?

  7. Bob — it isn’t generally the pose, but rather your breathing pattern that will make the most impact.

    Try paying attention to your breathing and make sure that you’re not inhaling or exhaling every time you step with the same foot. If you do, try changing your breathing pattern to see if you can be breathing as your foot-falls alternate sides. This may help with the side-aches.

    Good luck!


  8. All I can say is eat about 8 ounces of roasted mutton exactly 45 minutes before your run/jog. It really gets rid of the side aches. Don’t eat anything else with it. Make sure to stretch before and after your run/jog.

  9. Hello

    Side pain when you run is mechanical because you don’t get it when you don’t run, eating certain foods before you run will not affect the pain and is most likely coincidental.
    Everyone is different and you each need to analyse the way you run and walk so you can combat the problem. I suggest creating a diary for the same route for a week or 2 that you train on, noting the point at which you achieved the side ache then start thinking about if it is a time problem, or road level issue or how your breathing changes at this point.

    I haven’t run in years due to vitamin d deficiency however if yuo have flat feet and poor core muscles you are more likely to get side ache. get some proper orthotic inserts and work on your abs and hip muscles and do breathing exercises.

    If anyone wants to discuss anything to do with running give me an email happy to help.



  10. wow, thanks so much for this! i get side pains all the time. as soon as i hit about 3.5 km (i get tired) and start walking. when i run at full speed again, and the side pains hit me–hard! i feel like if i don’t take a break, i wouldn’t get them…

    again, thanks so much. excellent article. 🙂

  11. I stopped drinking soda, and my side pains stopped hurting. 😀

  12. […] can also: [15] burn more calories, can [16] help stop side-aches, you might even[17] appear more […]

  13. I am running half a mile everyday until it stops hurting but then I will run a full mile when it stops

  14. Once I got on the band wagon of working out almost everyday and being fit I never for side aches. After a week of vacation and lots of drinking and eating I came back to find I was getting bad side aches I could hardly run. I learned really concentrating on inhaling thru the nose and exhaling out the mouth helped.

  15. I was really hoping to find a clear resolution to the side ache issue. I train well for all events, but still occassionally get one anyway. I’ve heard a little protein intake about 2 hours before a hard run does the trick. I tried without success. I’ve had it happen when I was swimming, so I’m throwing out the idea that it has anything to do with an up and down motion. I’ve been hydrated, and dehydrated, and still no difference. The only thing that might make since is the breathing, as I’ve found it happens when I’m pushing hard enough that I’m having a difficult time catching my breath. I do find that it happens a lot less if I’m in top condition. I’ll keep on training!

  16. I thought that I also just had a side ache for a really long time (2+ months). It turns out that I may have a strained psoas muscle or even possibly a deep cartilage tear in my hip (of all places). If your pain is long-term, I would recommend seeing a physician who specializes in athletes to make sure that it is not a bigger issue.

  17. All interesting… I’m a fit avid runner and weight trainer. My diet is very clean… I never get side aches until I run downhill. I run mountains and flat grade and it never bothers me till I hit the downhill. I am a female… Not sure if that makes a difference. But I still don’t understand how to combat this. It’s very debilitating and messes my workout up…. I will try the belly breathing. Maybe this will help.

  18. I used to run allot more in the past and I’ve struggled with side aches the whole time. The most effective treatment is building up your core muscles (mine are weak again and I’ve been getting side aches again) once I built up my core considerably I would run considerably faster with no side aches. I cannot eat with in three hours of running usually though when I was in top shape I was able to have a small granola bar or a fiber brownie before my work out. Another correlation is between my side aches and how fast I run which I think has to do with how much air I’m sucking down. When I breathe through my nose which I can’t do very long into a run I can keep them at bay I will feel one coming on but it stays very slight once I feel like I’m not getting enough oxygen I will start breathing through my mouth and typically thats when the side ache will really hit hard.
    meal under 100 calories about 45-50 mins before work out, building up core muscles, nose breathing.

  19. I always thought it was from not drinking enough water…when I began drinking mostly water, instead of soda, I never had side pain.

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