Common Causes of Lower Abdominal Pain When Running

Have experienced discomfort or lower abdominal pain when running? Maybe it didn’t hit you until you got back home, but either way, you’re left wondering what’s wrong and why you’re so uncomfortable. We’re going to dive in to some common causes today to help you find a resolution.

There could be numerous causes of lower abdominal pain during and after running, which is pretty standard for every single injury we have, right? Unlike some of the others, this isn’t as often about overuse, but could indeed be related to intensity.

The good news is that figuring out the cause will only help you take the steps you need to fix or prevent the issue from occurring in the future. Today, we are not focused on running through your period, which is the most obvious and frequent cause, but instead what else might be happening that needs to be resolved.

Stick with us as we detail some of the varying causes of lower abdominal pain in runners and what you can do to feel better soon.

What Area is Considered the Lower Abdomen?

To avoid having to detail all the issues we can have in our abdomen, because there are many, we thought it would be important to define what the lower abdomen is.

The lower abdomen is the area from your belly button down to your pubic bone. This means discomfort in that area could involve any of the organs or muscles between those two points.

Organs in this area include the small intestine, colon, appendix, ovaries, uterus, bladder, and parietal peritoneum. There are also numerous muscles that are fully in or at least partly in this area, like the rectus abdominis and the lower end of the obliques. And of course your pelvic floor and attachments to your groin.

If you’re feeling the more pain in the groin when running, checkout that article it might steer you in the right direction. Though the two could fully be related.

What Are Symptoms of Lower Abdominal Pain?

Because there are a number of things that could cause lower abdominal pain, there are varying symptoms. We’ll dig more into the symptoms of each issue below, but here are some common ones.

• GI symptoms
• Muscle discomfort
• General abdominal discomfort
• Pressure
• Low back or hip pain
• Bladder leakage

One thing I do want to clarify is that this article is not focused on groin pain. The groin is nearby and can also be an area of pain, but is separate from what we’re discussing here. You can check out our article on groin pain for more detailed information.

5 Causes of Lower Abdomen Pain When Running

If you’ve ever experienced lower abdominal pain during or after running, you are not alone. There are a few things it could be and there are ways to prevent the discomfort or alleviate it.

#1 Digestive Issues

One of the more straightforward causes of lower abdominal pain relates to digestive issues. You might also hear this called the “Runner’s Stomach.” This can be very common so if this is what’s causing your discomfort, you’re not alone!

It can have a multitude of symptoms ranging from gas to indigestion to diarrhea, or include things like nausea, bloating, and pain or discomfort. In addition to the multitude of symptoms, it also has a multitude of potential causes, including posture, fuel, hydration, and intensity of exercise.

Figuring out how to prevent these issues or stop them after they’ve begun may take some trial and error. You may need to play around with when and what you eat before heading out for a run and during the run, as well as monitor your hydration. You want to stay hydrated but also avoid that dreaded sloshing sensation that sometimes happens.

Read more on how to prevent runners diarrhea or nausea while running >>

There’s also the chance that you may have a more serious issue if your lower abdominal pain is more intense and you’re having some of the more severe symptoms. If that’s the case, it may be time to see a doctor to discuss irritable bowel syndrome, Crohn’s disease, and even appendicitis, particularly if your pain is severe and located in your lower right side. Although it’s important to remember, these are more rare.

#2 The Side Stitch

Another common complaint related to lower abdominal pain is exercise-related transient abdominal pain (ETAP), also known more colloquially as the side stitch when running.

The side stitch can be very uncomfortable, but thankfully often resolves relatively quickly. However, it can impact performance for runners, especially if you have to lower your intensity or stop running to get it to go away.

Again, there are a number of things that can cause a side stitch and it varies person to person. One potential cause may deal with what’s called the parietal peritoneum, this is basically what holds your torso together. When you fatigue as you run, the abdominal muscles may stop doing their job because they’re tired so other muscles take over and that can cause adverse side effects like the side stitch.

Strengthening your core muscles may help!

Other causes may include having a lower fitness level, your exercise intensity, inefficient breathing, and even a lack of a warmup. 

Again, figuring out the cause of this may take some trial and error. However, even if you determine that not warming up isn’t contributing to your side stitch issues, we still think you should take a few minutes to warm up before hitting the road. Hint, hint!

There could also be gastrointestinal issues going on too. As you can see, this really isn’t straight forward but again, it’s most likely not serious. However, if you find the pain does not ebb if you lower your intensity or stop running altogether, then it may be time to check in with your doctor.

#3 Abdominal Strain or Tendinopathy

As noted your muscles run not just through that six pack area, but all the way down to your pubic symphis, which means it’s absolutely possible to pull or strain them.

Overuse or improper warm-up can lead to strain and pain in the rectus abdominis during running.

Additionally, a lack of core strength can contribute to this issue, as a weak core places extra strain on the rectus abdominis, especially during activities with sudden changes in direction. Incorporating targeted core-strengthening exercises is crucial for preventing strains and maintaining abdominal muscle health.

Another possibility is an oblique muscle strain.

Straining the oblique muscles can occur due to sudden twists or movements. So it’s less likely you’ll have pulled this during a run, but possible that you start to feel it while running from say a wild day of pickleball or even something in the gym.

#4 Pelvic Floor Issues

We’ve saved this one for last because it’s arguably the most complicated of the issues we’re highlighting in this article. Additionally, it’s one that is commonly overlooked, but I’ve heard from many runners who addressed pelvic floor issues and it resolved everything from knee pain to IT Band issues!

And NO, this is not just for women. There are 28 muscles in our pelvic area and they work best when they all do their jobs, which is just like how your hip plays in to knee pain.

It’s often something we think of when dealing with peeing while running, but it can be SO MUCH MORE.

According to Amanda Fisher, a pelvic floor physical therapist, there are a few things related to our pelvic floor that can cause lower abdominal pain while running.

“Pelvic floor tension can increase pain in the lower abdomen while running,” said Fisher. “This may occur when the pelvic floor muscles are tight and not moving through a good range of motion. Think of how your arm can flex and extend and relax. We want this for your pelvic floor too. Sometimes it gets caught in tightness and the tissue doesn’t like that, sending a signal of discomfort or pain.”

She also pointed out that this can happen with PCOS and endometriosis too.

However, with that many muscles the potential for compensation or error is pretty high. When that happens, in addition to pain there may be leakage, pressure, prolapse symptoms, and even low back, hip or tailbone pain.

If you’re experiencing any of these issues or symptoms, it never hurts to check into a pelvic floor PT. Fisher is an advocate of preventative medicine and it never hurts to see what’s going on, even if your symptoms are mild.

“If the pain is happening more than a few times after you hit a certain mileage or run a certain number of days per week, it’s definitely time to reach out for help,” said Fisher. “Use the pain as a way to listen to your body. It’s trying to tell you it doesn’t like something.”

#5 Other Medical Issues

Obviously this isn’t comprehensive without knowing a whole lot more about you and your body.  If nothing above feels right, or you’re dealing with more sharp pains, there are a few other potential issues:

• Irritation of the ilioinguinal or iliohypogastric nerve
• Menstrual cramps as noted in the opening
• Testicular issues like strain, inflammation or trauma
• Diverticulitis
• Colon issues
• Ovarian issues

If you just can’t resolve it, it’s causing continued pain or messing with your form then suck it up buttercup and SEE A DR! I was dealing with something similar and started with a Physical Therapist because I wasn’t having food or breathing issues or sharp pain. Checkout your symptoms and see who might be the most likely to help.

Like I often say, this is not an all-encompassing list of what could be causing lower abdominal pain when running. However, it’s some of the most common causes, most of which are pretty benign but still need attention in some way.

Remember, you know your body best. Pay attention to the signals it’s sending so you can stay healthy, pain free, and running.

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