What to do if you...
...get a stitch
What's going on? Stitches are caused by the diaphragm cramping, creating a sharp pain under the lower edge of the ribcage. On inhalation, we take air into our lungs pressing the diaphragm downward. When we exhale, the diaphragm moves back up and stretches the ligaments that attach it to the liver. The constant short stretching of these causes the cramp - and the sharp pain. Stitches are common among novices who haven't established proper techniques and who tend to breathe more quickly and shallow.
What's the cure? As with any cramp, the best treatment is to stretch the muscle. To do this, try altering your breathing pattern. Take a deep breath in from your belly (not your chest) as quickly as you can, to force the diaphragm down. Hold the breath for a couple of seconds and then forcibly exhale through pursed lips. Deep breaths allow the diaphragm to lower fully, reducing the stress and relieving the ligament. If you only take shallow breaths when running, the diaphragm remains in a high position and never lowers enough to allow the connective ligaments of the liver to relax. If you press your hand firmly to your body just below the pain, this should push the liver up, relieving the strain.
Another way to get rid of stitches is to try mixing up the rhythm of your breathing pattern. If you normally exhale when your right foot strikes the ground, try exhaling with the left foot strike. The organs attached to the diaphragm on the left side of the body aren't as big as those on the right side hence there is less strain on the diaphragm.
If you still can't shift it, and you don't mind looking a bit odd, try extending your arms over your head, making your body as tall and stretched as you can, before crouching down while flexing your abs. Continue up and down till the pain subsides. If you have to stop, continue the run as soon as you feel better.
Prevent stitches by... having a good warm up; running slowly down hills; avoiding eating an hour before running; breathing through a scarf in cold weather.
What's going on? Although experts don't have a definitive explanation for the cause, a number of factors have been identified that are possible contributors including over-exertion, dehydration and poor nutrition. Important building blocks in a runner's diet are salt, potassium and magnesium, so when they are lacking a runner is prone to calf cramps. Leg cramps occur at night because we don't drink water or top up our electrolytes in our sleep.
What's the cure? Gentle massage is what your muscle wants - so do this in a circular motion to try to lessen the contraction. Stretch your legs straight and tight and hold that position for as long as you can or until the pain stops. To relax your muscles, apply heat via a heating pad or something similar.
If you feel calf cramps coming on during your run, slow down. You may be able to keep walking/running just at the threshold of getting leg cramps but when they hit you will have no choice but to stop running and stretch. A known stretch for the calves is to keep your heels on the ground, pull your toes up and try to reach your toes with your hands.
For hamstring cramps, place the ankle of your cramping leg behind the opposite ankle. Stand firm on the front leg and push hard against it with the cramping one. When the pain has subsided, you can try to start running again, but at a slower speed and try to avoid any sudden turns. Shorten your run as much as possible and make sure you have a warm shower afterwards. After that, apply some tiger balm or arnica oil to the calves to aid blood circulation.
Don't be lulled into a sense of security if you finish the race or run without suffering from cramps. Continue to drink plenty of water and restock your electrolyte levels as cramps commonly hit runners hours after the finish.
When you are running to become faster and fitter you should expect to get the occasional leg cramp attack. But if you feel you are doing everything right and they keep on coming back, go to see a doctor.
...hit the marathon wall
What's going on? The energy to power your muscles comes from a store of about 2000 calories worth of glycogen in your liver and muscles, which is enough to energise about 20 miles of running. When you run out of glycogen, your body is forced to rely upon fat metabolism to supply energy but, as the body is less efficient at converting fat to energy, it begins to slow down and to suffer from fatigue and hypoglycaemia.
Running a marathon is a real challenge for our bodies and creates an emergency problem scenario for our central nervous system which is trying to prevent our bodies from running out of the energy and nutrients it needs - and making sure our heart and brain has enough glycogen to keep operating. When it senses that we are pushing our body to the point of damage, it begins to cut off signals to our muscles forcing us to slow down to protect our vital organs and the muscles themselves.
In shorter races, the fatigue you experience is more likely to be peripheral fatigue which is due to hydrogen ion build up, potassium build up on the outside of your cells, muscle damage as well as hypoglycaemia. Hydrogen ion and potassium accumulation usually occur during fast-paced 5K and 10K races.
What's the cure?
Speed up Crazy, maybe. But there is a physiological reason that it works. If you've been running an even pace through the marathon you've been using the same muscle fibres throughout. Those muscle fibres have used up all of their glycogen and are now exhausted. But there may be some other muscle fibres that have not become exhausted - your fast twitch fibres. These muscle fibres have not been used much during your moderate marathon pace and increasing your pace will activate some of those muscles that still have some glycogen. It won't be a lot, but it could be enough to get you through those last couple of miles.
Get angry While your CNS is very powerful, you are able to override it for short periods of time. As it's a type of emergency power system, you can trick it into believing that you need to reach the finish line to survive. Pick a competitor in front of you and tell yourself you must pass them at any cost. Get madly desperate. Do whatever you need to do in order to break the hold your CNS has on you. Again, this will only last for a short time before your CNS regains its hold, but it could give you the extra mile or so you need to defeat the wall.
...experience runner's trots
What's going on? An estimated 20-50% of distance runners suffer from runner's trots, suffering from a range of symptoms which include cramping, flatulence and diarrhoea. This can occur during or after exercise. The reasons are not known for sure, but the causes will certainly be different among sufferers. One possible reason is that the up and down motion of running stirs the bowels. The flow of blood to the intestines is diverted to your legs, which may trigger the cramping or diarrhoea. The added chance of dehydration on long runs may also cause diarrhoea among some victims. It could also be due to an underlying lactose intolerance or irritable bowel syndrome, which is enhanced by the strenuous exercise.
What's the cure? Try to avoid eating for at least two hours before you exercise - the presence of food in the stomach will make things worse. Try to avoid any intake of caffeine or warm fluids, as this can speed up the movement of wastes through the body. Make sure you limit your intake of dairy products, particularly if you are susceptible to diarrhoea, and limit high-fibre foods in the days before a long race.
Drink plenty of fluids. It is best to drink a full 16oz of water an hour before your workout, giving the excess fluid time to pass through, and start off well hydrated. Be aware of your bowel habits and try to time your workouts after such movement times.
If all other precautions fail, for races or special events where you know toilets will not be readily available, consider the use of an over-the-counter anti-diarrhoea product such as Imodium. Studies have shown this has reduced problems related to those prone to exercise-induced diarrhoea.