Why do I get hiccups after running?

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After longer runs (10 miles or greater) I keep coming down with the hiccups. What the heck is going on? - Scott

Dear Scott,

Hiccups occur when the diaphragm contracts suddenly and unintentionally. The diaphragm is your main breathing muscle and separates your lung space from your abdominal space; as it contracts, the air is sucked into your lungs. When running, these contractions occur at an increased rate to move the large volume of air required to get oxygen to the working muscles. During exercise the diaphragm is aided by the secondary muscles of breathing that lift your ribs to further enlarge the lung space and pull in more air. The involuntary contractions of the diaphragm during a hiccup rapidly pull air into your lungs causing your vocal cords to pull together and close the airway producing the hiccup sound as the vocal cords snap shut.

While many things are associated with the onset of hiccups, the cause is not really known. The important distinction is that association does not equal cause. The common denominator in the associations seems to be irritation of the diaphragm, the brain stem, the brain (usually trauma or infection), the vagus nerve or the phrenic nerve. Some medications and chronic medical conditions are also associated with hiccups. The common associations are eating too fast, drinking too much (especially alcohol or carbonated beverages), gastroesophageal reflux (GERD) and anxiety. When I am caring for pregnant women, the onset of hiccups in the baby signals that the phrenic nerve is connected to the diaphragm and a good sign that the baby is developing well. In some cases, especially when prolonged for days, the hiccups may signal an underlying medical problem. In your case like most people, the hiccups only last a few minutes and are not associated with a bad underlying problem.

So what causes your hiccups? My guess is either the increased diaphragm contractions forced by your running or, if you drink a large amount of fluid immediately after the run, distention of the stomach from post-run hydration. Tincture of time will usually resolve the problem, but there are many folk remedies, which may or may not work for you. Medications are only used for prolonged episodes.

Here are some common home remedies that work in some people: breath holding, drink a glass of water rapidly, induce a fright or surprise response (you will need an accomplice for this), harsh aromas, pull hard on the tongue (ouch), dry sugar on the back of the tongue, a spoonful of honey, or list odd or difficult things that distract you from the hiccups (states, state capitals, longest rivers of the world, etc).

Some people who get hiccups frequently in their younger years find they disappear with aging.

I would not stop running because of the hiccups, as the long-term benefit of continued fitness likely outweighs the inconvenience of the problem. However, you might stop short of 10 miles for each run and get the same long-term health benefits.