Don’t let side stitches, muscle cramps, and other workout woes stop your fun. Here’s how to work past (and prevent!) them — plus, when to call for help.
Ah, summer! Warmer weather and longer days of sunlight make it the perfect time to enjoy all your favorite outdoor activities.
Which makes it doubly frustrating to have your walk, hike, swim, or pickleball match interrupted by a cramping calf muscle, a side stitch, sudden headache, or other common workout woe.
“When we’re having fun doing an activity that we love, we want to power through,” says Brandee Waite, M.D., co-director of UC Davis Health Sports Medicine and a professor in the Department of Physical Medicine & Rehabilitation.
“It can be hard to figure out when something is okay or if it is concerning,” Dr. Waite says.
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Here, our medical and fitness experts explain how to handle the most common disrupters — and how to make sure they don’t happen again.
Note: Common medications used to treat chronic conditions like hypertension, heart disease, diabetes, thyroid issues, cholesterol, acid reflux, pain, and more will affect how your body responds to exercise and may make you more susceptible to workout woes. As always, please consult your physician before beginning a new exercise routine and anytime you experience any of these disrupters.
Workout Woe #1: Side Stitch
Why it happens: Technically called “exercise-related transient abdominal pain,” side stitches affect most exercisers at one time or another.
Consider, for example, these stats from reports in Sports Medicine and Medicine and Science in Sports and Exercise: 75 percent of swimmers, 52 percent of aerobics exercisers, 70 percent of runners, and 62 percent of horseback riders can all relate to side stitches.
“The jury is still out on exactly why side stitches affect exercisers,” says Anthony J. Wall, a senior director at the American Council on Exercise (ACE) and an ACE-certified personal trainer.
One theory is that the muscles between the abdomen and diaphragm rub together during repetitive vertical motion such as running or horseback riding. This motion is especially aggravating if you’re breathing hard or are new to the sport.
What to do: “The best course of action is to slow down or stop completely,” says Wall.
To speed relief, he recommends:
- Press on the tender spot, which might help realign diaphragm tissue
- Take deep breaths
- Hold yourself upright
- Gently stretch to the side opposite the pain
“It might go away very quickly or in a few minutes,” says Wall.
When to call a doctor: “If a side stitch is continuous, won’t go away, and becomes more discomforting even after you stop exercising, that’s a sign you should seek medical help,” Wall says.
Prevent it next time: Warm up before you participate in any physical activity, advises Wall.
Sip a noncarbonated drink like plain water or sugar-free sports drink before your workout and hold off exercising for two hours after a big meal.
Once you’re well into the workout, remember to take frequent short breaks. If you’re new to an activity or coming back after a long layoff, do about half of the prescribed workout — like 15 minutes of a 30-minute water workout.
Workout Woe #2: Muscle Cramps
Why they happen: More than half of adults age 65 and up experience muscle cramps as often as once a week, according to researchers in the United Kingdom. Calf cramps, aka charley horse, are particularly common.
The root causes include dehydration, electrolyte imbalance, and muscle fatigue.
“When we are asking a muscle to do more than it’s capable of doing from a strength or endurance standpoint, muscle cramps can happen,” says Heidi Prather, D.O., physiatrist at Hospital for Special Surgery in New York. “When it gets hot and humid, you can get behind on taking in enough fluids and also experience cramps.”
What to do: Stop the activity, stretch the muscle gently, or massage the area.
Consider trying Grandma’s remedy of a shot of pickle juice: Science shows it decreases the duration and severity of muscle cramps, possibly by shutting down cramp-triggering neurons, according to a report from the American College of Sports Medicine.
When to call a doctor: Muscle cramps generally aren’t concerning, unless you notice them happening more often, more intensely, and disrupt your normal daily activity or wake you up repeatedly at night, says Dr. Prather. In those cases, it’s best to consult your physician.
Prevent them next time: Dr. Prather recommends easing into activities by taking a short walk then stretching your warmed-up muscles.
During your workout, sip a drink with electrolytes. Options include a commercial sports drink (mix with an equal part water to cut down on sugar content) or coconut water, nature’s best sports drink.
Workout Woe #3: Sudden Joint Pain
Why it happens: Exercising for longer periods or with more intensity than usual tires you out. That can cause your form to deteriorate and make you more susceptible to rolling your ankle, tweaking your knee, or feeling a hitch in your hip.
Why? “You’ve stirred up some inflammation in the joint,” says Dr. Prather. This is especially true for the nearly 50 percent of folks over 65 who have arthritis, according to the Centers for Disease Control and Prevention.
What to do: The first course of action is to take a load off the joint, apply ice, and try compression with a sock, ace bandage, or sleeve, says Dr. Prather.
“If you have sudden onset joint pain because you overdid things, once you tend to it, your body will start to heal,” she adds.
Rest the sore joint but keep moving by engaging in a different activity that isn’t painful while you’re recovering — active rest speeds healing.
When to call a doctor: Dr. Prather says to seek medical help if you experience any of the following:
- You notice swelling or redness
- You feel weak, wobbly, or unstable in the joint
- You can’t put weight on it without pain
Prevent it next time: Pay attention to warning signals, says Wall. When you start getting tired and you feel yourself slouching or not picking up your feet, take a breather.
“Accept that your body may not be able to meet the demands that your mind thinks you should,” says Wall.
Workout Woe #4: Exercise-Induced Headaches
Why they happen: When you start an activity, blood volume increases in the vessels in the muscles of the head, neck, and scalp. That causes pressure that may lead to headache, especially during high intensity cardio and especially in hot and humid conditions.
An exertional headache, as they’re called, can be in the neck or one or both sides of head, according to a report from the Cleveland Clinic. You may feel throbbing or pulsing. Exercise headaches can mimic migraines with aural disturbances, light sensitivity, and nausea.
“People who are older may have uncontrolled high blood pressure, they may be taking medications, and they may be dehydrated, all of which contribute to workout headaches,” says Ronan Factora, M.D., Center for Geriatric Medicine at the Cleveland Clinic.
What to do: Stop the exercise, sit (in the shade, if outside), sip a cool drink, and make sure your blood pressure returns to normal resting rate.
“If you are outdoors and it is hot, a headache could be an indicator of heat stroke,” says Dr. Factora.
When to call your doctor: “If the headache doesn’t go away after you stop, talk to your physician, who will want to investigate other causes,” Dr. Factora advises. “If exercise is precipitating the headache, there may be something else going on.”
Prevent it next time: “Most people can avoid exertional headaches by not exercising in extreme heat and humidity and by easing into activities,” says Wall.
Stay hydrated. If you aim to beat the heat by going for your daily walk before breakfast, down a glass of water first. Switch up your activities on hot days — trade your pickleball session for a pool workout, for example.
Workout Woe #5: You Can’t Catch Your Breath
Why it happens: “Some shortness of breath is to be expected when you start exercising,” says Dr. Waite, whose patients include both professional athletes and weekend warriors. “Especially if you are exercising harder than you normally do, it’s harder for your lungs to keep up with the demand.”
What’s more, chronic conditions like COPD and heart disease, along with medications, can impede your ability to take deep breaths, which is why it’s always smart to consult a doctor before beginning an exercise program.
What to do: “Slow down so you can catch your breath, pull back from the activity,” says Dr. Waite.
Dial down your intensity or stop altogether, seek shade, sip a cool drink, and ease back into your activity.
When to call 911: “Shortness of breath is significant if it is accompanied by dizziness, chest pain, headache, or excessive (for you) sweating,” says Dr. Waite. Seek help immediately.
Prevent it next time: Ease into it: If you’re going for a hike, start with a stroll. Lob a few balls before starting a pickleball match.
And be mindful of what’s normal breathing for you; don’t try to keep up with your doubles partner, especially if she’s a decade younger.
Workout Woe #6: Racing Heart
Why it happens: When you start exercising, your heart rate naturally goes up to pump more blood to your working muscles. That’s normal.
“Any exercise is going to make your heart rate go higher, especially if you’re doing cardio, because your heart and lungs are working harder,” says Dr. Factora.
When you stop exercising, it should go back down within a few minutes. If you are not exercising regularly and you push yourself too early or too long, your heart rate may go too high.
What to do: Stop activity, get in the shade, drink some fluids, and check your pulse, says Dr. Factora. It should go back to your normal resting heart rate within 5 minutes.
The American Heart Association says most adults have a resting heart rate between 60 and 100 beats per minute. To find what’s normal for you, put your finger over your pulse and count the beats for 60 seconds. Do this while seated and relaxed.
When to call a doctor or call 911: If your pulse stays high even after you stop exercising, that’s a concern your doctor should know about, says Dr. Factora.
Seek immediate medical help if you have shortness of breath, weakness, dizziness, lightheadedness, fainting or near fainting, and chest pain or discomfort.
Prevent it next time: Exercise in the cooler morning or evening hours, in shaded areas, pre-hydrate before activities and sip a cool drink during.
Dr. Prather suggests wearing a fitness watch that provides feedback on your heart rate, so you know what’s normal for you. “It helps you feel safe because you know your body,” she says.
Workout Woe #7: Dizziness
Why it happens: “You don’t have enough blood flow to the brain,” explains Dr. Waite.
“When you’re standing upright, your heart has to pump blood to your brain against gravity, and if your brain isn’t getting enough blood, your brain makes you pass out,” she continues. “It’s your body preserving the brain over other body structures.”
You may also be dehydrated, from exercising in the sun or from medications you’re taking, says Quratulain Syed, M.D., a geriatric medicine specialist in Atlanta.
What to do: Experiencing a dizzy spell during exercise is a sure sign to stop.
“Never exercise when you’re feeling dizzy, because you risk falling down or passing out,” says Dr. Waite. “Stop, sit down, drink water, breathe.”
When to call a doctor or call 911: If dizziness persists despite getting a drink of water or for more than a few minutes, Dr. Syed recommends seeking emergency care.
Prevent it next time: “Try to plan your exercise around times when there is less sun,” says Dr. Syed. “Pick a shaded trail, take your hat, sunscreen, and fluid with you so that you don’t get overheated.”
If heat brings on dizziness, gym and pool workouts are a good option. Dr. Syed advises her patients in hot and humid Atlanta to walk in an air-conditioned mall or do workout videos in the house.
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