Journal of Exercise Physiology in Special Populations

Exercise-Related Transient Abdominal Pain (Stitch Pain): A Systematic Review of Mechanisms, Risk Factors, and Management Strategies

Document Type : Original Article

Authors

1 Department of Sport Science Education, Farhangian University, Tehran, Iran

2 Department of Sport Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

3 Department of Sport Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

4 Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

Abstract

Objectives and Study Background:
Exercise-related transient abdominal pain (ETAP) is a common complication among athletes, especially runners, affecting up to 70% of runners. The aim of the present study was to investigate the mechanisms, risk factors, and management strategies for ETAP.
Review Methods and Data Sources:
The present study was a literature review. The search period for articles in Persian and English was from 2000 to 2025, which was conducted in Scopus, PubMed, WOS, Google Scholar, and SID databases. Finally, 19 articles were reviewed based on the inclusion and exclusion criteria.
Findings:
ETAP associated with exercise can be managed with preventative strategies, but if it persists, alternative causes such as median arcuate ligament syndrome should be considered. Some studies have reported a higher incidence of this pain in women, but others have not found a significant association with gender. All studies agree that it gradually decreases with age. Short intervals between meals and exercise, stress, inadequate warm-up, and high intensity of activity are among the contributing factors. Strengthening core muscles and focusing on rhythmic breathing are among the possible contributing factors in preventing this pain.
Conclusion:
Despite the widespread prevalence of this pain, the underlying cause is unclear and research is limited. Due to the limited treatment methods, Further studies are needed to better understand the causative mechanisms, risk factors, and develop targeted therapies.

Keywords

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Journal of Exercise Physiology in Special Populations
Volume 2, Issue 3
September 2026
Pages 1-16