"Håll"

[gorken]

Är det någon som vet varför man får "håll" när man springer? Det sägs att man får det lättare om man ätit?? Och i så fall varför??

[King Grub]

"The two causes of ETAP that have traditionally featured in the literature are diaphragmatic ischaemia and stress on the subdiaphragmatic ligaments supporting the abdominal viscera. However, recent findings have proposed challenges to both theories. Evidence against a diaphragmatic origin of ETAP include the high prevalence of the complaint among horse riders, an activity characteristically not of high respiratory demand, as well as the distribution of the pain as low in the abdomen as the iliac and hypogastric regions. Further, it has been shown that spirometry measures remain unchanged during an episode of ETAP. The observed variability in the site of the pain is similarly inconsistent with the visceral ligament theory as is the observation of the pain when swimming, which lacks the torso "jolting" dynamics pivotal to the theory. In addition, the visceral innervation of the ligaments seems at variance with the well localised nature of ETAP, as the characteristics of ETAP suggest a somatic origin. These observations have led to the development of an alternative explanation for the ailment.

We have argued that characteristics of ETAP are consistent with irritation of the parietal peritoneum. The parietal peritoneum is sensitive to any torso movement when irritated, and as it extends throughout the abdomen it can give rise to well localised pain in various sites. Further, the subdiaphragmatic portion of the parietal peritoneum is supplied by branches of the phrenic nerve, which can account for the observation of shoulder tip pain in association with ETAP. The mechanism of irritation is speculative, but we have proposed that exacerbated friction may be responsible.

Friction could be the result of increased pressure on the tissue, as in the case of a viscus being distended such as after a meal, or as a consequence of changes in the volume or properties of the serous fluid contained within the peritoneal cavity. Interestingly, clearance of the serous fluid from the peritoneal cavity is increased by diaphragmatic excursion."

Exercise related transient abdominal pain, Br J Sports Med 2003;37:287-288