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What Does It Mean If I Throw Up After Working Out?

That I’m out-of-shape? That I ate something bad for lunch? That my workout was particularly intense? That I should get to a doctor ASAP?

The mid-workout vomit scene is a common movie and TV trope. You may not be able to feel the full force of the strain that results when a punching bag is being battered by an actor playing a SWAT team rookie, but you’ll have to accept it as fact when you watch the fresh vomit spew forth after a round of oceanside pull-ups. This breaking point is achieved when your body has achieved a pinnacle of physical performance so intense that it can no longer retain the very food that sustains it — or so the theory goes.

For the record, in the many thousands of swim practices, cardio sessions and strength-training workouts I’ve engaged in over the course of my life, I have vomited a grand total of once. It was during a swim practice when I was no older than 12. Everyone else in the pool shouted “Ewww!” while Coach Harding calmly retrieved the skimmer net and began to reroute all of the pale, pink vomit into the gutter of the pool. He then divided the occupants of our lane amongst two other lanes, and swim practice resumed. 

So if puke is the by-product — if not the evidence — of a tough workout that has struck its target, were none of my subsequent workouts ever of sufficient intensity? Should we not be chasing the purging of our stomachs during every training activity?

What is it that causes vomiting during workouts?

First of all, if you happen to have had the pukey misfortune of throwing up during your training, let’s start with the reasons you should hope that you barfed all over your best friend’s new Lululemons. As you may have guessed, those reasons have something to do with your intake of food and liquids prior to your workout.

As you exercise, blood flows into your muscles and away from other organs. This often results in food remaining undigested in the stomach for much longer than is advantageous to your body, a scenario known as “delayed gastric emptying,” or gastroparesis. This being the case, the undigested food may form into a solid mass that your body opts to rid itself of in the simplest manner possible, which is to expel it through the same opening it entered.

Gastroparesis is among a general category of gastrointestinal problems that can afflict athletes while they train, endurance athletes most commonly. Specifically, they’re the most likely athletes to experience the confluence of factors that can induce vomiting. These include the presence of undigested food, dehydration and low sodium in the blood. Each is sufficient to induce vomiting on their own, but the combination of two or more of them elevates that likelihood.

While we’re on the topic, we should probably discuss the food that’s occupying your stomach to begin with. The thing is, though, some people have the likelihood to experience food-related discomfort trained out of them, while others are far more sensitive to the presence of food in their bodies during exercise, and are less likely to ever tolerate it. Certainly, if you intentionally consume a heavy meal and then deliberately forgo hydration, you multiply the likelihood of an eruptive episode.

You state that as if there is a worse reason I could be throwing up.

There sure is: It’s called rhabdomyolysis.

CrossFitters in particular have been known to invite the onset of “rhabdo” into their workouts. When muscles are severely overworked and begin to break down, continuing to stress them may cause them to rupture, resulting in their cellular contents being released. This involves the myoglobin from the muscle cells spilling out into the blood, manifesting in weakness and lethargy, and often inducing nausea and vomiting.

Worse yet, one in 20 sufferers of rhabdomyolysis succumbs to death because of the condition. As such, you’d be well advised to seek immediate medical attention if you feel that the intensity level of your training has induced your vomiting, if everything else — adequate hydration, recency of food intake and so forth — seems to be in order.

Needless to say, then, puking during or immediately following a workout should never be viewed as a welcome sign, and like most things, is best left to the movies.