The side stitch!

Us runners have come across a side stitch or two in our running life. I don’t know about you but it certainly is annoying and always appears at the worst time! It slows me down and brings down my speed!! UGH!



A side stitch, side cramp, stitch, whatever you want to call it, is an intense stabbing pain right at the end of the ribcage. Also known as exercise related transient abdominal pain(ETAP). It is most common in running and swimming.13 (86)

What causes side stitches?

hhmmm this is a tough question because it can be a variety of things. Every time we breathe in, air enters our lungs having our diaphragm move down. Running causes to have a higher demand of oxygen for our body. We take in more air than we normally do trapping the air in our diaphragm, therefore, causing the stabbing pain in the end of the rib cage on either side.

In addition, most runners are “footed”. They begin and end a respiratory cycle on the same foot while running. As our breathing then becomes synchronized with our stride, exhaling consistently occurs on the same leg. If one repeatedly exhales (causing the diaphragm to move up) when the right foot hits the ground (forcing the organs on the right side of the body to move down), a side stitch may develop.

One study reported that consuming reconstituted fruit juices and beverages high in carbohydrate, either just before or during running triggered the onset of a stitch. Another study showed Most people exhale as the left foot hits the ground, but some people exhale when the right foot hits the ground. It is the later group who seem more prone to get side stitches. Exhaling when the right foot hits the ground causes greater forces on the liver (which is on the right side just below the rib cage).sports-training-diaphragm-breathing1



Another cause is lack of fluids. Since being dehydrated does lead to muscle cramping. Not having enough fluids will cause you to have a side stitch. Keep food intake to a minimum. Just eat a small snack, and wait at least an hour before you run to prevent a side cramp.


Here are some ways to relieve and prevent side stitches:

  • Massage or press on the area with pain. Bend forward to stretch the diaphragm and ease the pain.
  • Raise your right arm straight up and lean toward the left. Hold for 30 seconds, release, then stretch the other side.
  • Slow your pace until pain subsides.
  • Breathe deeper to stretch the diaphragm when you feel a cramp coming on. Then, breathe slowly out of your mouth with pursed lips; this tends to relax the diaphragm. If you can, hold it for 3 seconds. Exhale when the leg on the opposite side from the stitch strikes the ground.
  • Decrease fast pace for a few minutes and continue deep breathing techniques during running. A common running sequence is a three-step inhale and two-step exhale pattern. Slowing down your pace will allow you to keep up with that pattern. As you increase your speed, your breathing will become more labored. Pushing your stomach out when you inhale and relaxing it as you exhale. 

To prevent a side stitch:

  • Strengthen your core muscles. Check above I have a few core strengthening exercises.
  • Warm up properly before a run.
  • Avoid too much too soon. Don’t push it too much where you can’t catch your breath.
  • Pre-stretch before running by doing side torso twists. One of the best ways to pre-stretch the area is to lift your arms over your head and lean to the left and right at the waist.
  • Take a few deep breaths and hold it for 5 seconds before running to prepare your diaphragm for the running. Do this a few times before you head out.

TRY THIS!!  – lie on your back and place a heavy book on your belly. As you breathe in the book should rise; it should lower as you exhale. Keep this pattern in mind when you are standing. =)

A side stitch is no fun and can definitely affect our performance. So hopefully following these tips will help you out next time one develops while running.







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