You could be midway through a scenic run, nearing the finish line of a race, or just starting out on an early morning jog—and it hits you: the dreaded side stitch. The pain, which can appear on the left or right abdomen, can range from a dull cramp to a sharp stabbing sensation.
Despite being extremely common, the cause of side stitches, or exercise-related transient abdominal pain (ETAP), isn’t totally understood. No one has come up with a definitive answer as to why it happens.
Though there are different theories, some experts think stitches are the result of a cramp in the diaphragm, perhaps due to ischemia (your diaphragm not getting enough blood). As you run, you increase pressure on your abdominal muscles and breathe rapidly, expanding your lungs. Those two actions create a dual pressure: a push up from the abdominals, and a push down from your lungs—with your diaphragm getting pinched in the middle. That pinch can cut off the flow of blood and oxygen, causing the cramp. Another theory is that the stitches are the result of irritation of the parietal perietal, the membrane that lines the abdominal wall and helps support your organs.
And runners aren’t the only ones who get side cramps. Swimmers, basketball players, horseback riders, and cyclists also report being plagued by stitches.
Personally I think the stitch comes from poor breathing or eating food too soon before you train. Here are some tips to stop you getting the stitch.
Your Action Plan
Now for the good news: Side stitches typically go away the more you run.
Before a Run:
1. Avoid fatty and high-fiber foods.
Food itself may add to the diaphragm’s distress. A meal of less digestible, fatty foods—say, spaghetti and meatballs—could make the stomach heavier and increase that tug on the diaphragm. High-fiber foods are also associated with gastrointestinal issues, such as nausea, side cramps, or worse. Spacing your meal and run a few hours apart will definitely help.
2. Don’t overdrink before a run or during….
Drinking fluids before and during exercise has been associated with side stitches, so take small sips before and during to reduce symptoms.
3. Strengthen your core.
Strengthening your transversus abdominis muscles, which are located behind your ”six-pack” (the rectus abdominis), might reduce the incidence of stitches. This can help minimize that parietal peritoneum irritation we mentioned earlier. The muscles run horizontally around your body to help stabilise your lower spine. You can activate them by sucking your belly button toward your spine and strengthen them through a number of abs exercises.
4. Stand tall.
Having proper posture might also prevent side cramps.
5. Don’t skip your warm-up.
While there aren’t studies proving that a warm-up can prevent side stitches, slowly getting your heart rate up before a run could help.
During a Run:
1. Find a rhythm.
If you’re new to running, try counting your breaths and focusing on keeping them even and steady,
2. Exhale as your foot strikes the ground.
If you’re mid-race and don’t want to totally stop, slow down and focus on deep belly exhales as your opposite foot strikes the ground. So if the stitch is on your left, focus on breathing out as your right foot hits the ground.
3. Stop, breathe, stretch.
Take a long, deep breath and stretch your arms up to the sky, Next, bend at the waist toward the opposite side of the stitch with your arms extended above overhead. (If your stitch is on the right side, bend to the left.)
4. Sprinkle some salt.
If you’re on a longer run, you may need to replace some of the electrolytes you’ve lost.