A stitch, medically known as Exercise-related Transient Abdominal Pain (ETAP), is a common, sharp, or stabbing discomfort often felt just below the ribs during physical activity. This pain is particularly prevalent in high-impact exercises like running. While it is not a serious medical condition, a stitch can be debilitating, forcing a runner to slow down or stop entirely. Understanding how to relieve the pain and its underlying causes is key to managing this frequent running nuisance.
Immediate Techniques for Stopping the Pain
When a stitch strikes, slow your pace to a walk or stop completely to reduce the jarring impact on your torso. Focusing on deep, diaphragmatic breathing can help relax the diaphragm muscle, which is often implicated in the pain. Instead of shallow, rapid chest breaths, try inhaling deeply through the nose to fill the abdomen and exhaling slowly through pursed lips.
Applying gentle but firm pressure directly to the painful area, typically with one or two fingers, can also provide relief. As you exhale, push slightly deeper into the spot, holding this pressure for about ten seconds while continuing to take slow breaths.
Stretching the affected side is also effective; raise the arm on the side of the pain overhead and bend the torso away from the stitch. This side bend helps stretch the abdominal wall and the diaphragm, which may alleviate the cramp.
You can also try altering your breathing rhythm to exhale as the foot opposite the side of the stitch strikes the ground. This may help distribute the forces that irritate the abdominal lining. Once the sharp pain subsides, gradually transition from walking back into a slow run, maintaining the deep, controlled breathing pattern.
Why Stitches Occur
Several theories offer insight into why stitches occur. The most widely supported theory suggests the pain results from irritation of the parietal peritoneum, the sensitive membrane lining the abdominal cavity and the underside of the diaphragm. Repetitive jarring movements, common in running, cause friction against this lining, particularly if the stomach or intestines are full.
Another prominent theory focuses on the diaphragm, the primary muscle for breathing, suggesting the pain is a spasm or a result of ischemia (a lack of blood flow). During intense exercise, blood is redirected to working leg muscles, potentially reducing the supply to the diaphragm and causing it to cramp.
Gastrointestinal factors also play a significant role, as eating a large meal or consuming hypertonic (high-sugar) beverages too close to a run is strongly linked to stitches. A full stomach pulls on the ligaments that connect the abdominal organs to the diaphragm, placing stress on the abdominal lining and increasing the likelihood of discomfort.
Preparation and Prevention
Preventing a stitch begins with proper preparation regarding food and fluid intake before a run. Avoid consuming large volumes of food or beverages for at least one to two hours prior to exercise. Meals high in fat or fiber should be avoided before a run because they take longer to digest, increasing the risk of abdominal discomfort.
Focus on consistent hydration throughout the day instead of large amounts of water immediately before a run. During a run, sip small amounts of water rather than gulping to prevent stomach distension, which puts pressure on the abdominal lining. Beginning any workout with a dynamic warm-up gradually prepares the body and breathing patterns for the upcoming exertion.
Strengthening the core muscles, especially the deep stabilizing muscles like the transversus abdominis, provides better support for the internal organs during the repetitive impact of running. A stable core reduces excessive movement of the torso, which minimizes the stress placed on the abdominal ligaments and the parietal peritoneum.