Experiencing a sharp, cramping, or aching sensation in the side while running is a common occurrence for many athletes, from casual joggers to seasoned marathoners. This discomfort is widely known as a “stitch” or, more formally, exercise-related transient abdominal pain (ETAP). It can significantly disrupt a run and is reported by approximately 70% of runners annually.
Understanding the “Stitch”
The precise cause of a side stitch remains uncertain, but leading theories point to several physiological mechanisms. One prominent hypothesis suggests that the pain arises from irritation of the parietal peritoneum, a sensitive membrane lining the abdominal cavity. Repetitive movements during exercise, particularly those involving torso rotation and extension, may cause friction between this membrane and internal organs, especially if the stomach is full.
Another theory attributes side stitches to diaphragm spasms. The diaphragm, the primary breathing muscle, can cramp if overworked, stretched, or lacking oxygen. Ligaments connecting abdominal organs, like the liver, to the diaphragm may also pull on it during intense movement. Reduced blood flow to the diaphragm during exertion, as blood redirects to working limbs, could also contribute.
Strategies for Prevention
Preventing side pain often involves incorporating specific practices before and during a run. A proper warm-up gradually increases blood flow to muscles, including the diaphragm, preparing the body for activity. Starting with a brisk walk for five to ten minutes before gradually increasing pace can acclimate the respiratory system and prevent irregular breathing.
Effective breathing techniques during running reduce the likelihood of a stitch. Deep belly breathing, where the diaphragm fully lowers and the abdomen expands with each inhale, ensures adequate oxygen and reduces diaphragm stress. Adjusting breathing rhythm, such as exhaling on alternating footfalls, can distribute stress on the diaphragm and its supporting ligaments.
Strengthening core muscles provides better support for the spine and abdominal organs, reducing strain on the diaphragm and peritoneum during running. Exercises like planks, glute bridges, and bird dogs build this strength. Maintaining proper hydration is important, as dehydration contributes to muscle fatigue and spasms. Drink fluids consistently throughout the day, rather than large amounts right before a run.
Timing and content of meals before exercise influence stitch occurrence. Avoid large or heavy meals, especially those high in fat or fiber that take longer to digest, within one to three hours before a run. Limit sugary drinks or highly concentrated beverages before or during a run, as they can slow stomach emptying and potentially increase irritation.
Immediate Relief Techniques
When a stitch occurs during a run, several immediate techniques alleviate the pain. Slowing down to a walk or gentle jog provides relief, allowing muscles to relax. Applying gentle pressure to the painful area, typically just below the ribs, with fingers or a hand eases the cramping. Some suggest pressing firmly into the area while exhaling through pursed lips.
Stretching the affected side is also effective. Raise the arm on the opposite side of the stitch over the head and gently bend towards the pain. Alternatively, stretch by bending forward at the torso or raising both arms overhead to open the area and promote deeper breathing. Focusing on deep, rhythmic breathing, inhaling and exhaling fully, brings oxygen to affected muscles and calms the diaphragm. Once the stitch subsides, gradually increase pace back to running.
When to Consult a Doctor
While side stitches are generally harmless and resolve with rest or the techniques described, there are instances when the pain might signal a more significant underlying issue. If the side pain is severe, persistent, or occurs when not exercising, it warrants medical attention. Pain accompanied by other symptoms, such as fever, nausea, vomiting, dizziness, or pain that does not improve with rest, should also prompt a consultation with a healthcare professional. These symptoms could indicate conditions beyond a typical exercise-related stitch.