A stitch, also known as exercise-related transient abdominal pain (ETAP), is a common and often frustrating experience for many individuals engaging in physical activity. This sharp, localized discomfort in the abdominal region can disrupt an otherwise enjoyable run. Understanding the nature of this pain and its potential origins can help runners manage and prevent its occurrence.
What is a Running Stitch
A running stitch presents as a sharp, cramping, or dull ache in the side of the abdomen, usually just below the rib cage. While it can occur on either side, it is more commonly reported on the right. This sensation can range from a mild annoyance to a debilitating pain that forces an individual to stop exercising. Despite its intensity, a stitch is considered a harmless condition that resolves on its own once activity ceases or is modified.
Why Stitches Occur
Several theories explain why stitches occur during physical activity. One suggests irritation or spasm of the diaphragm, a large muscle involved in breathing, where repetitive jarring motion may strain its connecting ligaments, leading to pain. Another hypothesis points to irritation of the parietal peritoneum, the membrane lining the abdominal cavity, as this membrane contains nerve endings and friction or stretching could trigger discomfort. Inadequate blood flow to the diaphragm during strenuous exercise is another proposed factor, as the body prioritizes blood flow to working muscles. Additionally, poor posture while running, such as slouching, can compress the abdominal area and restrict diaphragmatic movement, and consuming large meals or sugary beverages shortly before a run can also increase stitch likelihood.
Preventing Stitches
Implementing specific strategies can help reduce the chances of developing a stitch during a run. A proper warm-up routine, including light cardio and dynamic stretches, prepares the body for exercise by gradually increasing heart rate and blood flow to muscles. Focusing on deep, diaphragmatic “belly breathing,” which involves expanding the abdomen with each inhale rather than just raising the chest, can also be beneficial. Maintaining good posture while running, staying upright with shoulders relaxed and a slight forward lean, can prevent undue pressure on the abdominal organs and diaphragm. Finally, avoiding large meals or sugary drinks within two to three hours before a run and staying adequately hydrated throughout the day, especially before and during exercise, supports overall bodily functions and helps prevent muscle cramps.
How to Relieve a Stitch
If a stitch develops during a run, several immediate actions can help alleviate the discomfort. Slow down your pace or stop and walk until the pain subsides, as this reduces jarring motion and allows the body to recover. Applying firm pressure with your hand to the affected area of the abdomen while exhaling slowly can help release tension in the area. Stretching the torso can also ease a stitch; try raising the arm on the side of the stitch overhead and bending away from the pain, or leaning forward from the hips while exhaling deeply. Focusing on deep exhalations, particularly by pursing the lips and slowly blowing air out, can help relax the diaphragm and release trapped air or tension.