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How to Prevent Side Stitches from Ruining Your Workout

Let’s set the stage: You’re in the middle of a highly effective workout, feeling absolutely in the zone, when all of a sudden you’re hit with a sharp pain in your side, just below the rib cage. At first, you think you can handle it, but the side stitch becomes hard to ignore, throwing off your workout and causing the kind of acute discomfort that would make your abdomen scream if it could. Sound familiar? While side stitches are a fairly common occurrence during exercises like running, that doesn’t make them any easier to manage. The pain can be (temporarily) debilitating and has the power to derail your entire workout.

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 What Is A Side Stitch? Understanding, Preventing, & Managing the Runner's Nemesis

Side stitches are a common problemmany athletes face, especially during running or other aerobic exercises. This painful sensation can happen to anyone regardless of fitness level. The medical term for side stitch is exercise-related transient abdominal pain (ETAP), and most people experience this discomfort at some point.

 Where do side stitches come from?

Although very common, until recently side stitches hadn’t been extensively studied. Scientists have not yet identified their exact cause, but one hypothesis seems more likely than the others. This hypothesis is irritation of the peritoneum, a thin membrane that covers the inner wall of the abdomen. The peritoneum is made up of two layers, which protect the organs located in the abdomen. A liquid between these two layers prevents rubbing.

Articles of Interest

Stitch in the Side

Side stitch, side cramp, side ache, and subcostal pain are terms used to describe an acute, sharp, localized abdominal pain related to exercise. This vexing but relatively benign condition is also called exercise-related transient abdominal pain (ETAP) - Randy E.Eichner MD

Stop Side Stitches from Ruining Your Run

A side stitch is a turd in the punch bowl: it can ruin your trail-running party. Sometimes, it can even end your party altogether, forcing you to stop your run or DNF your race.

How to Avoid and Treat Side Stitches

Interestingly, some people report feeling a stitch in their side when they’re not working out. So, what causes a stitch when not exercising? Non-exercise-related side cramps can result from poor posture, dehydration, gas buildup, or even stress-related muscle tension. Slouching for long periods can compress the diaphragm and mimic the discomfort of a side stitch. Digestive issues like bloating or constipation can also produce side stitch-like symptoms.

Investigation of the side pain "stitch" induced by running after fluid ingestion

Our observations cannot be explained readily by mechanisms involving digestion-induced changes in blood flow but are consistent with the notion that stitch arises when the fluid-engorged gut tugs on visceral ligaments.

Real Runners Offer Advice For Avoiding Side Stitches

Combating the “stitch in the side” often focuses on proper breathing technique. If you typically take a lot of shallow breaths while running, the diaphragm remains in a high position and never lowers enough to allow the connective ligaments of the liver to relax. The diaphragm becomes stressed, and a stitch results. Learning how to “belly breathe” can prevent the stitch from occurring.

Side Stitch: What It Is and How To Get Rid of the Pain

There’s no single reason why side stitches occur. The leading theory suggests increased blood flow to your liver and spleen. Another theory is that pain is caused by internal organs pulling down on your diaphragm. This doesn’t explain why side stitches frequently occur in swimming, though. Another possible reason could be when you eat right before any physical activity, as your body moves blood to your stomach to help with digestion leading to less blood in your diaphragm.

The dreaded side stitch

Breathing deeply while running reduces the stress on the supporting ligaments of the diaphragm and can help relieve side stitches. This type of deep breathing is referred to as belly breathing.

Why You Get Random Side Stitches (Even When You're Not Exercising)

Getting a stitch while relaxing or resting is usually due to one of the following: poor posture, dehydration, digestive issues, or sudden diaphragm strain from laughing/coughing. However, it could also be gallstone-related.

Resources

4 Ways to Relieve a Stubborn Side Stitch

There’s nothing like an annoying, sharp side stitch to zap your energy and suck the fun out of your run. You might find comfort in knowing you’re not suffering alone: Seventy percent of runners report experiencing exercise-related transient abdominal pain (ETAP)—a.k.a. side stitches—while training, reports a new review in the journal Sports Medicine. Despite how common side stitches are, though, there has never been definitive proof for why they occur.