Sweat365 » Ouch that Hurts! - Runner’s Side Stitch

Today, was an exciting day for me, I helped coach my sister and daughter as they completed their first triathlons. They both had a great time, and accomplished all of their goals. But interestingly, and not surprisingly they both experienced one of the most common exercise related complaints of new athletes: the side stitch.

Fortunately for both of them, they had each had some experience in dealing with side stitches, and so they had their own techniques to work through the pain. But it got me thinking, why do we get side stitches?

Side stitches, which are technically referred to as exercise related transient abdominal pain (ETAP), are a sharp pain radiating from the lower part of your ribcage. Sometimes simply called a stitch, a side sticker, runner’s sideache, or a side cramp, most people find that side stitches occur on the right side of their body, but others may experience them on the left side, or both sides of their body. I know that for my, if I get a side stitch it will often occur on my left side. Exactly placement of the pain will also differ for each person, which gives us some possible insight into what causes side stitches.

Side stitches are often associated with running, however, some athletes complain about them during swimming, jumping, equestrian sports, or other sports that involve a great deal of vertical movements (did someone say camel races?) . They rarely occur in sports like cycling. One theory behind the cause of side stitches is that the internal organs (liver, stomach, intestines) are pulling on the diaphragm and ligaments in the abdominal region. Some people report the pain radiating from closer to their back near the tip of the shoulder blade. Since this area is a referred site for the diaphragm, it supports the theory that the pain is related to actual effects on the diaphragm.

“Great, but…” you say, “How do I prevent a side stitch?”

Well, the list of prevention techniques tend to revolve around the following recommendations for strengthening your abdominal muscles and reducing the effect of sudden impacts. But let’s take a closer look at more specific suggestions.

• Don’t eat before a run. - There are many good reasons to avoid eating right before a run. But as it relates to side stitches, the basic theory goes something like: if you just ate, your stomach will be filled with food, and fluids to digest that food. This extra weight exacerbates the impact of the downward force of the exercise and increases the probability of pulling the diaphragm. So next time, avoid eating before your run.
• Don’t exercise beyond your fitness level. - This could mean keep your pace at an appropriate level, or avoid running when you’re already fatigued. It follows that as your abdominal muscles become more conditioned to running, they will be less likely to become stressed, and you’ll avoid side cramps. You could also take this advice to support the recommendation of doing core and abdominal strengthening workouts to improve your running fitness.
• Change your breathing. - This suggestion comes from the idea that your diaphragm is a hard working muscle that controls your breathing, and while you’re internal organs are bouncing up and down as you run, you’re putting more stress on that already hard working muscle. If you hit the ground with downward force right as your diaphragm is at it’s highest and tightest position (as you exhale) then you’re further increasing the probability of this pulling action causing pain. So change your stride, pace, cadence, or breathing rhythm.

I’m reminded of the old joke, about the guy who goes to his doctor and complains about a pain when he does his favorite activity, to which the doctor replies “Don’t do that.” For those of us who’ve been bitten by the fitness bug, we can’t just turn off our desire to go out and exercise. So if you suffer from side stitches, don’t despair, and don’t… “Don’t do that.” Instead, take these simple preventative measures, and work on improving your core strength as you increase your running fitness.

Filed under: Articles, ETAP, Injury Prevention and Recovery, Library, Running, exercise related transient abdominal pain, runners side ache, runners sideache, side cramp, side sticker, side stitch, sideache, sidestitch  |  Digg! this story.  |  Leave a Comment