Preventing Side Stitches

Submitted by Jeremy Chin
Posted on 03 May, 2020

A side stitch is felt as a sharp pain in your abdomen just below your ribs. It’s usually localized to one side, occasionally accompanied by pain at the tip of your shoulder on the same side. Side stitches most commonly affect runners and swimmers. Horseback riders complain about it too.

What Causes It?
A lot of research has been invested into understanding side stitches, and the results suggest that they are brought on by a number of things. Some studies have shown that it is the result of a cramp in the diaphragm, while some suggest that it is cause by the tugging” on the ligaments and membranes that link the various muscles, bones and organs in your body. Diet has also been shown to have a significant effect on side stitches, as do activities that put pressure on your spine.

Your Action Plan
The good news is that there are a variety of effective strategies that can help prevent side stitches from happening. Some of these strategies can be implemented before you run, and some can be applied if you get hit by side stitches in the middle of a run.

Before Run

Time your meals appropriately.
Exercising on a full stomach can make people more susceptible to side stitches as a heavier stomach increases the “tugging” on the ligaments and the membrane which hold and connect all of the various muscles, bones, and organs inside the abdomen. As the theory goes, impact during activity pulls the organs in your abdomen downwards, causing irritation of the ligaments. This explains why side stitches are common in running and horse riding, but are rare in cycling.

Avoid fatty and high-fiber foods.
Foods that are high in fat and fiber take longer to digest, and so should be avoided one to two hours before you run. If your body is still digesting food, there will be less blood flowing to the diaphragm, which can induce spasms.

Avoid fruit juices.
A few survey-based studies on runners have established that drinking reconstituted fruit juices and other beverages high in sugar before and during exercise will increase your risk of developing a stitch. Each person, however, reacts differently to different fluids. So you may consider keeping a log of the foods and drinks you consume pre-run to single out the ones that give you problems.

Strengthen your core.
Having strong abdominal muscles helps reduce the incidence of stitches. By strengthening weak diaphragm muscles, they become more resilient to fatigue and less likely to cramp. Core strengthening exercises like planks and donkey kicks are very effective, as are yoga and Pilates.

Don’t skip your warm-up.
Going from stationary into full speed creates irregular, rapid-fire breathing patterns, which can trigger side stitches. It is best to start with a few minutes of brisk walking, gradually working your way into an easy run pace, and then into your planned running workout pace.

While Running

Breathe deeply.
Side stitches occur quite often as a result of shallow breathing. When exercising, focus on taking deep breaths from the belly, periodically exhaling through pursed lips. This technique has been found by many runners to be effective for side stitch prevention.

Run like a swimmer.
Swimmers can only breathe when their faces are out of the water. As such, their breathing is always in sync with their body. Erratic breathing greatly increases your susceptibility to side stitches, so it’s important to establish a steady breathing tempo and match it with your stride.

Recalibrate your stride.
When a person exhales, the ligament between their diaphragm and internal organs is fully extended, and vulnerable. So when a runner’s foot impacts the ground, it sends a shock up that side of the body and puts undue strain on the extended ligament. To take pressure off the side that is experiencing discomfort, only exhale on your strong side. So for example, if your stitch is on the right side, you’d want to exhale when your left foot hits the ground.

For more breathing tips, check out: Breathing Tips That Could Change Your Life

Final Word

The good news is that side stitches tend to disappear the more you run. Almost all seasoned runners will testify to this. But till your body earns its immunity, do experiment with the techniques listed above. We hope they help.