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Every runner knows that feeling: you’re running along feeling on top of the world, when BAM! It feels like someone stuck a knife in your side. Typically in the lower ribcage area, a sharp pain appears out of nowhere that nearly doubles you over. The pain makes breathing difficult, and running feel impossible. It’s the dreaded runners side stitch.
This painful and unexpected cramp can stop you right in your tracks. As a coach, I typically hear side stitch complaints most often in newer and younger runners. Some of you more experienced runners may be reading this thinking “oh yeah, I remember those!” . I’m also willing to bet it’s been a while since you had a side stitch.
Same here. I remember when I first started seriously running. I’d be a mile or two into my run, feeling great, when suddenly a side stitch popped up out of nowhere. It was incredibly frustrating, mostly because it was unpredictable, and nearly impossible to run through.
Have you ever wondered exactly what a runner’s side stitch is? Have you wondered what causes it, or why you might not experience it as much as you once did? Let’s dive into the science a little deeper:
What Exactly IS a Runners Side Stitch?
Medically referred to as exercise related transient abdominal pain (ETAP), the exact cause of a side stitch is still somewhat of a mystery. Dr. Lewis Maharam ,MD, FACSM, explains one theory behind the cause of a side stitch is due to pressure placed upon the diaphragm.
The diaphragm, for those unfamiliar, is a dome-shaped muscle that separates the thorax (upper part of your torso) from the abdomen (lower part of your torso). The diaphragm plays a major role in breathing, as its contraction increases the volume of the thorax, and in doing so, inflates the lungs.
While running, there is increased abdominal pressure pushing up on the diaphragm from below, while rapid breathing expands the lungs and puts pressure on the diaphragm from above. This pinching effect experienced on the diaphragm from pressure above and below shuts off the flow of blood and oxygen, and causes spasms, and as a result, the painful side stitches.
Another possible theory is that over eating, or eating fatty foods before exercise may cause stress on the diaphragm. Poor posture, as well as dehydration are also thought to be possible causes of a side stitch.
And though side stitches often seem to be a common ailment among newbies, it turns out no runner is immune to the evil cramp. A study done by the Avondale Centre for Exercise Sciences shows that the occurrence of side stitches was unrelated to gender, body type, or running pace. Though the study did show that the frequency of side stitches decreased with age.
But the good news is: the study reports that individuals who trained more frequently reported less instances of experiencing side stitches.
Are Side Stitches Preventable?
Since the exact cause of a side stitch is unknown, it can’t exactly be prevented with 100% certainty. However, physicians and running coaches have numerous suggestions that may prevent the onset of a side stitch.
- Ensure that you are properly hydrated and avoiding large meals before a run.
- Begin your run with a proper warm up, and avoid over exerting yourself early during your run…if at all possible. Obviously this doesn’t apply to speed work day.
- Practice proper breathing techniques, such as belly breathing, and inhaling through the mouth (more examples in this Runner’s World article).
As mentioned in the study above, most experts agree that the frequency of side stitches decreases with experience. In other words, proper endurance training through consistent running will aid in the prevention of side stitches.
Related post: What to Do if the Couch to 5K Program is Too Difficult
Once I Get a Runners Side Stitch, How Can I Get Rid of It?
Good news! Even though they may feel like they last forever, the truth is side stitches typically do not last long. If you experience a runners side stitch, slow down and focus on your breathing. Deep, calm breaths help the spasms of the diaphragm subside. One technique to focus on your breathing is to exhale through pursed lips, as if you are blowing out a candle.
Another common method is to exhale as the left foot strikes the ground, instead of the right foot. This technique puts less strain on the diaphragm (source). Runner’s World recommends stretching: raise the arm of the same side in which you are experiencing the pain, and then lean to the opposite side. If nothing else, these techniques will distract you from the side stitch pain until it passes.
And last resort: walk. Get your breathing under control and relax. This too shall pass, and there is absolutely no shame in a brief walk break.
In conclusion: side stitches suck. And while the exact cause remains to be determined, taking preventative actions to avoid their onset, as well as practicing the tips mentioned above to help cure side stitches, may help lessen or altogether avoid the discomfort of a runner’s side stitch.