Side Stitches

Audio Transcript

Coach Claire Bartholic: Hello everyone, Welcome back to the runners connect Run to the Top Extra Kick podcast.

We go in deep into your running or training related questions each day.

Today’s question is from Lawrence and it is about side stitches. He asks, “I’ve been getting side stitches during nearly every run and I can’t seem to shake them.

Sometimes they’re up near my rib cage, and other times, down just above my hip. Do you have any advice on preventing these and getting rid of them when they pop up? Thanks.”

Thanks for sending in your question. What you are experiencing is very common. I too sometimes get side stitches and they feel like a stabbing pain right underneath your ribs.

The pain can be so distracting that running it becomes far more difficult than it needs to be. If it gets too bad, you might even feel the need to stop.

That’s not exactly what you want to do in the middle of a hard workout or race. What does science say about side stitches?

They are so common that they should be well studied and have an easy solution right? Well, not so fast.

A few survey-based studies on runners and other athletes have shown that eating a large meal or drinking concentrated sugary fluids like fruit juice close before running, will increase your risk of developing a stitch.

Interestingly, being older and training more often seems to have a protective effect with older and more experienced runners suffering from fewer sides stitches.

Beginner runners are also more likely to be susceptible to them. If you are a newer runner, consider the foods you are eating as a starting point.

Now you might think that’s all there is to it. Eat too much sugar too close to exercise and you are likely to get a side stitch, but that’s not quite the whole picture.

Cyclists are far less likely to experience side stitches than runners. It might not be just exercising on a full stomach that’s doing it.

Do you know what other type of athletes also suffer from side stitches almost as commonly as runners? I’ll give you a minute to guess. Give up?

It’s horseback riders. That’s right.

You might never have thought that running and horseback riding have much in common, but up to 62% percent of horseback riders claim to experience the same kind of sides stitches that runners do.

Horseback riding is a low intensity, yet high impact sport where cycling is low impact. Perhaps the impact has more to do with the problem then timing or sugar content of the food you eat.

One explanation is that a side stitch is irritation of the connective ligaments inside the abdomen.

This theory claims that, it’s the impact during activity that pulls the organs in your abdomen downward, tugging on those ligaments in the upper abdomen and creating irritation or a side stitch.

This would explain why consuming a meal, regardless of its contents, too soon before running, can bring on a side stitch.

It also explains why side stitches are common in running and horseback riding but are rare in cyclists.

The only problem with that idea is that sugar content actually does seem to have an effect on the occurrence and intensity of side stitches.

One study shows that ingesting fruit juice and even popular sports drinks before running, cause side stitches more often than just plain water.

The whole idea of impact being the root cause; Well that theory doesn’t hold water with those 75% of swimmers who report getting side stitches as well.

While the scientists are busy trying to figure out why cyclists seem to be immune while horseback riders, swimmers, and runners suffer, there are still some ways that you can prevent and eliminate side stitches.

The first step is to make a note of what you are eating and drinking before running. You might want to try running in the morning on an empty stomach to see if you get any relief.

If that’s not feasible for your schedule, make sure that your last meal is at least 2-3 hours before you run and that you’re hydrating with just plain water.

What if you do that and you still get a side stitch? There’s good evidence that deep breathing and contracting the abdominal muscles will get rid of the stitch, without slowing you down.

One technique is to force your stomach to do the opposite of what it naturally wants to do. Usually, when you breathe in your abdomen expands with air.

When you breathe out, it contracts. Try forcing it to do the opposite. It’s a little difficult to get the hang of it first, but practice a few times when you’re not running and it will become easier.

Once you’ve got the rhythm down, make your breaths deep and forceful taking in all the air that you can, every little gulp that you can manage, and then letting it all out forcing out every molecule.

Do this a few times on the run, and your cramp will disappear.

I’ve tried this technique on a run and honestly, I never did get the hang of it because I found something that similar but just a little easier and just as effective.

When a side stitch appears, stretch your diaphragm to alleviate the pain. Your diaphragm stretches when you exhale and contracts when you inhale.

To stretch it completely, take a big breath in and then blow the breath out as entirely as you can until you are most coughing.

It sounds like this [Breathing sound 00:07:02.3]

Try it a few times and the stitch should disappear. You’ll still have to slow down a little at first because of the change in breathing rhythm, but you won’t have to stop completely.

The more you do it, the better you’ll get. Once you are free of those annoying and painful side stitches, you can get back to enjoying your run, and listening to your new audio book that you just downloaded from Audible.

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Thanks again for sending in your question Lawrence. If you are listening and have a question that you’d like answered on the show, click over to runnersconnect.net/daily and record your own and we’ll answer it in a future episode.

Have a great run today.