A side stitch strikes at the worst moment, mid-race, during a hard interval, or just as you settle into a group run.
That sharp pain under your ribs feels like it will force you to stop.
You can usually get rid of a side stitch in under a minute without stopping, once you know what sets it off.
Slowing to a walk works too, though it costs you time you may not want to give up on race day.
Here’s what you’ll learn about stopping and preventing side stitches:
- What a side stitch is and why runners get them
- The main causes you can control
- How to clear one in the middle of a run
- How to prevent them before they start
- When side pain is a sign of something more serious
What Is a Side Stitch When You Run?
A side stitch is a sharp, localized pain in the abdomen that comes on during exercise and fades soon after you slow down.
Researchers call it exercise-related transient abdominal pain, or ETAP, and it usually sits just below the ribs on one side.
A review of nearly 1,000 athletes found that 69% of runners had felt a side stitch in the past year, second only to swimmers.
The pain is usually sharp or cramping, and it can also feel like pulling or stabbing.
The leading explanation is friction inside your abdomen.
Two thin layers of tissue, the parietal and visceral peritoneum, line your abdominal wall and wrap around your organs.
When those layers rub together during running, nerves in the outer layer send a sharp pain signal to the abdominal wall.
That friction model explains why the pain feels so specific and why it eases within minutes once the movement and pressure change.
Side stitches show up most often on the right side, just below the ribs.
The liver sits on that side and adds a little extra weight and pull on the surrounding tissue as you run, though a stitch can land on either side.
What Causes a Side Stitch While Running?
Side stitches trace back to what you put in your stomach before a run and how you hold your body while you move.
2 triggers you can control explain most cases.
Eating or Drinking Too Close to Your Run
A full stomach is one of the most reliable ways to bring on a side stitch.
When researchers tested different pre-run drinks, concentrated sugary fluids provoked more side pain than water or a sports drink.
High-sugar drinks like undiluted fruit juice empty from your stomach slowly and draw extra water into your gut.
That added weight tugs on the ligaments that anchor your stomach and organs, which irritates the tissue behind a stitch.
Poor Posture and a Rounded Upper Back
How you carry your torso while running is the second big factor.
In the same research, side stitches were more common among athletes with a hunched, rounded upper back.
A collapsed posture compresses your abdomen with every stride, which adds to the friction and tugging on the peritoneum.
Newer and younger runners get side stitches more often, and they fade as your fitness and posture improve.
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How Do You Get Rid of a Side Stitch While Running?
You can usually clear a side stitch in 30 to 60 seconds using a few adjustments, without stopping completely.
Try these adjustments in order:
- Ease your pace and press on the spot. Slow down and push 2 to 3 fingers firmly into the painful area for a few strides.
- Exhale hard as your opposite foot strikes the ground. If the stitch is on your right side, breathe out forcefully each time your left foot hits the ground.
- Breathe deep from your belly. Take slow breaths that push your stomach outward as you inhale, keeping a steady rhythm.
- Stretch the side that hurts. Raise the arm on the painful side overhead and lean gently the other way for a few steps.
Exhaling as the foot opposite your stitch hits the ground is the fastest way to release a stitch without stopping.
Pairing your breathing to your stride with a rhythmic breathing pattern keeps the same side of your body from taking the downward force on every exhale.
How Do You Prevent Side Stitches When Running?
Preventing side stitches comes down to how you fuel and hydrate and how you hold your body before you run.
A few habits cut down how often stitches show up.
- Leave time to digest. Finish a large meal 2 to 3 hours before running, and keep any pre-run snack small.
- Skip sugary drinks beforehand. Choose water or a diluted sports drink over concentrated juice or soda in the hour before you head out.
- Warm up gradually. Start with a few minutes of easy running so your breathing and stride settle before you push the pace.
- Build your core and run tall. A strong core and an upright posture reduce the strain on the tissue that triggers stitches.
Cutting high-sugar drinks in the hour before a run is one of the simplest ways to prevent a side stitch.
| Side stitch trigger | What to do about it |
|---|---|
| Eating too close to your run | Finish large meals 2 to 3 hours before, and keep snacks small |
| Concentrated sugary drinks | Switch to water or a diluted sports drink beforehand |
| Starting too fast | Warm up with a few minutes of easy running |
| Rounded, hunched posture | Run tall and build core strength |
| A stitch mid-run | Press the sore spot and exhale as the opposite foot hits the ground |
When Is Side Pain Something More Serious?
A true side stitch fades within a few minutes of slowing down or stopping.
Pain that behaves differently is worth a closer look.
Check in with a doctor if abdominal or side pain does any of the following:
- Stays sharp or intensifies after you stop running
- Comes with chest pain, shortness of breath, nausea, or dizziness
- Shows up at rest, not just during exercise
- Keeps returning to the same spot over days or weeks
These patterns can point to problems that have nothing to do with running, from a muscle strain to an issue with an organ in the area.
For a closer look at what separates a harmless stitch from a warning sign, read our guide on whether side stitches are ever dangerous.
4 Responses
I have been running for over a year and I still have issues with pacing myself and breathing. The articles I have read here give great, practical advice on these elements and I will put them into practice on my next run.
I love your articles and they are really helpful but I have a question on motivation. I can run about a 9 minute mile but everyone else on my cross country team can run 8,7,6, even 5 and i’m always left behind and whenever something painful happens on the track the coaches of my team won’t let me do barely anything and i’m feeling really bad about myself now so what do I do to motivate myself?
Hi Danielle, thanks for reaching out. We actually have some great posts about motivation and what to tell yourself during a run. This is probably the best example of this https://runnersconnect.net/coach-corner/marathon-training-tips-how-to-motivate-yourself-during-intense-and-monotonous-weeks-of-marathon-training/ It is tough for us to give you specific advice as if you are in pain, it is not a good idea to continue running, so you are best to back off like your coach says. However, if you continue to focus and get the work in through cross training when you cannot run, it will help you continue to get stronger. Hope this helps!