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Many runners have faced the discomfort of a side stitch during their runs.
Hemera/ThinkstockWhether you call it a pain, cramp, or simply a side stitch, most runners can relate to the feeling, as it’s a common experience. While unpleasant, a side stitch is not an injury, but rather a discomfort located on either side of your abdomen, just below the rib cage. It's like an internal cramp, occurring in your diaphragm—the muscle that separates the upper and lower torso and plays a role in breathing.
The movement of your diaphragm and internal organs causes the spasm. Activities that involve repeated bouncing or jarring movements can trigger side stitches. However, because running involves constant jostling, it is the most common activity linked to this temporary side pain.
A side stitch can be startling due to its sudden appearance and intensity. However, there’s no need to worry if you understand what’s happening and how to address it. It’s a common issue that can be treated [source: The Stretching Institute]. By adjusting your running form, breathing techniques, and even the terrain you run on, you can reduce its duration. Furthermore, changes to your pre-run nutrition and warm-up routine, along with steady improvements in cardiovascular fitness, will result in fewer side stitches. The bottom line? Whether you're just starting out or are a seasoned runner, we can help make sure this unwelcome discomfort doesn’t occur too often or linger for long.
What Causes a Side Stitch?
Take a deep breath and it will pass.
Hemera/ThinkstockRunning causes your body to move up and down with every step. Breathing also involves an up-and-down motion of your diaphragm. But what happens when your breathing and running stride aren’t aligned? That’s right—you get a side stitch.
When you breathe in, your lungs expand, and your diaphragm moves downward. During exhalation, the diaphragm rises. However, if your foot strikes as you exhale, the diaphragm is pulled in opposite directions. Repeatedly doing this causes the muscle to go into a spasm [source: Bodyresults.com].
Side stitches are especially common among beginners. This is partly because beginners tend to breathe faster, which prevents the diaphragm from fully relaxing during the downward phase. With the constant upward tension and downward pull caused by the pounding of feet on the pavement, side stitches become more likely [source: Bodyresults.com].
Side stitches are more often felt on the left side of the body than the right. This is because the liver, the largest internal organ in the abdomen, is located on the right side and is attached to the diaphragm by two ligaments [source: Johnson]. Gas pockets or a stomach full of food can also cause imbalance, adding stress to the diaphragm.
Runners, no matter their shape, size, or skill level, tend to share one thing in common: They exhale when their left foot strikes and inhale when the right foot lands. This is true for approximately 70% of runners, according to some estimates [source: The Stretching Institute]. This is the ideal pattern, but if your breathing becomes misaligned during a run, it can create a tugging sensation in the diaphragm and internal organs, leading to the infamous side stitch.
How can you address the issue? Simply take a deep breath and turn to the next page for more tips.
How to Treat a Side Stitch
At times, simply stopping to catch your breath and waiting for the spasm to subside is all you need to do.
iStockphoto/ThinkstockAs your cardiovascular fitness improves, side stitches will become less frequent. This is because your deeper breaths allow your diaphragm to move more freely, instead of staying tight and lifted. However, even the most seasoned runners can experience side stitches, so it's a good idea to be prepared with a strategy for dealing with them. Here are a few remedies to consider:
- Stop shallow breathing -- If you find yourself taking short, shallow breaths, focus on adjusting both your inhalation and exhalation patterns.
- Hold your breath -- While running, inhale deeply, hold your breath for a moment, then exhale quickly.
- Change your pace -- Altering your running speed may help correct the imbalance between your footstrikes and breathing, which likely caused the stitch.
- Take a break -- If all else fails, walking for a bit can give you time to catch your breath and allow your diaphragm to settle down.
Take note of when you typically experience side stitches. Is it after eating? When you dive straight into an intense workout without warming up? Or perhaps when you're running downhill? These situations increase the likelihood of a side stitch. To avoid it, steer clear of heavy meals before running, allow your body to ease into the day's pace, and remember that for new runners, the diaphragm might not be accustomed to the strain of downhill running combined with deep breathing.
Side stitches tend to come and go. While they may be briefly uncomfortable, they won’t last long, and you'll be back to running smoothly in no time.
