Ask Kikay Runner: How to Prevent or Cure Side Stitches

    

This is a section on my blog where I answer questions people ask me. If you have any questions for future Ask Kikay Runner entries, email me, tweet me, or leave me a message on the Kikay Runner Facebook page.

Wace asks: Any techniques/advice to prevent side stitch when running? :) Thanks!

The medical term for side stitches is exercise-related transient abdominal pain. I haven’t had a side stitch in a while but I do recall they are nasty when they happen — they knock the wind out of you and force you to stop or slow down. This happens because the diaphragm, like any muscle, can spasm during exertion.

There’s no definitive knowledge about what really causes side stitches, but there are some possible causes. The one I hear most often is: exercising too soon after eating. It takes approximately 30 minutes for food to exit the stomach, so schedule your large meals about one or two hours before doing a run. If you must eat shortly before a run, make it a light and easy-to-digest snack to prevent stomach upsets (avoid fatty or high-fiber foods).

Not warming up properly or working out too intensely can also cause side stitches. It’s always better for the muscles in your body when you warm up and pick up the pace of your workouts gradually. Also notice how your breathing is shallow and fast when you’re forced to sprint without warming up. This kind of breathing does not allow the diaphragm to relax fully, which can lead to spasms.

Speaking of breathing, not breathing well contributes to side stitches. The pumping of leg muscles when running puts pressure on the diaphragm from below. Lung expansion due to rapid breathing puts pressure on the diaphragm from above. This pinches the diaphragm, decreases blood circulation, and causes spasms. Breathe deeply and according to a pattern: at a slow pace breathe in for three counts and out for two counts, while at a fast pace breathe in for two counts and out for one count.

Side stitches are more frequent in less trained individuals, who have poor muscle conditioning of the abdominals and diaphragm. It’s just like leg muscles cramping when you run at a pace you’re not used to. Improve your fitness and endurance and the side stitches will go away.

Now, when you already have a side stitch, what can you do to cure it? The first thing to do is slow down or stop, and see if the pain lessens or stops. Then, take some slow, deep breaths to stretch out your diaphragm. You can do side bends to help stretch out your abdomen, but do them gradually so the muscle doesn’t spasm from being stretched too quickly (this is known as the stretch reflex). If that doesn’t help, massage the area by pressing your fingertips against your abdomen right where it hurts, and exhale as hard as you can.

Good luck with the side stitches. Don’t let them stop you from running!

References:
Ask the Running Doc: How Do I Prevent Side Stitches?
Ask Alice: Side Stitch Prevention
Runner’s World: Four Ways to Stop the Dreaded Side Stitch
Core Knowledge: Everything You Need to Know about Side Stitches

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