Side stitches while running are caused by irritation of the diaphragm or abdominal lining. Slow down, breathe deeply, and avoid heavy meals before running.
Why it happens
Exercise related transient abdominal pain (side stitch) is thought to come from irritation of the abdominal lining (peritoneum), diaphragm strain or reduced blood flow. The exact cause is not settled.
Triggers
- Eating or drinking sugary fluids shortly before running.
- Shallow breathing.
- Poor core strength.
- Starting too fast.
Who
About 70% of runners get stitches each year.
What helps
- Slow down and breathe deeply.
- Push your fingers into the sore spot.
- Exhale as the opposite foot hits the ground.
Prevention
Warm up and avoid heavy meals 2 hours before.
Exercise-related transient abdominal pain
A side stitch is formally called exercise-related transient abdominal pain (ETAP). It affects about 30 to 70 percent of runners, swimmers and horse riders in studies. The cause is not fully proven. Theories include irritation of the parietal peritoneum, diaphragm strain and stress on ligaments that connect the diaphragm to organs.
- A study by Morton and Callister of 965 athletes found stitches were more common in younger people and in activities with torso movement like running.
- Eating or drinking a large amount of fluid, especially sugary drinks, within 1 to 2 hours before exercise raises the chance of a stitch.
- Pain usually appears on the right side and fades with rest.
What helps
Slow down, breathe deeply, exhale as the opposite foot strikes, press fingers into the painful area and stretch by lifting the arm on the painful side. Warm up gradually, avoid large meals 2 to 3 hours before running and strengthen core muscles. See a doctor for pain that persists after exercise, comes with fever, vomiting, blood in stool or chest pain.
Exercise related transient abdominal pain
The sharp pain in the side while running is called exercise related transient abdominal pain, affecting up to 70 percent of runners at some point. The cause is unclear, with theories including diaphragm irritation, stress on ligaments connecting organs and irritation of the abdominal lining.
What helps
Slow down, take deep belly breaths, press on the painful area and stretch. Avoid large meals and sugary drinks 2 hours before running. Warm up well. Seek care for pain that persists after stopping or comes with chest pain.
Theories behind the stitch
Proposed mechanisms include diaphragm ischemia, irritation of the parietal peritoneum, and traction on ligaments connecting the liver and diaphragm. A 2003 study in Medicine and Science in Sports and Exercise found 69 percent of runners reported a stitch in the past year. Eating or drinking before running, especially hypertonic drinks, raises risk.
Prevention and response
Warm up for 10 minutes, avoid a heavy meal for 2 to 3 hours before, improve core strength and breathing technique, like exhaling when the opposite foot hits the ground. When it hits, slow down, take a deep belly breath and stretch the arm on the painful side overhead. Persistent or severe side pain after stopping, or with fever or vomiting, needs medical advice.
Based on data from Medicine and Science in Sports and Exercise and the Mayo Clinic
