Let’s set the stage: You’re in the middle of a highly effective workout, feeling absolutely in the zone, when all of a sudden you’re hit with a sharp pain or dull ache in your side, just below the rib cage. At first, you think you can handle it, but the side stitch becomes hard to ignore, throwing off your workout and causing the kind of acute discomfort that would make your abdomen scream if it could.
Sound familiar? While side stitches are a fairly common occurrence during exercises like running, that doesn’t make them any easier to manage. Side stitches can be (temporarily) debilitating and have the power to derail your entire workout.
The good news is, by understanding what causes side stitches, you should be able to reduce the risk of these pesky pains ruining future workouts.
This article will review what causes side stitches, how to prevent them, and also how to get rid of them when you get sideswiped with one.
What Is a Side Stitch?
So, what exactly is a side stitch? The medical term for it is exercise-related transient abdominal pain, or ETAP. According to the National Library of Medicine, ETAP is a type of localized pain that tends to feel sharp or stabbing, but may also feel less intense. While it can be terribly uncomfortable in the short term, it’s not harmful long-term.
It is also worth noting that what we’re discussing is specifically related to pain during physical activity. If you experience what seems like a side stitch while you are inactive, it's likely something else entirely, like a cramp or indigestion. If you’re concerned about what feels like a cramp in your side that occurs even when you’re not exercising or that persists after you stop your activity, seek medical care.
What Causes a Side Stitch?
Exercise-related transient abdominal pain is common during sports and athletic activities, especially running and swimming. It can also be brought on by any type of aerobic activity that strains the torso.
There are different theories as to what causes side stitches. Stitches have been attributed to increased stress or pressure on the diaphragm during rapid, labored breathing, as well as ligament strain, poor circulation, GI issues, and more.
Side Stitches & Running
Running is the biggest trigger of side stitch symptoms. Keep in mind that many sports involve running, such as soccer, football, basketball, lacrosse, and more.
Exercise-related transient abdominal pain (say that 10 times really fast!) appears to be related to activities that require repetitive torso movements. Studies have shown that nearly one in five runners reported not only having ETAP the prior year, but that it tended to recur, often in the same location each time.
How to Prevent a Side Stitch
Side stitches are very common and not something to be feared. But that doesn’t mean you shouldn’t try to prevent them from occurring if possible, or to manage the pain when it does occur. Here are some healthy tips that might just help you stave off a stitch:
Focus on Good Posture
It’s true that good posture makes everything better! Poor alignment and spine issues will affect your torso and may make you more likely to experience stitches, according to research. So, make sure to pay attention to your posture and work on strengthening your core, which supports your spine and pelvis and is crucial for maintaining proper body alignment. If you tend to experience side stitches while running, check your running form.
Properly Warm Up Before Exercising
Take some time to warm up your muscles before attempting to run. You can check out these warm ups for inspiration. This will help get your blood flowing and warm your body, signaling to your diaphragm that you’re about to really start using it.
Avoid High-Fat and High-Fiber Foods Before Exercising
High-fat and high-fiber foods take longer to digest, causing more blood to travel to your digestive tract, which could mean less oxygen-rich blood is able to properly circulate to other areas of your body. Opt for a light meal or snack to fuel your workout. And, no matter what you eat, don’t run too soon after consuming it.
Decrease the Length of Your Workout
If you’re prone to side stitches, try shorter, higher intensity workouts to discover if it might be the endurance workouts that are causing your side pain. Mixing up your routine may help you achieve the best results. For example, smart training may mean you incorporate both running and cycling into your routine.
Avoid Drinking Right Before Exercising
Make sure you hydrate 1-3 hours before your physical activity, but definitely don’t chug all your fluids immediately beforehand. You don’t want a stomach full of water causing you any more discomfort than necessary.
Increase Your Level of Fitness Gradually
Don’t push yourself too hard, especially if you’re just starting out with running. When it comes to running, ease into it gradually, so your body can more easily adjust.
How to Get Rid of Side Stitch While Exercising
Once the dreaded side stitch pain occurs, here are some things you can do to get rid of side stitches and recover quickly:
Slow Down or Take a Break
Take a moment to slow down or stop, focus on your breathing and collect yourself instead of muscling through, which could cause even sharper pain.
Focus on Your Breathing
If there was ever a time to challenge yourself to some deep breathing, it’s during a side stitch episode! Try to slow down and keep your inhales and exhales controlled and measured. You could try box breathing and inhale deeply for 5 counts, hold the breath for 5 counts, exhale completely for 5 counts, and then wait 5 counts before inhaling again.
Stretch Your Abdominal Muscles
Some light stretching of your abdominals might help the stitch subside. Reach the arm on the opposite side of where the pain is above your head and gently lean toward the side of your stitch. Alternatively, try dropping into a gentle cobra pose to stretch out your core.
Massage the Stitch Away
Lightly massage the area where you are feeling the sharpest pain and lean slightly forward. Try to stay in this position and breathe steadily while counting to 30.
While you shouldn’t hydrate excessively right before your workout, it’s a good idea to make sure you hydrate during your workout. You can even err on the side of caution by keeping your drink breaks to a minimum, refraining from chugging, and avoiding extra-cold fluids.
When To Contact a Doctor About a Side Stitch
When it comes to side stitches, what’s most important is that you listen to your body and try to honor any cues it might be giving you.
If you’re consistently experiencing side stitches, you can try switching up your routine and testing out a different form of exercise to see if the stitches lessen. If they persist, it’s a good idea to check in with your physician to ensure there are no underlying issues contributing to it. The same goes for chronic discomfort in your sides or abdomen.
New or Severe Pain
A stitch is never fun, but it shouldn’t cause severe pain or major discomfort, particularly not for extended periods of time. If this is something you’re experiencing, stop exercising, and speak to a medical professional for appropriate guidance.
Side stitches shouldn’t be accompanied by other symptoms such as dizziness, nausea, trouble breathing, tightness in your chest, or chest pain. If you’re experiencing any of these, speak to your doctor or seek immediate medical attention.
If you’re just starting to get into running, make sure to pace yourself and give extra attention to building your stamina before going all-out on an endurance run. More seasoned runners should find the right race pace to avoid injury, including side stitches. And runners of all levels can’t go wrong with the best running advice.
Hopefully, you’ve picked up some helpful tips to help work through the next stitch or avoid it altogether, so you can get back to enjoying your workout, pain-free.
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This content is for informational and educational purposes only and does not constitute individualized advice. It is not intended to replace professional medical evaluation, diagnosis, or treatment. Seek the advice of your physician for questions you may have regarding your health or a medical condition. If you are having a medical emergency, call your physician or 911 immediately.