I’m sure most of you have experienced it. You’re halfway through an enjoyable run, or nearing the finish line of a race, or just a few minutes into your early morning run when it hits you–the awful side stitch. Pain that can range from a dull cramp to a sharp, stabbing, piercing sensation and on either side of the abdomen. And according to recent statistics, close to 70% of runners have experienced a side stitch within the past year. Thankfully, there are several strategies you can use to help ease cramps, as well as preventative measures to keep them from occurring in the first place.
What Causes Side Stitches?
Even though side stitches are extremely common, the cause isn’t quite fully understood. Although there are a number of different theories out there, some medical experts think that side stitches, also called exercise-related transient abdominal pain (ETAP), is possibly due to a lack of blood flow to your diaphragm. As you run, pressure increases on your abdominal muscles and you breathe rapidly, causing the lungs to expand. These two actions–a push up from your abdominals and a push down from your lungs–create a dual pressure. The result? Your diaphragm gets pinched in the middle, which can cut off blood flow and oxygen, thus causing the cramp. And it’s not just runners who report side stitches–swimmers, cyclists, and soccer players also report being plagued by the dreaded pain.
Can Side Stitches Be Prevented?
There may not be a foolproof method for avoiding side stitches altogether, but there is a bit of good news…side stitches generally go away the more you run. Now, elite athletes are not immune, but they certainly get them less often. So, you’re not an elite runner yet? Then following these strategies before a run can help prevent the onset:
1) Don’t skip your warm-up–While there is currently no known scientific evidence that shows that a proper warm-up prevents side stitches, getting your heart rate elevated before a run is always a good idea. Dynamic stretches, such as high knees, butt kicks, and walking lunges, should be your warm-up of choice.
2) Strengthen your core–A recent study found that strengthening your transverse abdominis muscles, located behind your “6-pack” (rectus abdominis), might reduce the incidence of side stitches. The muscles run horizontally around your body to help stabilize your lower spine. You can activate them by sucking your belly button toward your spine and strengthen them through a variety of ab exercises such as Kegel’s exercises.
3) Stand tall–Having good posture may also help to prevent side stitches. One study found that individuals who had a thoracic kyphosis (humpback) were more susceptible to exercise-related transient abdominal pain (ETAP)
4) Avoid fatty and high-fiber foods–Whereas food itself may add to discomfort when running, a meal of less digestible, fatty foods might make the stomach heavier and increase the pull on the diaphragm. It’s also not a bad idea to space out your meals and run several hours apart.
5) Skip fruit juice–While drinking water and sports drinks may be associated with side stitches, it seems that fruit juice, specifically, seemed to cause them the most often. This may be due to the fact that liquids that have a low osmolality (relating to the concentration of liquids), such as water and sports drinks, (that are closer to the body’s own osmolality) are easier for the body to absorb quickly.
What If I Get A Side Stitch During MyRun?
1) Find a breathing rhythm–If you’re a relative newcomer to running, try counting your breaths and focus on keeping them even and steady. Often times you may find yourself forgetting to breathe and end up constricting your breath. If you breathe erratically, you most likely will be hit with a side stitch in no time.
2) Breathe out as your foot hits the ground–If you’re in the middle of a race and obviously don’t want to stop, try slowing down and focus on deep belly exhales as your opposite foot hits the ground. This means that if your side stitch is on your right side, concentrate on breathing out as your left foot hits the ground.
3) Stop, breathe, stretch–Take a long, deep breath and stretch your arms up toward the sky. Then, side-bend toward the opposite side of your side stitch (still with your arms extended overhead).
A Word Of Caution
If you notice that your side stitch starts to travel up to your shoulder, particularly on the left side, it could be one of the warning signs of a heart attack. Seek medical attention immediately. Also, if you start to experience side stitches with growing frequency, that could indicate a problem with blood flow to your intestines. Seek medical attention for this as well. If you experience only the occasional side stitch, keep on running and trust that as you get better, their frequency will diminish.
And as always, if you or someone you know is having pain with running, don’t wait to take action. Call my office at once at (302)691-9055 or visit my website at www.wildermanphysicaltherapy.com to schedule your FREE 30 minute consultation to see how Physical Therapy can help. Don’t delay–schedule now!