What is a Stitch?

A stitch, also known as a side pain or exercise-related transient abdominal pain (ETAP), is a pain in the side of the abdomen many people experience from time to time whilst partaking in physical activity. It can cause a sharp stabbing sensation, cramping, aching, and sometimes even pain in the tip of the shoulder too.

The pain is usually only prevalent under the rib cage on one side and occurs much more frequently in athletes taking part in sports where the upper body is often utilised, such as running and swimming.

Experiencing a stitch can be one of the most frustrating things for runners to encounter. They tend to develop all of a sudden and with no forewarning, inevitably having a significant impact on your performance. You might be hit with a stitch while you’re out training, or even worse, when you’re approaching the finish line at a race, and apart from stop to allow the pain to ease, there’s not much else you can do to combat it.

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What Causes a Stitch When Running?

Despite extensive research and studies into the topic, the exact cause of a stitch still isn’t clear. Many reasonable explanations have been put forward, all of which have some evidence to support them.

Here’s a summary of some of the most common theories –

• Some people believe that a decrease in blood flow to the diaphragm is the main cause of a stitch. Your diaphragm is the muscle which expands your lungs to allow you to breath, and exercising increases the demand placed on it, therefore causing localised irritation and pain.
• Another possible explanation is that a stitch is your ligaments and the membrane (which hold and connect all of the various muscles, bones and organs inside the abdomen) ‘tugging’. The impact and movement during physical activity pulls the organs in your abdomen downwards, tugging on the ligaments in the upper abdomen and thus causing irritation.
• Others believe that stitches are caused by irritation of the spinal column. This line of reasoning suggests the pain caused from a side stitch is a result of applying pressure to the vertebrae along the upper spine, and those with a more sharply curved upper spine are particularly prone to suffering from them.
• Failing to warm up correctly and eating and drinking inappropriately are also thought to increase the possibility of causing a stitch.

How to Avoid Stitches

Although the causes of a stitch are yet to be conclusively determined, there are some ways you can reduce the likelihood of developing one. Here are some of our top tips for minimising the chances of sustaining a stitch next time you go for a run –

• Although you should drink plenty of water in the 12 hours before your next long distance run to make sure you’re properly hydrated, in the 2 hours leading up to your run only consume small amounts of liquid. This way you’ll ensure your stomach isn’t bloated and less likely to press on the lining of your abdominal cavity.
• Likewise, avoid eating large volumes of food in the hours leading up to your run. Rather than eating a large meal opt for a light breakfast which is low in fibre instead. If you’re still feeling really hungry with less than an hour to go, eating a banana or other light snack should be ok.
• Be sure to correctly warm up beforehand. Not only will it prepare your muscles for your run, but it also promotes optimal breathing.
• If you seem to develop a stitch more times than not when running, an idea we recommend is to start slowly and gradually increase your pace. Starting off too hard can overwhelm your body and put you at a higher risk of incurring a stitch.
• The faster and further you run, the more oxygen your body will need so try to control your breathing. Irregular or shallow breathing patterns may provoke a stitch.
• Strong abs can reduce the probability of suffering from a stitch, so spending just 15 mins a day to work on strengthening your abdominal muscles can be of considerable benefit.

How to Get Rid of a Stitch

If you do happen to experience a stitch whilst on your next run, the following techniques might help to reduce the pain –

• Slow down to walking pace (and stop if necessary).
• Stop running and stretch your stomach. Carrying out some small stretching exercises in your upper body will enable you to relax your diaphragm and abdominal cavity and help to alleviate pain.
• Take some deep breaths.

If the pain is unbearable or you suffer from a stitch every time you go out running, consult a specialist.

Virtual Challenges with Race at your Pace

Here at Race at your Pace, we’re passionate about helping people of all abilities to enjoy running. Every month we organise a variety of awesome, non-competitive virtual challenges that task you to run a specified number of miles at a pace that suits you and in however many stints you require. It’s the perfect training challenge for both beginners getting into exercise for the first time and experienced athletes preparing for a race.

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