Training
Solving the Stitch By Sean Falconer
Most runners have experienced a side stitch , but not all of them know how to cure the problem . Here ’ s what you need to know so you can keep going next time you get all stitched up .
The stitch is just one those things that most runners experience sooner or later … an aching or sharp pain just below your ribs , usually just on one side , and sometimes accompanied by some pain in the shoulder . However , the treatment or cure for the stitch is where things get interesting . Sometimes you ’ ll see athletes trying to push their hands under their rib cage to alleviate the pain , while still trying to run at race pace ! Unsurprisingly , this doesn ’ t really work so well .
What ’ s the Problem ?
There are various theories as to the causes of the stitch , one of which is thought to be irritation of the ligaments and the membranes that hold and connect the various muscles , bones and organs of the lower abdomen . Basically , the impact of running pulls the organs downwards , tugging on the ligaments in the upper abdomen and creating irritation . This would explain why consuming a big meal before running can bring on a stitch , with the extra weight of the food in the gut adding more pressure on the ligaments . However , swimmers also often complain about side stitches , so vertical tugging due to impact doesn ’ t fully explain the stitch .
Another theory is that a stitch is cramping of the diaphragm , the muscle that expands your lungs and allows you to breathe , which becomes over-exerted by heavy breathing and thus cramps during highintensity activity . Furthermore , another theory holds that this cramping can be made worse by consuming certain foods or fluids , notably concentrated sugary drinks , which causes more blood flow to the stomach to help with digestion , thus decreasing blood flow to the diaphragm and speeding up the cramping . However , horse-riders are another group who often complain of side stitches , and while they are subjected to high impact , their activity is usually lowintensity in terms of breathing .
• Eat and drink carefully : Stay hydrated throughout your run , because less water means less oxygen and less blood flow to your muscles , but avoid heavy meals three hours before your run , as a full stomach will place added pressure on your diaphragm .
The good news is that most stitches quickly go away as soon as you slow down or stop running , so it is relatively easy to cure .
Yet another theory is that stitches are caused by irritation of the spinal column , as some studies showed that the pain from a side stitch can be reproduced by applying manual pressure to the vertebrae along the upper spine . This may explain why some stitches are accompanied by pain at the tip of the shoulder , as nerves running to both the diaphragm and the shoulder are connected to the same vertebrae . That , in turn , may explain why runners and horse riders ( high impact on spine ) and swimmers ( repeated rotation of the spine ) all experience high rates of stitches , but cyclists do not .
Images : Pexels
SELF-REMEDY FOR THE STITCH
As you can see , there are several possible factors causing your side stitch , and similarly , there are several things you can try to alleviate or prevent the pain :
• Breathe easy : Make sure your breathing is regular . If you ’ re pushing yourself too hard , your breathing will automatically become shallow , which puts extra pressure on the diaphragm , shutting off blood flow and creating that ‘ pinch ’ under your ribcage . If you get a side stitch often , practise belly-breathing on the run , which will lower and relax your diaphragm .
• Stretch it out : Extend your arm on the cramping side upwards and hold for a few seconds . As with any cramp , gently stretching the muscle and massaging the pain will increase blood flow , alleviating the contraction .
• Stop or slow down : Runners are stubborn and try to “ run through it ,” but it ’ s important to take any pain as a warning . If the pain subsides , then you can carry on at a slower pace before speeding up again .
• Work on speed and strength : Concentrating on abdominal and lower back strengthening exercises can also help with stitches . The tighter the muscles are in your core , the less movement of the organs and lining , or pressure on your spine . And training to go fast will allow you to race without getting a stitch .
Sean Falconer has been a running journalist and magazine editor for 25 years , and in that time has interviewed five Marathon World Recordholders as well as sprinting great Usain Bolt . He joined Modern Athlete in 2009 and is now one of the three co-owners of the magazine . He has been running since 1995 , has done hundreds of races through the years , and counts running the Himalayan 100-Mile Stage Race in India as one of his best running experiences .
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