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Few things conjure up memories of the mile in gym class quite like a good ol’ side stitch. You’re chugging along just fine when suddenly you have a sharp pain on the side of your abdomen, just below your ribs. You wonder, “Was it something I ate?” “Am I going too fast?” “How can I MAKE IT GO AWAY?!”
While a side stitch has no long-term or serious consequences, it’s nearly impossible to ignore. “It can really take the joy out of running if every time you walk out the door, you get awful side stitches,” says Janet Hamilton, an exercise physiologist and running coach with Running Strong based near Atlanta.
Experts aren’t exactly sure what causes side stitches, but one theory is that insufficient oxygen to the working muscles, particularly the diaphragm, is to blame. Inadequate conditioning, gut issues and electrolyte imbalance or dehydration are all possible risk factors.
The good news is, as you become a stronger and more conditioned runner, side stitches are less likely to affect you, says Hamilton. “If you can respect that this is just a temporarily weak link in your chain, and you can work through it, you’ll come out stronger on the other side,” she says.
In the meantime, here are steps you can take to reduce the likelihood of experiencing a side stitch.
Preventing Side Stitches
If insufficient oxygen is the culprit behind side stitches, your best defense is to ensure your working muscles—including your breathing muscles—have enough oxygen. One basic way to do this is to warm up before you run, which increases blood flow to your body, says Hamilton.
Strengthen Your Core
Your diaphragm is a respiratory muscle, but it’s also a part of your core. “If you’re not using your core properly, or if these muscles are weak, they have to work hard already. Add in breathing hard while you run, and you’re taxing them even further,” says Hamilton. She recommends including core work in your training program to help your diaphragm and other deep core muscles get up to snuff.
Leave At Least Two Hours Between Meals And Running
Your gut has to compete with your working muscles for oxygen when you run. Hence, lowering its workload can reduce the likelihood of gut-related cramping. If you need a snack, choose something light that you can quickly digest.
Take In Adequate Electrolytes
These can help you absorb water more quickly. It’s possible—although not proven—that water sloshing around your gut could contribute to side stitches.
Check In With Your Posture And Breathing
Relax your shoulders and arms to avoid breathing at your neck and chest and to take in more air with your diaphragm. If you currently breathe with an even rhythm—for example, inhaling for two steps and exhaling for two steps—consider switching that rhythm up and breathe in for two and out for three, or in for three and out for two.
Stopping Side Stitches
Prone to side stitches? Try this resisted exhalation trick from Coach Janet Hamilton of Running Strong to stop one in its tracks.
- Stop running, walk a few steps and then take three or four fingers and place them directly on the spot where you feel pain (usually just below your ribs on one side).
- Push into the painful spot as you exhale/blow through pursed lips.
- Repeat two to three times.
- Walk for a few minutes before gradually picking up your pace to resume running.
Consider taking intermittent walk breaks and slowing your pace so that you don’t get the side stitch in the first place. When you’re stronger, you can take out the walk breaks.