How to Prevent & Beat Side Stitches When Running

There is nothing worse than those stabbing, crippling stitches that hit below the ribcage that strikes just as you are breaking into your running pace.  Urghhhhh!!!!

In fact, running with those painful side stomach cramps can be a march through hell.

Even now, after years on the running track, I still get a side stitch every now and then, but it’s nothing like it used to. During my first few months as a runner, I used to get plagued by these painful cramps, and when they strike, running was no longer an option.

Of course, side cramps are more common among beginners than longtimers, but in my experience, they can strike at any time—regardless of how fit you are.

And if you don’t know how to deal with them (or what’s causing them in the first place), then they will definitely stop you in your own tracks.

That’s why today I’m gonna share with you some useful strategies for preventing and beating side stitches when running. But before I do that, let’s first take a look at some of the science and root causes of this condition.

The Science of Side Stitches

In the medical world, the side stitch is usually referred to as “exercise-related transient abdominal pain” and the label tells us as much about the condition as anyone knows.

The fact is, beyond the medical definition, the primary cause of the side stitch is yet a mystery to be solved.

It’s the weirdest thing.

In spite of all the scientific innovation and the research being carried out in the world of physiology and performance, there is no exact consensus on how and/or why this stinging pain in the rib cage arises.

Sure, theories abound, but the reality of the matter is that no one knows for sure what causes the pain, but it’s real and can be really discouraging for all runners from all levels and training backgrounds.

Runner resting tired exhausted after running

Here are some of the current theories on the root cause of the side stitch:

Theory.1: Your organs “Fight” with each other

Some physiologists have suggested that the common side stitch is the result of the bouncing effects that running causes within the abdominal walls.

Essentially, your stomach and other organs—like the spleen and liver—smack into each other as your feet hit the ground running, causing the connective tissue to stretch on the nerves, leading to pain and cramps.

Theory.2:  Fatigue in the diaphragm

Or it can be caused by a diaphragm spasm. According to the experts who champion this approach, the diaphragm—which is the sheet of muscle that runs across the bottom of the rib cage—can fatigue and cramp under too much stress—when running for instance.

Other experts suggest that side stitches are caused by the overstretching of the ligament that extends from the liver to the diaphragm.

Theory.3 Bad Pre-run Eating Choices

Another theory of the side stitch is blamed on consuming a too large, too fatty meal too close to a run. This fills the stomach can put extra stress on the diaphragm, causing it to spasm.

How to Prevent Side Stitches

Although the science is still hazy on the subject, it doesn’t mean that you cannot take some preventative steps to ward off the pesky cramps.

As a result, here are five ways to prevent the side stitch, along with one simple tactic to for stopping it in its tracks.

1. Warm up right

Jumping straight into a fast running pace can indeed help you shed off some minutes on the watch, but it can also lead to rapid-fire, irregular breathing patterns, probably setting the stage for side stitches, premature fatigue, and injury.

Therefore, be careful and start all of your runs—and other workouts—with the right warm-up.

Do at least five minutes of brisk walking, and then slowly and gradually work your way into an easy running effort before picking up the pace.

If you have a quality workout on schedule—such as a sprint session or hill reps—then do this dynamic warm-up routine to start on the right foot and get your body ready for the intense work ahead.

Opting for a solid warm-up will not only prevent those stomach cramps, but also help you avoid premature fatigue, injury as well as improving overall performance.

2. Strengthen your Core

One of the remarkable benefits of a strength training routine is, of course, the gains in terms of strength that comes with. And if you are serious about making the most out of your strength session, then you should be working on your core muscles—especially the muscles around the diaphragm—on a regular basis.

If you have weak diaphragm muscles, then they will be less resilient to the pounding effects of running, thus more likely to cramp.

Nonetheless, a stronger core, hence a more robust diaphragm, would be more resilient to fatigue, thus less likely to yield to fatigue and cramps.

Plus, strengthening your core will can also help you prevent injury—by adding more support to the body and keeping good form.

Just don’t do crunches and sit-ups; they are just a waste of time anyway.

Instead, focus on exercises like the plank, the Russian twists, Superman, the side plank and other exercises that hit your whole core.

Here is the routine you need.

3. Mind your Pre-run Meal

To reduce the risks the of these side cramps, you should consider what you eat before you head out the door and see if there might be a correlation (or connection) between your pre-run meals and the frequency (or intensity) of your side stitches.

In most cases, all you have to do here is to give yourself more time between eating and running. If your body is still processing food, there will be less blood coursing to the diaphragm, which can induce spasms.

Therefore, have your meal, at least, three hours before your run. 

If you need a pre-run snack, then have it at least an hour before you head out, opting for high calorie, low protein, low-fat snacks, and foods at all times.

Also, pay attention to what you eat. As a rule of thumb,  avoid high fiber and fatty food since they take longer to digest and be absorbed. Eating these foods is not necessarily a bad thing, but doing it prior to a run can lead to stomach upset, stitches, and other troubles.

What’s more? Avoid high sugar beverages and fruit juices before you run.

Side stitch - woman runner side cramps

4. Work on your Breath

I believe that what helped me the most fight off side stitches is deep breathing.

In fact, as I started taking deep breaths while running—inhaling and exhaling fully and deeply—the frequency of side stitches dropped drastically.

Of course, this is just my observation. And it’s not a bullet-proof scientific method. Just try it out for yourself and see if it helps.

Here is what to do.

According to research, opting for a 2:1 or 2:3 breathing cadence—as in, inhale for two steps, then exhale for one step, or in for two and out for three—can increase the depth of your breath, and help you run pain-free.

Matching your breathing to your stride will not only help you prevent the side stitch, but can also improve the efficiency oxygen transport, helping you run faster longer.

As a result, spend time learning this breathing pattern and matching it to the rhythm of your stride.

For more on proper running breathing strategies, check this post:

5. Stop the Side Stitch on the Run

If all of the above preventative steps proved futile, and you are still plagued by side stitches, then let me suggest something you could do to stop the pain.

If you are hit with a side stitch in the middle of a run, then all you need to do is slow it down, and breathe deeply to release the tension.

If slowing down wasn’t enough, then you may need to stop running, walk slowly and press your finger on the right side of your body, giving it a slow rub.

At the same time, make sure to powerfully exhale while holding your lips closely together. No one knows why this works, but it does help.

You can also bend forward and try reaching for your toes with your fingers. This theoretically provides more space within your internal organs—mainly moving the liver away from the diaphragm.

In other words, massage or press on the area where you feel the spasms, while bending forward slightly.

And once the pain subsides—and it will unless it’s something else—feel free to pick up your running pace slowly.

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Well, the above steps are some of the most helpful strategies I know of.

So have you dealt with side stitches before? And what worked the best for you? Please feel free to share your experience and insights.

Featured Image Credit – .matter. through Flickr

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