Almost every runner has experienced side stitches on one or more occasion. It also afflicts athletes in other sports: aerobics, skiing, and others. It's not truly a sports injury like shin splints, but it can still sideline the victim for at least a few minutes. The good news is that by understanding what causes it, it can be stopped or prevented altogether.
The medical term for the side stitch is ETAP (Exercise related Transient Abdominal Pain). The transient part is important; as soon as it goes away, the running can continue.
What causes side stitches?
It is commonly believed that ETAP is a medical condition that results from the stretching of ligaments that run from the diaphragm to the internal organs, notably the liver. The thoracic diaphragm is basically a muscle group located at the bottom of the rib cage. It's purpose is to contract and expand to alter the shape and capacity of the thoracic cavity to allow the lungs to expand during the inhalation process.
So, it comes as no surprise that the steady rhythm of breathing that running produces, coupled with the jarring caused by foot strikes, can cause things to go a bit goofy. In particular, spasms can develop during the right foot strike while exhaling. (The liver is located on the right.)
Make the pain go away!
The first thing to do is to reduce forward speed; slow down. This will lower the pressure of the foot strike and lessen breathing. Place the right hand on the afflicted area and gently press up and in. This is believed to help support the liver and take the pressure off the diaphragm muscles. Soon, the pain will go away, and regular activity can be resumed.
Also, change your breathing pattern. Runners that exhale on the right foot strike, should change it over and exhale when the left foot comes down.
Preventing side stitches
People that are susceptible to stitches report that they become less frequent as the runner's fitness level improves and weekly mileage logged increases. The logic is that the body gets acquainted with the stress and makes adjustments.
Other things can be done to lower chances of muscle spasms from happening. These include:
- Be sure to hydrate properly before running; dehydration is thought to increase the odds of it happening.
- Don't exercise right after eating. Remember “don't go swimming after eating?” Well, the jury is still out on that one, but it makes sense that not having a full belly leaves more room for the lungs to expand and the organs to move.
- Warm up with a light jog or stretch before running. This increases flexibility and can stave off problems.
- Go out easy, then pick up the pace.
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