Forget about that stitch !

What runner has never had a stitch?

This frequent pain appears on the side at the junction between the thorax and the abdomen. A stitch in the side is in no way serious, even if it forces some athletes to stop running temporarily.

Stitches are common among running beginners or physically inactive people who start to exercise, but it can also happen to the regular athlete. For regular runners, stitches are rare and are especially felt during running on steep terrain (mainly during descent).


Why do we get a stitch?

We don't know exactly what causes a stitch in the side. There are several possible explanations: muscle cramp (diaphragm, intercostal muscles), minor abdominal problem usually related to circulation overload (spleen, liver, stomach,etc.), digestive problems (fermentation of gas in the digestive system), etc.


What are the risk factors likely to cause a stitch?

  • Meal that is too close to the training session and too heavy.
  • Lack of training.
  • Beginning too fast.
  • Running downhill.
  • Running while "always breathing on the same foot" (i.e. breathing synchronised with the rhythm at which you step, causing you to always breathe in on the same foot) which creates diaphragmatic tension.
  • Hot weather conditions, with a risk of dehydration.


To get rid of a stitch, you can try several things:

  • Breathe deeply.
  • Change your running rhythm, your running pace and your "breathing foot".
  • Change your breathing rhythm.
  • Lean forward, pressing on the side that hurts.
  • Try stretching the opposite side.
  • Take a break.


How can you avoid stitches ?

  • Train regularly.
  • Warm up properly before the session.
  • Don't eat a meal just before exercising: rule of three hours between the last meal and practising a sport.
  • Don't eat a heavy meal before exercising, and especially keep an eye on carbohydrate intake due to the risk of fermentation.


Beware of false stitches!

Be aware and don't mix up a stitch with thoracic pain: heart attack, pulmonary embolism pain, pain arising from pulmonary difficulties (collapsed lung), etc.

A pain that occurs when you are at rest, after minor activity, that does not go away within a short time or does not feel like a stitch is not a stitch and a doctor should be seen immediately. 
If there are other symptoms (feeling unwell, dizziness, shortness of breath, etc.), or if the pain creates a feeling of tightness in the rib cage, a doctor must be called immediately.

In short: Respect the following four points: Follow these simple rules to avoid this inconvenience.

  1. DIET : Try to have your meal 3 hours before you start.
  2. HYDRATION:Drink small mouthfuls of water at regular intervals and avoid gulping down mouthfuls that are too big.
  3. WARM-UP : Don't forget to warm up to prepare your body for the physical effort.
  4. BREATHING :Breathe fully during exercise, breathe in and out deeply



"There is no magic solution to the side stitch. Everybody has their own little tips, I'm sharing mine.

Aside from stopping the activity, which is best, if I can't get rid of a stitch, for example during cross country running, I squeeze the place that hurts with my hand. It's not very practical, but it's better than stopping, and often it works. 

If you decide to stop, I remember I used to push my fingers right under my false ribs, and I'd force them back with the pressure created by  fully exhaling after deeply inhaling for a few seconds.
It's really a problem that everyone has their own solution to. Try mine, you never know! 
Enjoy your run!"


Stéphane Diagana


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