A stitch in time…


Most runners have experienced a side stitch somewhere along the way, but not all of them know how to simply and easily cure the problem. Instead you’ll see athletes trying to push their hands under their rib cage to alleviate the pain while still running at full speed! Here’s what you need to know so you can keep going next time you get stitched up. – BY SEAN FALCONER

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 pain in the shoulder. 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 soon before running can bring on a stitch. However, swimmers also often complain about side stitches, so vertical tugging due to impact can’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 cramps during high-intensity activity like running.

Furthermore, another theory holds that this cramping can be made worse by consuming certain foods or fluids, notably concentrated sugary drinks, which causes more bloodflow to the stomach to help with digestion, thus decreasing bloodflow 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 low-intensity in terms of breathing.

Still another theory is that stitches are causes by irritation of the spinal column, thanks to studies that showed that the pain from a side stitch could be reproduced by applying manual pressure to the vertebrae along the upper spine.

The researchers believe that this may also 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.



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 on a high-intensity run. If you’re pushing yourself too hard, your breathing will automatically become shallow, which puts extra pressure on the diaphragm, shutting off bloodflow 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 right arm upwards and hold for a few seconds. As with any other cramp, gently stretching the muscle and massaging the pain will increase bloodflow, alleviating the contraction.

•   Stop your run: 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 hopefully speeding up again.

•   Work on your speed and strength: Concentrating on abdominal and lower back strengthening exercises can also help you out 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 go fast in races without getting a stitch.

•   Eat and drink carefully: Stay hydrated throughout your run, because less water means less oxygen and less bloodflow 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 times a stitch quickly goes away as soon as you slow down or stop running, so it is a relatively easy pain to cure.