You had me in Stitches.

A look at Side Stitches, those painful side issues that can rob a run of all joy.

Where they hurt.

They typically occur on your right hand side just below the rib, although they can also move to just below the sternum.

Pain may also move up into the right shoulder joint.

What makes them flare up?

Stitches occur when exercising in an upright position. For a runner that’s bad news, for a triathlete you get your jail free card for both the swim and cycle, but it might just get you on the run. They are reliant on you jolting the body, so can happen when doing things like skipping or running.

Swimmers occasionally can get side stitches. There is obviously no jolting during a swim and so it has been proposed that an irritation to the stomach lining might bring that about.

Downhill running or running too fast. They typically strike during time trial events or 5 to 10 km races due to increased speed.

Eating and drinking too close to the start of exercise.

A lack of training.

Weakness in your abdominal muscles.

Let’s get more technical. (If you’re not interested in the technical stuff, then jump to the next heading.)

A series of studies done by (Sinclair 1951; Abrahams 1961 and Rost 1986) suggest that there are a group of ligaments involved. The ligaments link organs such as the stomach, spleen and liver to your diaphragm. It seems as if jolting caused by running places strain on your diaphragm and that then leads to a spasm.

A side stitch can be felt for a few days after as a tender area just under the ribs.

The ligaments link to the diaphragm close to where you can feel your ribs.

This is one of the reasons why it is a bad idea to eat or drink too much less than two hours prior to your event thus placing more strain on a stomach that will be bouncing up and down.

What to try out. (You might want to try memorise these)

You can try to lie down and elevate your hips. This should immediately help. This is a good idea if you suspect that you might be experiencing some kind of cardiac event. Get medical help if pain persists after lying down.

Walk for a while so that you reduce jolting on the ligaments linking your stomach, liver and spleen to your diaphragm.

Try breathing out and force the air out of your lungs. This will help stretch the diaphragm out.

It’s a good idea to work on your your breathing, so that less breath enters via chest breathing and more air enters via diaphragmatic breathing. Add the following into your weekly strength training regime. Lie flat on your back and place a book on your tummy. Breathe deeply from your belly. You should see the book rise and fall when you get this right.

Get your abdominal muscles strong. Time for some sit-ups and stomach crunches.

The other thing you can try alter is to breathe out when landing on your left foot vs on your right foot. Expect a lot of brain work in order to get that right. So, left foot lands, you breath out. 

Run slower on uphills if you stitch on the ups. The reason for this is that a lot of runners tend to start panting while running uphill. Short breaths can put the diaphragm into a spasm.

It is beneficial from time to time to get your breathing muscles released. There are a vast number of muscles that get involved in the complex movement of breathing and these can tighten. I can help with that.

I hope this helps. See you side stitch free on the road soon.

Regards,

Mike Roscoe.