The term ‘runner’s stitch’ refers to that special kind of cramp that every runner seems to experience at some point; that debilitating pain that grabs at the side of your body under your ribs.
It’s an extremely common complaint among runners but as yet there are no concrete answers backed up by scientific research to explain why it happens. However, there are plenty of theories!
Top 3 Tried And Tested Remedies for Runner’s Stitch
Listed below are the top three tried and tested methods of dealing with a stitch when it strikes:
1. Direct pressure
The technical term for runner’s stitch is exercise related transient abdominal pain and one popular theory is that it’s caused by, not so technically termed, jiggling!
There is no doubt that running causes the internal organs to be jiggled about and it’s thought that this repetitive movement creates irritation in the muscle walls of the abdomen.
Many runners report feeling a cramping pain in one or both shoulders at the onset of a stitch and this ties in with the jiggling theory because of nerve connections between abdomen and shoulder.
The most effective remedy appears to be simply placing your hand over the painful area and pushing firmly.
In most cases, this can be done without stopping but slowing the pace or walking will certainly make it easier.
The direct pressure, along with possibly bending the body in the direction of the stitch, provides an almost instant ‘cure’ and the runner can generally pick up pace and carry on without any more trouble.
2. Deep breathing
Breathing quickly or using short, shallow breaths places much greater stress on the diaphragm compared to normal, slower breathing.
Another theory is that this extra stress may cause the muscles and supportive tissues of the diaphragm to spasm or cramp, creating a stitch.
Synchronising breathing with footfalls is reported by runners to be effective in easing the pain of a stitch and also as a preventative measure. Most runners will naturally breath in time with their stride but it seems to be a case of thinking more about the number of strides it takes to inhale and then the number it takes to exhale.
Lengthening the exhaling process can help to alleviate the pain of a stitch so, for example, if you normally inhale for two strides and then exhale for two strides, changing the latter to take three strides can make all the difference.
Concentrating on taking deeper breaths and slowing the pace if your breathing rate becomes too rapid may be all it takes to avoid a stitch occurring in the first place.
3. Run on an empty stomach
Ask six runners to advise you on what and when to eat before running and you’ll get seven answers!
This really is something that becomes personal preference and will be discovered through a process of trial and error.
However, it’s generally agreed that eating, or even drinking large amounts, should be avoided for at least one hour prior to running.
Hydration levels can be maintained by drinking small amounts regularly throughout the day and most runners find that the little and often approach works best when planning meals too.
Raising your hands above your head to create a stretch in your stomach is one way of dealing with a stitch or another is to stretch the affected side of your body by raising the arm on the same side and stretching it across the top of your body to the opposite side.
This can often be done without stopping but slowing down or walking momentarily may help.
A full stomach will undoubtedly push against the diaphragm which will have the domino effect of pushing against the lungs.
The combination of extra stress on the diaphragm and shallower breathing may be enough to create a stitch but it might simply be that a heavier stomach will be subject to even greater jiggling!
One piece of factual evidence linking all of the most common theories is that new, or less experienced, runners are far more prone to suffering from runner’s stitch.
This suggests that the process of becoming a more experienced and therefore more efficient runner may bring with it an end to the condition.
More experienced runners will have developed greater strength and stability in their core running muscles which will help to limit the effects of jiggling on the internal organs; seasoned runners will have developed a greater level of fitness and control over their breathing patterns; and running experience will also provide valuable knowledge regarding what and when to eat.
Preventing and Treating Side Stitches
Few things are worse than getting a side stitch during a run. A side stitch is that jabbing pain in your side, sometimes also accompanied by some stress or tightness from your shoulder down your side.
While the exact cause of side stitches is still under debate, there are certain activities that tend to cause them that you can proactively be aware of and take measures to prevent them.
Many beginner runners experience side stitches only to have them occur at less frequency and severity as their running fitness level improves. As an experienced runner, I encounter them only once or twice a year and never at a debilitating pain level.
Here are three ways to prevent them, and strategies for stopping a stitch while running.
1. Warm-up before you run
When you head out for a run, starting off on your planned pace might seem like the most logical idea, but your breathing is not in an established rhythm yet. In fact, during the first 8 – 10 minutes of exercise your body starts in an anaerobic state of exercise and then transitions to an aerobic state assuming you are running a proper pace.
Not breathing in a consistent rhythm is thought to be one of the most common culprits of side stitches.
Consider these strategies to start your run or to conduct your workout and avoid side stitches.
My favorite strategy is to run for a half to full mile at an easy pace to warm up. I can make up the time during the run if desired or another option is to not start the watch on your workout until after your warm-up.
Many runners start the clock right when they head out the door, but will stop it once they finish running and not add in the cool down. Don’t factor your warm-up as part of your distance for the day, just as you don’t count any walking cool down you do as part of your distance either.
2. Regulate your breathing
When you are running you should aim to breathe deeply from the diaphragm as opposed to quick shallow breaths from your lungs. Shallow breathing may be linked to an increased frequency of side stitches.
Try this strategy to encourage slower deeper breaths – inhaling for two to three strides and exhale for the same. The faster the pace, the shorter the sequence (fast pace = one or two strides per breath, slower pace = three or four strides per breath).
This will not only reduce the chance of stitches, but also helps your body use oxygen most effectively.
3. Eat carefully before you run
While most side stitches are rooted in breathing issues what you consume before hand is also thought to be a cause.
Foods that are high in fat and fiber are often triggers of side stitches. Experiment with a variety of pre-run food before you run, eat lightly rather than a whole meal, and give yourself plenty of time to digest. In doing so practice your race day fueling strategy remembering that you should practice everything in your training. Race day is no time to try something new!
Watch your intake of fluids before you head out running and aim for your last fluid intake to be at least an hour before you head out to run. The preferred approach is to hydrate evenly throughout the day rather than consuming a lot of fluid just before your run. Consuming fluid throughout the day encourages your body to be well hydrated all the time and you won’t have feel the urge to intake large amounts before heading out.
If you consume too much fluid before you head out you will likely get a not only a side stitch, but also an upset stomach from fluid sloshing around in your stomach. Sometimes this can lead to vomiting.
Treating A Side Stitch
If you experience a side stitch while running, take action immediately and don’t wait for it to get worse. Your best chance of preventing it is heading it off at the first sign.
Slow your pace or even speedwalk and exhale forcibly from your diaphragm as the foot on the opposite side of the stitch hits the ground. This doesn’t mean every time that foot hits the ground, but as you exhale, do so at the same time with that opposite side of where the stitch is occurring.
Another strategy is to hold your breath for a few of seconds and then forcibly exhale. This can release the tension in the muscle causing the side stitch.
Getting a side stitch does not mean you will get another once you are able to relieve it. Run with confidence once you feel the stitch has passed.
As mentioned, the good news is with time and experience you are less likely to experience side stitches.
As your body acclimates to running, many of the causes of side stitches remedy themselves through developing proper running form and fitness.