Struggling with side stitches when you run? These are the five mistakes you’re probably making, according to a running coach
And learn what to do if a stitch does strike
There’s nothing like a sharp cramping in your side to bring your run to a premature halt. While stitches can hinder even the most experienced athletes, they’re especially common if you’re new to running, but they're also easily preventable.
Officially known as exercise-related transient abdominal pain, stitches typically present as a sharp pain around the ribcage.
According to Jill Becker, a certified running coach and personal trainer at Life Time Westminster in Colorado, “cramps can be caused by a spasm in the diaphragm or stomach irritation”.
Although the exact cause is still debated, the current consensus is that stitches result from irritation to the parietal peritoneum—the membrane that lines your abdominal cavity.
Whatever the underlying cause, one thing is for certain: no one wants a stitch to derail their run.
That’s why I asked Becker to explain what might trigger a stitch and offer some guidance on what to do when one strikes.
From eating too close to your workout to irregular breathing patterns, here are all the common missteps you could be making.
Five things that may cause a stitch
1. Eating right before a run
Whether you’re embarking on a 20-mile trail run or an easy three-mile route around the block, fueling mistakes could bring on a stitch. To avoid one, Becker says that you should never eat right before a run.
“Always allow 30 minutes to two hours depending on the intensity of your run and your experience,” she says, adding that high-fat and high-fiber foods should be avoided in particular because they take longer to digest.
The same applies to hydration. While drinking enough water before you head out could help reduce your risk of getting a stitch, Becker advises against drinking large amounts too quickly, especially during a run, because overloading your stomach can increase your chances of getting a stitch.
2. Breathing irregularly or shallowly
For new runners, erratic breathing can cause a multitude of issues, but the dreaded side stitch is the most common.
An uneven breathing pattern may disrupt the normal function of your diaphragm, so Becker urges you to focus on controlled breathing.
“Consider walking and building up to a run to keep your breathing even,” she says.
The same goes for shallow breaths, which leave your diaphragm in a high, tense position. For this, Becker says you should focus on deep belly breathing, which activates deep core muscles.
Also known as diaphragmatic breathing, this is the practice of drawing air deep into the lungs by contracting your diaphragm rather than expanding your chest.
3. Improper running form
Few of us will achieve perfect running form and that’s OK. Unless the way you run is causing injury, it’s often wise to let your form naturally improve as you run more.
But Becker identifies some elements that may cause a stitch. “Sluggish posture and an improper foot strike can all bring on a stitch,” says Becker.
Slouching, for example, can constrict your chest and interrupt your breathing, while fatiguing your core can overwork the diaphragm, consequently causing a stitch.
An inefficient foot strike or excessive twisting through the torso can also create jarring forces that contribute to the problem.
4. Starting out too quickly
To keep stitches at bay, avoid the temptation to set off too quickly at the start of your run. By pushing your pace too early, you risk an irregular breathing pattern and bad form, both of which can bring on that cramping sensation.
“Always start runs conservatively instead,” says Becker. “Don’t go out too hard, and ease into your run gently to regulate your breathing rhythm, and focus on your mechanics.”
5. Skipping a warm-up
Warming up before a run is essential for priming your muscles and avoiding strain or injury. It can also help to prevent a stitch during your workout.
By gradually increasing your heart rate and stimulating blood flow to the core, you avoid a sudden onset of physical stress on the diaphragm.
“A dynamic warm-up is key,” says Becker. She suggests working on all planes of motion, including movements like overhead side bends, trunk twists, side steps and high knees.
How to get rid of a stitch
If a stitch does strike, don’t try to run through the pain as this can make it worse.
“Stop running or slow down to a walk,” suggests Becker. “Lean to the other side of where your stitch is to try to stretch your core and lengthen the diaphragm.
“You can also try putting your arms overhead in an upright posture, exhaling forcefully when your opposite foot strikes the ground, and pressing fingers into the cramp and massaging the area.”
