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Side Stitches
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JumpUSA.com Topic #465
 
Side Stitches: What they are and How to Cure and Prevent them  

Most of us experience them at one time or another. That sharp twinge of pain just below the rib cage usually on the right. It is particularly common in runners and has been known to slow some down to a walk until the pain subsides.

Up until recently there was no clear explanation for the cause of this annoying cramp. Now researchers believe that the side stitch is caused by stretching the ligaments that extend from the diaphragm to the internal organs, particularly the liver. The jarring motion of running while breathing in and out stretches these ligaments. Runners tend to exhale every two or four steps. Most people exhale as the left foot hits the ground, but some people exhale when the right foot hits the ground. It is the later group who seem more prone to get side stitches.

Exhaling when the right foot hits the ground causes greater forces on the liver (which is on the right side just below the rib cage).

So just as the liver is dropping down the diaphragm raises for the exhalation. It is believed this repeated stretching leads to spasms in the diaphragm.


Stopping a Side Stitch

To stop a side stitch when running, stop running and place your hand into the right side of your belly and push up, lifting the liver slightly. Inhale and exhale evenly as you push up.


Preventing a Side Stitch

To prevent a side stitch, take even, deep breaths while running. Shallow breathing tends to increase the risk of cramping because the diaphragm is always slightly raised and never lowers far enough to allow the ligaments to relax. When this happens the diaphragm becomes stressed and a spasm or "stitch" is more likely.


Some other ways to alleviate the pain of a side stitch include:

Time your eating. Having food in your stomach during a workout may contribute to cramping by creating more force on the ligaments. Try to avoid eating one to two hours before a workout.

Stretch more. Stretching is a good additional way to prevent or relieve a cramp. To target this often overlooked muscle, raise your right arm straight up and bend your trunk toward the left. Hold for 30 seconds, release, then stretch the other side.

Ease up. Sometimes it's as simple as decreasing your intensity until the pain subsides. Try lowering your arms and slowing your pace the next time the pain hits.

Breathe deeply. This helps to stretch the diaphragm. Some people also find exhaling forcefully when the opposite foot strikes the floor to be helpful. For instance, if the pain is in your left side, exhale forcefully every time you land on your right foot.

Drink more fluids before exercise. Dehydration can cause muscle cramps.
Rub it away. Massage or press on the area where you feel pain. You may also want to bend forward slightly. This seems to stretch the diaphragm and ease the pain.

* If you continue to experience pain, see your doctor.

Quinn, sportsmedicine.about.com

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