12 Tips To Avoid A Side Stitch When Running

Woman holding a hand on the side of her stomach

No matter if it’s a 10k, a half or full marathon, we try our best to be fully prepared for our runs. We plan in regeneration phases and tapering, we swear on carboloading, including a pasta party, and indulge in an easily digestible runners breakfast. Also, regarding equipment, we are prepared for heat, pouring rain and wind. Basically, nothing could go wrong… right?

…and then it happens, at kilometer 8 the nasty side stitch appears. “Oh no, did I start off too fast? Did I breathe irregularly? Was my breakfast too heavy?…” – such thoughts creep into your mind. And, while the unpleasant pulling continually slows you down, you wonder if it ever will go away.

We have some great insights on how you can prepare (as best as possible) for the dreaded side stitch. In addition, we have tips on how to relieve the pulling in the side should it occur unexpectedly.

Young man taking a break during his run.

How does a side stitch develop?

Today there are different theories on how and when the stabbing pain below the ribs – or even in the entire abdominal cavity – appears during running. The explanations range from poor blood supply in the diaphragm resulting in cramps in the abdominal muscles, to irritation of the peritoneum, the serum lining in the abdominal cavity. The theory of poor blood circulation and decreased oxygen supply to the diaphragm sounds plausible to us.

The diaphragm plays a crucial role while breathing. Through shocks while running, the internal organs move with every step, as does the diaphragm when we breathe in and out – this creates tension in the body and cramps can occur in the diaphragm.

Also, nervousness, improper breathing, posture problems, starting off too quickly, weak abdominal muscles, a full stomach or the wrong running style can provoke a side stitch.

Although a side stitch is basically harmless, it can be quite painful.  And oftentimes we are forced to quit a race in the middle due to the relentless pain.

How to prevent a side stitch

1. Breakfast

Eat a lightweight breakfast, low in fiber and fat.

2. Breakfast 2.0

Eat your breakfast 2 – 3 hours before the start. A small power snack right before the race, like a banana, is an exception.

Young woman taking a break after her run.

3. Warm up

Warming up is required. A casual running warm-up prepares not only the muscles, but also promotes optimal breathing.

4. Slow & steady

Start slowly and increase your speed. A side stitch is a signal that your body is overwhelmed.

5. The upper body is the key

A side stitch occurs more frequently in sports where the upper body is heavily involved – running, swimming or horse back riding. A well-trained core reduces rotational movements in the trunk of the body. The internal organs are actively supported and you are less prone to cramps.

By the way: a strong trunk not only improves your running efficiency, but also prevents injuries.

6. Strong abs

In a study, researchers found out that well-trained oblique muscles help prevent a side stitch. Five to ten minutes of daily abs training can pay off.

7. Control your breathing

With increased running speed, your body needs more oxygen. Irregular and shallow breathing can especially lead to a side stitch. As is an efficient stride, the breathing rhythm is also crucial.

Are you well prepared, but you have the stinging sensation of pain in the abdominal area? Then try out the following tips …

Tips for an acute side stitch

1. Breathe!

Proper breathing can contribute to relaxation of the diaphragm and respiratory muscles. Breathe in two steps and on the third step breathe out – that improves your breathing depth and the relaxation of the muscles. A deep breath in the abdomen (belly breathing) is especially helpful.

2. Use your hand

Press with your hand on the painful area and relieve the pressure while breathing out. Conscious and deep breathing assists in this exercise!

Young woman running on the street.

3. Shift down a gear

Slow down your speed or take a walking break.

4. Stop for a moment and stretch

Small stretching exercises can help to relieve the tension. Just lean your upper body to the side and stretch a little further with each exhalation.

5. Stop and bend your upper body forward

To relax the diaphragm and the abdominal cavity, you can put your arms above your head while inhaling & then lean your upper body forward while exhaling and just let your arms dangle.

Perhaps you have found a strategy for you to enjoy your next run without a side stitch or a method on how to relieve the pain faster and to continue “stitch-free”.

Good news: Running is the best way to prevent a side stitch. After all, the better your endurance, the less often a side stitch will occur. This is because while running, you train your diaphragm and your respiratory muscles! Therefore – keep on running!

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