12 Tips To Avoid A Side Stitch When Running

exhausted woman with side stitches

Whether it’s 10k, a half-marathon, or a full marathon, we try our best to be fully prepared for our runs. We plan in recovery phases and tapering , we swear by carboloading, and are careful to eat an easily digestible runners’ breakfast. We are prepared for heat, pouring rain, and wind with the right equipment. Basically, nothing could go wrong… right?

And then we get a side stitch…

Oh no, did I start off too fast? Did I breathe irregularly? Was my breakfast too heavy? And, while the unpleasant stabbing sensation slows you down, you wonder if it ever will go away.

You’ll find answers to the most common questions in this article on side stitches:

Running group

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 – develops 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 makes a lot of sense.

The diaphragm…

… plays a crucial role in 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 drop out of a race in the middle because of it.

Woman running

How to prevent a side stitch

  1. Breakfast: Eat a light 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.
  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. Control your breathing: The faster you run, the more oxygen your body needs. Irregular and shallow breathing can provoke a side stitch. Like an efficient stride, your breathing rhythm is key.
  7. Strong abs: Well-trained oblique muscles have been shown to prevent a side stitch. Five to ten minutes of daily abs training can pay off.

Are you well prepared but still get 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 relaxes your muscles. A deep breath in the abdomen (belly breathing) is especially helpful.
  2. Apply pressure: Press your hand on the painful area and release the pressure while breathing out. Conscious, deep breathing helps when trying this strategy.
  3. Shift down a gear: Slow down or take a walking break.
  4. Stop for a moment and stretch: Small stretching exercises can help relieve the tension. Just lean your upper body to the side and stretch a little farther 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 let your arms dangle.

Hopefully one of these strategies will help you enjoy your next run without any side stitches or relieve the pain faster so you can continue “stitch-free”.

Good news: running is the best way to prevent a side stitch. The higher your endurance, the less often a side stitch will occur. This is because while running, you train your diaphragm and your respiratory muscles!

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