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12 Days of Fitness 2015: Day 4 – Side Stitches: Causes and Treatments

December 12, 2015 1 Comment

(This is Part 4 of a 12 part series to provide you with some helpful blurbs and tips to keep your fitness in focus over the holiday season)

SideStitchThere are some pains you can easily identify like a sore butt from a squat workout or a burning sensation from a strained muscle. But some irritants are not always easily traced back to a cause and none can be more annoying than the vaunted side stitch. If you’ve ever run or played a sport, chances are you’ve had the experience of at least once with a side stitch – that crampy, tight feeling in the about mid/lateral abdomen area that either slows down or halts your activity. For years there were myths about what they are and what you can do about them. I’m here now to provide some insight.

Possible Causes

Although they typically occur most in runners, a side stitch is non-life threatening nuisance that occurs in the midst of sustained physical activity. They classically manifest themselves as an aching, stabbing, or sharp pain in the abdomen, just below the ribs and are usually localized to one side. Traditionally, it was thought that side stitches were the result of eating or drinking too close to a physical activity. This gave merit to the theory of diaphragmatic ischemia (a decrease in blood flow to the diaphragm muscle that allows you to breathe) since increased blood flow to the stomach to help digest/process food and liquid would restrict blood flow to the diaphragm. Research has proved that to not be the case. Another possible explanation is the irritation or “tugging” of the ligaments that support the muscles and structures in that area of the torso. The theory says that impact during activity pulls the organs in the abdomen downwards, tugging on the ligaments in the upper abdomen and eventually creating irritation.  This could also  explain why consuming a meal (regardless of its contents) too soon before an activity can bring on a side stitch, and it explains why side stitches are common in running but are rare in cycling.  Unfortunately, there is little research to support that theory. A final theory to side stitches is that they are the result of irritation of the spinal column; a direct result of poor posture. A few studies have looked at the effects of kyphosis or “round back” on certain participants and saw that those that had a more pronounced curve in their spine then others were more likely to not only endure more side stitches, but the pain often times radiated to the shoulder on the same side as the side stitch. However, not all people with poor posture endure side stitches so again we are left with a poorly supported theory.

Prevention and Treatments

Unfortunately, the cause (or causes) of side stitches have yet to be completely determined. Like many things in fitness, the roots of side stitches are likely more complex than one single factor.  On the bright side, we can glean some useful information from the science available. If you have a history of side stitches, take note of what you eat and drink before you start your workout. Giving yourself more time after eating might stave off a side stitch. Stretching the muscles of the abdomen/torso, deep breathing, and contracting the abdominal muscles while bending forward can all help alleviate a side stitch. If you have chronic side stitches, it may be worth having a doctor or physical therapist examine your spine to see if dysfunction there could be exacerbating your side stitches. As more research on side stitches is done, we should move closer to fully understanding how the diaphragm, the ligaments and membranes of the abdomen, and the spinal column all affect side stitches. Until then, you’ll have to experiment with some of the techniques listed above to help you get over your side stitches.


See you tomorrow for Day 5 of the 12 Days of Fitness


Til next time, train smart, eat well, and be better.

Day 1 – Chew Your Food
Day 2 – Fitness for the Road
Day 3 – The Many Names of Sugar


About the Author:

Jeff Harrison is a fitness coach based in Pottstown, PA. He received a BS in Exercise and Sport Science from Penn State University and is an NSCA Certified Strength and Conditioning Specialist (CSCS), NSCA Certified Personal Trainer (NSCA-CPT) and ACE Advanced Health and Fitness Specialist (ACE-AHFS). Jeff's articles have been published in peer-reviewed journals as well as consumer oriented websites and magazines.

Comments (1)

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  1. Chuck E. says:

    A good one, Jeff.

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