Side Pain while Running

What are side stitches?

Many people who exercise, especially runners and persons who have just started exercising, experience intense side pain, called as side stitches. A side stitch, also known as exercise-related transient abdominal pain (ETAP), is a pain felt on either side of your abdomen. It’s more commonly reported on the right side. Symptoms may range from cramping or a dull ache to a pulling sensation or a sharp, stabbing pain.

Why do you get side pains when you start exercising?

The exact cause of a side stitch is unknown. Some studies show that a movement of blood to the diaphragm or muscles during physical activity can lead to a side stitch.

But other research shows that an irritation of the lining of the abdominal and pelvic cavity may be the cause. This irritation can occur during physical activity when there’s a lot of movement and friction in the torso.

Athletes often report shoulder tip pain along with a side stitch. This may be because when the abdominal lining is irritated, it can result in localized pain in different areas, including the tip of the shoulder. But more research is needed to pinpoint the cause for this additional pain.

Eating a large meal or drinking sugary sports drinks may also result in a side stitch. Younger athletes may be more likely to get a side stitch than experienced athletes. But side stitches can affect anyone who exercises for a prolonged period of time.

Side stitches are basically diaphragm spasms, and like other types of muscle cramps, they’re thought to occur from the strain associated with the accelerated breathing from exercise. The good news is, the better you get at exercising, the less likely you’ll be to experience debilitating side cramps.

How to treat a side stitch?

You can try the following steps to help reduce your pain and resolve the side stitch:

  • If you’re running, take a break or slow down to a walk.
  • Breathe deeply and exhale slowly.
  • Stretch your abdominal muscles by reaching one hand overhead. Try bending gently into the side where you feel the stitch.
  • Stop moving and try pressing your fingers gently into the affected area while you bend your torso slightly forward.
  • Stay hydrated while exercising, but avoid sugary sports drinks if they irritate your stomach.
  • Practicing deep “belly breathing” while running in particular can reduce the stress on the supporting ligaments of the diaphragm and can help relieve side stitches. Belly breathing simply means you’re using your stomach instead of your chest. Chest breathing is associated with shallow breathing, while belly breathing is associated with deep, productive breathing.

A side stitch will usually resolve on its own within a few minutes or after you stop exercising. But if your side stitch doesn’t go away after several hours, even after you stop exercising, you may need to seek medical care. It may be the result of a more serious underlying medical condition.

Seek emergency medical help right away if you’re experiencing sharp, stabbing pain accompanied by a fever or swelling on the side of your abdomen.

How to perform belly breathing?

Before you hit the trails with your running partner, here’s how to figure out how to belly breathe. Simply lie down on the floor and place a hand on your belly. Breathe deeply. If you feel your hand rise and fall slightly with your breathing, congrats, you’re belly breathing! If your chest is moving instead of your stomach, you’re not breathing deeply enough, and need to adjust. 

How to Prevent it?

To prevent a side stitch, avoid eating heavy meals or drinking a lot of liquids one to three hours before exercising. Also, take the following precautions:

  • Practice good posture. Athletes with a rounded spine may experience side stitches more often.
  • Avoid high-fat and high-fiber foods before exercising.
  • Decrease the length of your workout and up the intensity instead.
  • Take a break to walk
  • Stretch your body
  • Avoid sugary beverages or all beverages right before exercising.
  • Increase your level of fitness gradually.
  • Increase your mileage by a few miles a week if you’re a runner.
  • While you’re running, keep breathing deeply and every once in a while, take a very deep breath and forcefully exhale, pushing all the air out of your lungs. While you exhale, drop your shoulders, shake out your arms, and relax. Take another deep breath and continue on your run.

If you’re prone to side stitches, you may want to seek the help of a physiotherapist. They can review your technique and posture if they believe that’s what’s causing you to get side stitches.

The takeaway

Most athletes, especially runners, experience a side stitch from time to time. They’re a common occurrence in endurance events.

A side stitch should go away within a few minutes after you stop exercising. If you’re prone to them, try reducing the length of your workouts. Let your doctor know and seek medical help if you’re experiencing pain in your side or abdomen that’s not related to exercising, or if you have a side stitch that lasts for several hours. It may be the result of a more serious condition.

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