Ever been in the middle of a great run and suddenly you’re hit by an annoying, bend-you-over, come-and-go pain in the side? Yep… You’re a victim of the side stitch.
We’ve all been there! (if you’re a regular runner and have never suffered this irritating pain, please let us know your secret!).
While it’s not usually dangerous, it can be painful and annoying enough to ruin a run that was going pretty well.
Here’s our advice on how to get rid of a side stitch that won’t go away while you’re out on a run!
What Is a Side Stitch?
The scientific name for a side stitch is exercise-related transient abdominal pain (also called ETAP!). That explains it pretty well, actually.
Exercise-related: Have you ever got a side stitch while you’ve been sitting around doing nothing? Nope… It’s brought on by exercise.
Transient: This means that it doesn’t last long. It hangs around for a little bit, but it passes through and disappears fairly quickly.
Abdominal: This is quite self-explanatory! ETAP pain occurs in the side of the abdomen, although interestingly, it’s more common on the right-hand side.
You’ll know a side stitch when you get one! Firstly, the location is usually a giveaway. It can pop up on either side, but it’s more common on the right.
You may feel a sharp, sudden cramp. It usually eases into a dull ache, sometimes within a few seconds or it may take a couple of minutes.
It’s often also accompanied by a pulling feeling in the side, that makes you want to double over!
What Causes Muscle Cramps and Side Aches When Running?
It’s hard to really nail down what causes a side stitch. There are studies and theories and suggestions, but no real scientific evidence pointing to one thing in particular.
Some theories say that a muscle spasm in your diaphragm causes this pain in the side. Closely linked to this is the idea that weak abdominal muscles make you more prone to side stitches, as your core is extremely important for stabilizing you as you run.
Other things that are thought to be potential causes of side stitches include abdominal inflammation or irritation (made worse during exercise), low electrolyte levels, shallow breathing (which can trigger a diaphragmatic spasm), poor posture when running (adds stress on the spine), and not warming up before exercise.
However, all of these have one big problem. Unless you’re particularly prone to getting a side stitch every time you run, it usually happens intermittently.
You can do 20 runs without warming up first, and you may only get a side stitch twice. Or, you can have poor running form and posture but only get a stitch here and there.
It’s not usually something that happens to a runner often, which makes it even more difficult to pin down the cause!
Who Is More Prone to Get Side Aches?
A side stitch can catch anyone at any time. Sometimes, it’s actually not even associated with exercise! You can lift something a little heavier than normal, or walk from the bed to the kitchen too quickly and get a side stitch.
When it comes to athletics, though, younger and less experienced athletes are more prone to it than older, more experienced athletes. It’s more common in runners and swimmers than other types of athletes, interestingly.
That being said, it doesn’t mean that if you’re a young swimmer or runner you should be expecting a stitch to side-swipe you at any minute when you’re exercising. Similarly, it doesn’t mean that it won’t affect you if you’re older and more experienced.
Risk Factors Associated With Etap
While ETAP or side stitches really can pop up at any time in any person, there are some risk factors that are more closely associated with experiencing it.
Younger runners seem to be more susceptible to side stitches than older ones. However, older athletes who do experience ETAP report feeling less severe pain than younger runners.
It’s hard to pinpoint what this truly means, though. Does the body get used to it as you age and experience it more often? Do more experienced runners simply have a higher pain threshold than newbies?
If this is the case, it’s possible that older runners simply don’t report side stitches as often, because they just don’t feel them nearly as severely. They may still get them often, but because they’re less painful, they don’t really notice them as much.
Eating and Drinking Before a Run
Eating or drinking before a run can increase your chances of developing a side stitch during your run.
When you have a nice pre-run meal, your body doesn’t wait until you’re back home and relaxing before it begins the digestion process!
Your digestive system is going to start up while you’re running. This could cause some tummy upset, but even if you don’t feel pain, it could contribute to bloating or inflammation in the stomach, which may lead to a side stitch.
The solution? Either eat a lighter, more easily digestible meal before you run, or don’t eat or drink at all.
Low Fitness Level
If your abdominal muscles are weak (which is common in those with lower fitness levels), it may lead to a side stitch during exercise.
As you run, the abs may become fatigued. Although you don’t necessarily feel them engaging as you run, they’re extremely active during running, keeping you stable and upright as you move.
The solution to this is to strengthen your abs, although it’s a long-term thing, not just something you can do quickly. Add abdominal exercises to your cross-training and see if your side stitches go away.
High-intensity exercise can be super beneficial for a variety of reasons. But if you leap into it too quickly, or start without warming up, a side stitch could pop up during your exercise session.
Take note that this could happen to experienced or inexperienced athletes, no matter how good or bad your fitness level may be.
Not Warming Up
Warming up isn’t just to ease your brain into the fact that it’s doing exercise! When you warm-up, you’re getting oxygen-rich blood flowing through your body, giving your cells and muscles the power to work.
If side stitches are caused by weak abdominal muscles, they can just as easily be caused by non-warmed-up muscles.
Make sure you get your blood flowing nicely and easily before getting into the hard bits of your workout and you may see your side stitches decrease!
Running in Cold Weather
Breathing cold air can cause the diaphragm to tighten up and in some cases, lead to a spasm.
This could be the cause of a side stitch, so we recommend wearing a face mask when you run in the cold to try and reduce the chance of it happening.
How to Get Rid of a Side Stitch
So what do you do when you feel that familiar achy pain coming on during a run? Here are some tips on how to get rid of a side stitch that won’t go away on its own.
Strangely, applying pressure to the painful side could help to ease the pain until it disappears. Don’t hurt yourself in the process, though!
Just push on the area with your fingers and you should notice the pain easing up after a shorter while than it may usually.
Your breathing pattern can contribute to your diaphragm going into spasm. This is why breathing shallowly may bring a side stitch into existence!
Try to control your breathing to control the pain of the stitch. Take a deep breath, quickly, which will force your diaphragm into a lowered or flattened position.
Hold this breath in for a few seconds. Then, exhale forcibly, pursing your lips instead of opening your mouth fully.
This can help to sort of “reset” your diaphragm, helping it to get out of a spasm and reducing the chances of it happening again.
Change Striding Pattern
If you don’t want to stop running while you wait for your side stitch to disappear, try to change up your stride pattern.
Do you usually inhale when your right foot lands and exhale when your left foot lands? Try to switch this around so you’re inhaling on the left foot landing and exhaling when your right foot lands.
Firstly, concentrating on this could actually take your mind off the side stitch completely! And secondly, it may jolt your diaphragm out of any potential spasms and ease the pain.
Stretching can help to get rid of a side stitch that won’t go away. Stop and raise the arm on the affected side over your head. Lean over towards the unaffected side, stretching the affected side out.
This helps to ease stiffness and tightness in the side that’s painful. If it’s a muscular issue, this should go a long way towards helping reduce the pain.
If nothing else works or you’re at the point in your run where you’re actually too tired to do anything to try and alleviate the pain, you can simply slow down and wait it out.
They really don’t usually last very long, so you shouldn’t have to wait very long!
How to Prevent a Side Stitch?
None of us would choose to get a side stitch if we could help it! Here are some ways to prevent it from happening while you’re running.
Watch What You Eat
We’ve already discussed being more careful about eating and drinking before running. Ideally, you should avoid eating for an hour or two before your run, which will give your stomach enough time to get its digestion work done before you get out on the road.
But it’s also very important to be careful about what you eat. Nutrient-dense, healthy foods are always first prize. Keep in mind the 80/20 rule, though – you can eat 20% of those “cheat foods” if you stick to 80% healthy, whole foods.
However, try not to consume sugary, high-fat, or high-fiber foods before you go for a run. High levels of fat and fiber can cause gastric discomfort, and sugar can increase inflammation in the body.
As for water, try to increase your intake throughout the day. That way, you’re getting more than enough water without having to drink right before you go out for a run.
Be Mindful When Running
Being mindful can make a huge difference. This doesn’t mean that you need to meditate before your running session (although it could be beneficial too!).
It just means you need to be careful and considerate about what exactly you’re doing throughout the process of your running.
Warm-up properly and thoughtfully. Stretch and feel the stretch in your muscles. Take your time and don’t rush through it, although it’s always tempting to leap right into your workout!
When you do get out on the road or trail, pace yourself. If you aren’t training for a specific goal, keep it easy or slightly challenging; don’t go all out.
And remember to breathe properly. In fact, paying attention to your breathing could be the one thing that makes the biggest change both to your side stitches and to your performance!
Plan Ahead When Training
Take actions now that will benefit you in the future. Increase your mileage slowly (by 10% every week) and work on strengthening your core muscles. Also, tweaking your nutrition and getting into better eating habits will benefit you in the long run.
How Long Do Side Stitches Last?
The good news is that a side stitch isn’t usually dangerous and will disappear after a few minutes when you ease up on the exercise.
If your side stitch hangs around for an hour or more or doesn’t ease when you stop exercising, it’s probably a good idea to get it checked out by your doctor!