What is it?
A stitch, side-stitch, side-cramp, sticker… Whatever you call them, that intense pain under your rib cage that seems to come out of nowhere while you’re exercising is an absolute pain! It’s “official” scientific name is Exercise-related transient abdominal pain (ETAP)🤔. They usually occur during lengthened, repetitive cardiovascular activity such as running or swimming.
What causes it?
The exact cause of the stitch is unknown, but it is thought to be due to movement of blood, mainly the reduction of blood flow to the diaphragm.
Potential causes are:
- Eating a large meal close to exercising – you’ve been told not to go swimming straight after eating right? – this is the reason – a stitch while running is uncomfortable, however a stitch while swimming can be dangerous
- Poor digestion of liquids, particularly sugary ones may cause the gut to pull on the ligaments connecting it to the diaphragm causing it to cramp up and “stitch”
- Poor posture – a 2010 study suggests that people with a postural abnormality, specifically in the thoracic region – that runs from the base of the neck to the abdomen – people with hunched shoulders may suffer from more frequent and more severe stitches
- Frantic breathing, which in turn can cause diaphragmatic spasms, may increase the likelihood of stitches
Stitches are more apparent in those that are less experienced with exercise however, they can affect ANYONE that exercises over a prolonged period of time!
What do I do when I have it?
Stitches will go away on their own but leaving them to run their course is often difficult and uncomfortable, if you experience a stitch, you could try the following:
- Slow down or stop completely to try and get your breathing back on track
- Breathe deeply and slowly
- Try an exaggerated exhale – this almost shocks the diaphragm into relaxing and could help reduce the pain (breathe in deeply and then sharply exhale to empty your breath)
- Try stretching – reach your hands overhead and reach over to each side – remember to keep breathing!
- Apply light pressure to the area of the stitch and lean into it slightly
- Stay hydrated while exercising, but avoid sugary sports drinks if they irritate your stomach
Can I prevent it?
As the exact cause of stitches is unknown, it’s difficult to say whether they can be entirely prevented, however there are things that can be done to minimise the chances of suffering from them:
- Warm-up thoroughly – not only does this prepare your muscles for exercise, but it also acts as preparation for your breathing
- Stay adequately hydrated – maintaining hydration levels may assist with reducing the occurrence of stitches, small regular sips of plain water are the best bet
- Focus on your breathing – slow, steady controlled breathing helps keep any stitch pain under control
**** If you still feel pain from a stitch after a few hours, even once you’ve stopped exercising – seek medical help. If you notice any swelling or suffer from any other sharp pains throughout your body, stop exercising and seek medical help ****