How To Get Rid Of A Side Stitch

If you’ve ever been in the middle of a workout and felt a sudden, sharp, stabbing pain just below your chest, you’ll know how painful – and debilitating – a side stitch can be.

But what exactly is a stitch, and how can you avoid it?

What is a side stitch?

A side stitch, also known as exercise-related transient abdominal pain (ETAP), is a cramp in the diaphragm – the large muscle that separates the lungs from the abdomen.

It is especially common in activities that involve repetitive torso movement, such as running, swimming and horse riding. 

What can trigger a stitch?

According to a 2006 report published in the American College of Sports Medicine, the exact cause of a side stitch is still inconclusive, however, research suggests there could be three main explanations for a side stitch. 

The most popular explanation is “diaphragmatic ischemia and spasm [which is a] localized, lateral and mostly sharp” pain that is typically felt with intense exercise, but may lessen as an athlete gets fitter. However, because some athletes who participate in sports that require less respiratory demand may also suffer from ETAP (like horseback riders), there is also evidence that contradicts this view.

Second, could be due to stress placed on the peritoneal ligaments (the ligaments in your stomach) when you move during jolting activities like horse riding. However, there is evidence against this theory as ETAP occurs during other activities like swimming, where there is no vertical jolting.

As discussed in a 2015 Sports Medicine study on ETAP by Darren Morton and Robin Callister from the University of Newcastle, Australia, a third explanation could be “irritation of the parietal peritoneum”, also known as exertional peritonitis. The parietal peritoneum lines the abdominal wall and diaphragm to support your organs. 

Morton and Callister suggest that irritation may be a result of “increased friction between the parietal peritoneum attached to the abdominal wall and the visceral peritoneum that overlays the abdominal viscera.” This could be caused by exercising soon after a meal or a decrease in the lubricating serous fluid contained in the peritoneal cavity. This fluid protects your organs and may decrease during exercise.

Should you keep exercising with a side stitch?

If you feel a side stitch coming on while exercising, the good news is you don’t have to stop moving – in fact, stitches are harmless (albeit painful), and there are ways to stop the cramps from getting worse.

How to prevent and treat a side stitch

Here are a few ideas for avoiding – and treating – the dreaded side stitch.

Slow down

If you’re running, swimming or hiking and you get a side stitch, slow down and wait until the pain subsides before picking up your speed again. 

Change your breathing pattern

Once you’ve slowed down, focus on your breathing. If you get a stitch on your left side, exhale as your right foot hits the ground and do the opposite if you get a stitch on your right side.

Stretch it out

Stretch your abdominal muscles by reaching one hand overhead and bend gently towards the side you feel the stitch.

Don't run too soon after eating

Always wait at least two hours after eating before exercising. Your stomach may become irritated during exercise when it is full.

Sip water during exercise

Dehydration can cause a stitch – and so can drinking too much — so sip drinks (instead of gulping them down) before heading out on your run.

Strengthen your core

A 2014 study of 50 runners published in The Journal of Science and Medicine in Sport found that having a stronger core could reduce how often you get stitches.

When you run, jump or skip, your internal organs bounce up and down which pulls on the diaphragm muscles. Strengthening and engaging your core muscles can help strengthen weak diaphragm muscles, which makes them more resilient to fatigue and less likely to cramp. 

Improve your posture

Studies suggest individuals with poor postural alignment are more predisposed to stitches. Simple core, glute and back exercises can help improve your posture and correct a slouching posture – try bridges, back extensions and planks.

Manage side stitches and get back on track with your workouts

Most athletes, especially runners, will experience a side stitch from time to time, so don’t worry – it’s very common. 

A side stitch should go away within a few minutes after you slow down, stretch or stop exercising. If you find you’re getting them all the time, try to avoid eating anything too heavy before exercising or drinking too much liquid. Other tactics include practising good posture, decreasing the length of your workout if necessary, and gradually increasing your mileage. 

If you’re experiencing pain in your side or abdomen that’s not related to exercising, get in touch with your health care professional.