We’ve all felt a side stitch at least once during a run or a race. Where does it come from? How can you prevent it, and how do you get rid of it when it hits mid-run? Here are a few practical tips.
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How does a side stitch happen?
A side stitch can show up in several situations. It’s common for beginners, when you return to training after a break (short or long), or when your fueling and digestion aren’t on point. For example, it happens to me pretty regularly when I start running again after my yearly 2 to 3 week break. It can also pop up on downhill sections in trail running (you still need to breathe well on the descents).
A side stitch is a more or less intense pain in the abdomen caused by the diaphragm, your main breathing muscle, getting “stuck”. It’s most often linked to increased blood flow, for example too much blood going to the liver or spleen.
A side stitch is usually felt in three areas:
– Under the lower ribs, on the right or left side
– Near the collarbones or shoulder area
– Around the stomach
How to make a side stitch go away
To get rid of it, you need to address the source of the pain that’s disrupting blood flow around the diaphragm. Press on the organ with your fingers and the heel of your hand, while increasing your breathing rate. If it’s on the right side, press on the liver area. If it’s on the left side, press on the spleen area.
Back off the pace a little. It’s better to let the pain fade so you can get back to your target pace quickly. If the pain is too intense, don’t hesitate to stop. Focus on fully exhaling. Relax. Ideally, switch to belly breathing to calm your diaphragm, let your stomach expand as you inhale, then draw it in as you exhale.
Some runners also swear by holding a small stone in their hand, or squeezing their thumbs.
How to prevent a side stitch
Give your body time to digest. Ideally, eat about 3 hours before you go running. If you want to sleep in on the weekend, keep it light, avoid lactose-containing milk, industrial orange juice (very acidic), and hard-to-digest foods. Smart pre-run nutrition is a big part of endurance performance.
Start easy and build your pace gradually. Before your warm-up or before the session starts, you can also do some arm swings to open up the ribcage and help your breathing mechanics.
And when you’re a beginner, it’s recommended to follow an adapted training plan, sometimes alternating running and walking. With consistent endurance training, your cardiovascular system becomes more efficient, your breathing improves, and side stitches become much less frequent.
Watch out for other pain
Don’t confuse a side stitch with unusual discomfort or chest pain (higher than the typical side stitch). If you’re unsure, get medical advice.
If you’re into trail running, I recommend the humorous trail magazine Point de côté.
For beginners who really want to start running, you can download the RunMotion Coach app. You’ll be guided toward your wellness or performance goals, with personalized running advice.