Stitches are a right pain! I haven’t had one for ages and the other day, out of the blue, bang! A horrible, crampy pain in my right upper abdomen that I couldn’t ignore. I had to stop running. It reminded me that I used to be plagued by stitches, pretty much every time I ran. They would make running really unpleasant and put me off going in the first place. It’s now rare for me to get a stitch so I thought it would be useful to revisit this common and annoying topic.
What are stitches and why do we get them? What can we do to prevent stitches? And, importantly, are there things we can try to get rid of a stitch when we’re struck by one mid-run?
What is a stitch?
If you’re a runner you’ve probably had a stitch and know exactly how it feels. You can experience:
- A dull, sharp or crampy pain or ache.
- A pain across your upper abdomen, below your rib cage, usually to one side.
- A pain that’s worse when your foot hits the ground.
- A pain that makes it uncomfortable to breathe.
- The feeling that you just have to stop running to get relief.
The medical term is ‘exercise-related transient abdominal pain’ or ETAP for short. And that’s exactly what it is – a pain in your abdomen that’s triggered by exercise and doesn’t last long.
Stitches are harmless, annoying yes, but despite the feeling that something must be seriously wrong inside, they go away and don’t cause any lasting damage.
What causes stitches?
There are lots of theories about what actually causes a stitch. The truth is that we don’t really know and it’s most likely a combination of things and different for each individual.
The theories include:
- Internal organs tugging on the ligaments and tissues inside us as they get jolted around when we run.
- Friction irritating the lining of the abdominal cavity.
- Reduced blood supply to the gut when running.
- A lack of blood supply to the diaphragm muscle which separates our chest and abdomen.
- Pain radiating around from the spine.
Stitches are more common in runners than cyclists which adds weight to the argument that it could be jolting and friction causing a stitch. They’re also more common in people who have eaten close to running or who have worked at a higher intensity than normal. In both these situations we could blame a reduced blood supply. Blood is busy elsewhere taking oxygen to the skeletal muscles so there’s less for the gut and diaphragm.
Stitches are also much more common in beginner runners. It’s worth considering what changes happen as we become a more experienced runner, that might explain why stitches reduce. We certainly learn lessons about fuelling before we run but perhaps our body, in particular our gut, gets more used to the action of running.
How can I stop getting a stitch?
Preventing a stitch isn’t always possible. It’s hard to hands down stop something when you don’t know what the underlying cause is. There are however plenty of things you can try to reduce the likelihood of getting a stitch:
- Allow enough time for your food to digest before you run. You may need two or even three hours after a meal.
- Look out for trigger foods. Have you eaten something that’s harder to digest? Fatty and high fibre foods before a run can trigger stitches.
- Don’t drink a large quantity of fluid just before you run. Smaller sips over a longer period are better.
- Avoid high sugar drinks just before running. Fruit juices and sweet energy drinks could be to blame for your stitch.
- Warm up well. Getting your body gradually used to exercise and easing into a run can help to reduce stitches.
- Breathe well. Keep your breathing calm and relaxed. Breathe right into your diaphragm and not just into your upper chest. Find a comfortable rhythm with your running pace.
- Improve your posture. A good strong core will help you to remain upright and running tall over long distances. This allows plenty of room for your lungs to expand and breathing to be maximised.
- Persevere. Beginners are much more troubled by stitches. Over time you will find they reduce so try not to let them put you off!
How can I get rid of a stitch?
It’s so annoying when you’re in full running flow and suddenly struck down with a stitch. They can be mild but they can be so severe that you just can’t carry on. If you get a stitch when you’re running there are a few things you can try. None of these are based in scientific evidence, just anecdotal experiences:
- Run through it. This is hard but possible. It won’t do any harm. The stitch will eventually pass.
- Slow down. Cutting back on your exertion level can ease the pain. Drop to a walk if you need to.
- Deep breathing. Focus on taking full breaths and counting to keep them regular. Try to fill your entire lungs and breathe into your diaphragm.
- Apply pressure. Sometimes putting your hand firmly on the area where the pain is can help. This could be because it reduces movement and friction inside.
- Stretch. Try stretching the affected side. If your pain is on the right side, put your right hand on your head and bend your upper body over to the left. You can do this while running or stop to have a deeper stretch.
- Touch your toes. This often works for me. Stop briefly and bend over and touch your toes. Take a few deep breaths and stand back up again.
- Time your foot strike. Some runners swear by the technique of timing their foot strike with breathing out. If your stitch is on the right, exhale as your left foot strikes the ground and vice versa.
I try a variety of these things. To be honest, usually by the time I’ve gone through them the stitch has gone away so I don’t know whether it was the intervention or just the passage of time that has eased the stitch!
As I say, time and time again (sorry!), learning about and getting to know your body is key to getting the most out of it. You can enjoy and succeed with your running so much more if you understand what is going on inside.
I would love to hear your experience of stitches. Do you get them a lot? What triggers them? Do you have other tips that help get rid of them? Has a stitch hit you at a really bad moment or perhaps stopping because of a stitch led you to meet a really nice person?! Do share in the comments or on my social media.
There are other tips like these, including how to breathe into your diaphragm and plenty more about gut problems when running, in my new book Run Well: Essential health questions and answers for runners. Published by Bloomsbury and available to buy now.