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Side Stitches

You’re running down the hill and all of a sudden the pain sensation hits you. The unmistakable twinge of pain underneath the right side of your rib cage is called a “side stitch.” If you’d like to know what is a side stitch and how to prevent it from ruining a good run, read on.

Many years ago, side stitches, or “exercise-related transient abdominal pains,” were considered a “mystery cramp.” Researchers now know that side stitches are created by a stretching of the ligaments that extend from the diaphragm to the liver and other internal organs. The stretching of these ligaments is caused by a combination of the jarring movements and running and the breathing patterns that are used during the run. However, since side stitches do not happen on every run, there is still much speculation as to what specific conditions will cause their onset.

Possible causes include:

  • Breathing Patterns: In general, runners will tend to exhale every two to four steps. People usually exhale when the left foot hits the ground. However, there are some runners who tend to exhale when the right foot hits the ground. These runners are more prone to side stitches. Why do you suppose this happens? Think about it. What internal organ is on the right side of the body? If you answered “the liver” you are correct. Some researchers believe that exhaling as the right foot hits the ground puts pressure on the liver, since the liver is dropping down as the diaphragm is rising up. Other researchers believe that side stitches are caused by breathing patterns that are either too rapid or too shallow. Slowing down your breathing may be a good preventative measure.
  • Exercising on a Full Stomach: Having a full stomach prior to running can put more stress on the ligaments, which in turn can cause cramping. Eating dairy products before running may also cause side stitches. Eat your meal one to two hours prior to your run.
  • Dehydration: Dehydration can be responsible for many types of muscle cramps. Make sure that you are well hydrated when you run.
  • Intensity: Increasing the speed and intensity of your workout too quickly can also cause side stitches. Start slowly, and then gradually increase your pace.

To ease a side stitch, you will need to stop running. Place your hand into the right side of your belly and push up. This will lift the liver. Inhale and exhale at an even rhythm as you push up.

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