Dealing with stitches

[ChrisJG]

I've recently taken up running again, both treadmill and outdoor, after a long break due to recurring shinsplints (which have thankfully been solved using shoe inserts).

An element of running that I had totally forgotten about are stitches. I usually get them in my stomach/oblique area. I was wondering how other people dealt with them when they happen? I was advised a long time ago that you should regulate your breathing and also that holding your hands behind your head can help (both whilst still running). Certainly, both of these things seem to help and the stitches usually dissipate within 5 minutes or so. Can anyone offer any other useful advice?

I was also wondering exactly what stitches are if anybody knows.

 

[Wrangell]

I've recently taken up running again, both treadmill and outdoor, after a long break due to recurring shinsplints (which have thankfully been solved using shoe inserts).

An element of running that I had totally forgotten about are stitches. I usually get them in my stomach/oblique area. I was wondering how other people dealt with them when they happen? I was advised a long time ago that you should regulate your breathing and also that holding your hands behind your head can help (both whilst still running). Certainly, both of these things seem to help and the stitches usually dissipate within 5 minutes or so. Can anyone offer any other useful advice?

I think you're right - controlled breathing seems to help a lot. In most cases, simply slowing down or just walking it off while doing some deep ' belly ' breathing often works. And, it it gets too discomforting , then you can stop. Then, try bending over and raising your knee ( on the same side as the stitch ) while at the same time pushing on the area that hurts.

I was also wondering exactly what stitches are if anybody knows.

I've heard this cramp or " the stitch " also called ' exercise-related transient abdominal pain ' - or ETAP for short.

And for some reason ( at least based on what I've read ) it seems to occur on the right side more often then on the left side - I don't know why the right side is more susceptible. There a a couple of theories that have tried to explain why ETAP occurs but there is no one clear cut explanation as to why ETAP occurs - at least as far as I know.

That said, the reason I most often see for ETAP is improper hydration. So, some form of dehydration may be part of the explanation. I've also heard that if you eat a meal too soon prior to running / exercise, it may also bump the likelihood of ETAP.

 

[RedT]

Up until recently there was no clear explanation for the cause of this annoying cramp, also called exercise related transient abdominal pain (ETAP). Now researchers believe that the side stitch is caused by stretching the ligaments that extend from the diaphragm to the internal organs, particularly the liver. The jarring motion of running while breathing in and out stretches these ligaments. Runners tend to exhale every two or four steps. Most people exhale as the left foot hits the ground, but some people exhale when the right foot hits the ground. It is the later group who seem more prone to get side stitches.

Exhaling when the right foot hits the ground causes greater forces on the liver (which is on the right side just below the rib cage). So just as the liver is dropping down the diaphragm raises for the exhalation. It is believed this repeated stretching leads to spasms in the diaphragm.
Stopping a Side Stitch
To stop a side stitch when running, stop running and place your hand into the right side of your belly and push up, lifting the liver slightly. Inhale and exhale evenly as you push up.

Preventing a Side Stitch
To prevent a side stitch, take even, deep breaths while running. Shallow breathing tends to increase the risk of cramping because the diaphragm is always slightly raised and never lowers far enough to allow the ligaments to relax. When this happens the diaphragm becomes stressed and a spasm or "stitch" is more likely.

Some other ways to alleviate the pain of a side stitch include:


-Time your eating. Having food in your stomach during a workout may increase cramping by creating more force on the ligaments (avoid eating one to two hours before a workout)
-Stretching may prevent or relieve a cramp. Raise your right arm straight up and lean toward the left. Hold for 30 seconds, release, then stretch the other side.
-Slow down your pace until pain lessens.
-Breathe deep to stretch the diaphragm.
-Drink before exercise; dehydration can increase muscle cramps.
-Massage or press on the area with pain. Bend forward to stretch the diaphragm and ease the pain.
* If you continue to experience pain, see your doctor.

Source: Morton DP, Callister R. Factors influencing exercise-related transient abdominal pain. Medicine and Science in Sports and Exercise. 2002 May.