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What is a side stitch and how can you avoid it in sport

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Posted by Cags R under General on 2 March 2013 at 12:00 AM

Side stitch, side cramp, side ache, exercise related transient abdominal pain - whatever you want to call it, a stitch is one of the biggest annoyances to around 60% of sports people. It's also one of the hardest sports injuries to research, predict or explain.

Side stitch when runningWhilst we are not yet 100% certain of the cause of side stitches, research from the 2010 study by Nancy Clark  'Undesired Sideliners: Side Stitches and Runner's Trots' supported the earlier research of Will Hopkins (written up in Cederborg & Freinkel's 'Give Side Stitches the Slip') connects amount of liquid and type of liquid in the stomach to the likelihood of developing a side stitch.

So, what is a side stitch?

Research suggests that a side stitch is a pain caused by tension and stress on the ligaments with join the liver to the diaphragm. This theory is supported by the consistent location of pain from a side stitch - the upper right side of the abdomin - where the liver ligaments join the diaphragm.

What causes a side stitch?

Research carried out my Will Hopkins at the University of Otago connected fluid intact with the likelihood of developing a stitch.

  • You're more likely to get a stitch with a full belly
  • Liquids are likely to jostle in the stomach when gulped down
  • Liquids which take longer to absorb in the gut such as fizzy drinks are more likely to cause a stitch
  • As you tire you are more likely to suffer from a stitch

How can you cure a side stitch?

There are 3 main ways advised to get rid of a stitch:

  • Change your breathing pattern to deeper breaths - if you pace your running and breathing together, this may mean slowing down or adding an extra step in to your breathing pattern
  • Stretch it out - many sports people who suffer stitches find leaning forwards helps them to recover, stretching out the back and taking the weight and strain off the ligaments on the diaphragm. An alternative if you want to run through your stitch is to raise your hands up on your head and stretch out your abdominals - this will work well with the deeper breathing
  • Compress the stitch - having support around the stitch means the load is lessened on the ligaments. Hopkins recommended using a thick belt to help support the ligament but this can also be achieved by keeping your core engaged when running and keeping the affected area tight. This also explains why stitches are more common in tired sports people as the core engagement will have lapsed as exercise becomes more tiring.

How can you avoid a side stitch?

With the knowledge that side stitches are caused by excess of liquid and weight in the digestive system, a simple way to avoid side stitches is to control the amount of food and liquid intake before and during exercise. Sipping water before and during exercise will help satisfy your thirst without adding the burden of a full stomach.

If you are prone to stitches, make sure you note the timings and quanitities of food and drink your consume around the times you're exercising - it may seem a lot of effort but even having the process in place will make you more conscious of your eating patterns and hopefully help you avoid developing a side stitch.

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