How to Prevent Stitches During Your Run

Almost every runner – recreational or professional – would have experienced a stitch; that annoying and sometimes extremely sharp pain that develops in your side or abdomen during exercise.  While some of the time, you can run through the pain, often the sufferer will be forced to slow or even stop which can be extremely frustrating, particularly if it occurs during a race.

Currently, the exact cause of a stitch or “exercise-related transient abdominal pain” (if you prefer to use the technical name) remains unclear.  One theory is that the pain occurs due to irritation of the parietal peritoneum, which lines the abdominal cavity, possibly due to friction from movement. This lining is innervated in a way which allows for precise localisation of pain, unlike the contents of the abdominal cavity including organs and ligaments, which produce only a vague, poorly localized sensation of pain when irritated.

Unfortunately, due to our limited knowledge of the cause of a stitch, many of the techniques recommended to avoid one are based purely on anecdotal evidence so you may have to experiment to find what method suits you best.

Pre-run

Many runners will find that developing a stitch is directly related to their pre-run nutrition. Evidence suggests stitches may be associated with distention of the stomach, so make sure you leave plenty of time between eating and your next training session. Although it varies between individuals, approximately two hours should be plenty of time to allow for digestion, as long as you haven’t just consumed a 500g Steak or Mixed-Grill.

It is also important not to drink too much before running. Regular sips are the key, rather than drinking a large volume all in one go.  Furthermore, highly concentrated fluids such as fruit juice are more likely to trigger a stitch, so try to avoid these before a run and stick to water or isotonic sports drinks.

Evidently, stitches occur much less frequently in those who are highly trained.  If you are just starting out on a training program make sure you take it slow and steady, and then gradually increase your work load – as you get fitter, the chances of developing a stitch will decrease. Keep in mind however, not even Olympic athletes are immune to the dreaded stitch.

During the run

During a training run or shorter race, it is easy to avoid eating and drinking.  However, if you are partaking in a long distance event such as a marathon or an Ironman, it is imperative to take in fluid and energy during the race. Some recommended techniques to avoid the development of stitch

Some  recommended techniques to avoid the development of a stitch include drinking isotonic fluids such as specifically formulated sports drinks, taking small but frequent sips of fluid rather than big drinks and ensuring water is consumed when taking in energy in the form of gels or lollies.

The development of a stitch can sometimes be associated with irregular, shallow breathing patterns, where the athlete appears to be ‘panting’.  Try to focus on breathing deeply and regularly during your run.  There is some evidence to suggest that breathing out as your left foot hits the ground, as opposed to your right foot, can reduce the risk of developing a stitch as this is believed to place less stress on the diaphragm.  Also related to breathing, some athletes find that talking whilst exercising can trigger a stitch so try to keep chatter to a minimum when you’re out running with friends.

If you get a stitch:

Slow down or stop if necessary and concentrate on breathing slowly and deeply to give your body a chance to recover from the stitch.  Try stretching the abdomen by reaching your arms above your head and apply pressure to the area to help ease the pain.  After a little time, the pain of a stitch should subside.

In summary, it can take a bit of trial and error but eventually you should find a routine that suits your body and with improved fitness hopefully you will be able to enjoy running stitch-free!