Have you ever been out for a run and experienced a sharp stabbing pain or cramp in the right or left lower abdomen? Have those cramps - or side stitches - affected you enough that you had to stop your run, or at least slow down and try to get relief?
Side Stitches are an unfortunate side effect of running that affects some - but certainly not all - runners. Although the medical establishment has given 'stitches' a more impressive & complicated name - Exercise-Related Transient Abdominal Pain (ETAP) - there is no definitive explanation as to why this painful condition occurs. There are several theories to explain ETAP but they remain just that: theories.
As a bit of a safety sidebar, as a runner you should know that cramps can be an early warning of heat exhaustion & dehydration. Heat exhaustion is a serious and potentially fatal condition. If you suspect that you might be suffering heat exhaustion, it is critical to hydrate and cool down as quickly as possible.
So what can you do to prevent stitches? Remember that - since there is no clear explanation as to how and why stitches occur - there is no sure-fire remedy to prevent them or make them go away if you're having them. These actions are really based on what has worked for people and hypothetical remedies have given positive results in many cases.
Remedy Number 1 - Avoid Sweet Beverages Before Running
A number of people have reported experiencing stitches when they run after consuming fruit juices and beverages high in sugar. Although there is no mechanism explained as to just how sweet beverage consumption may cause ETAP, it is possible that the conflicting demand between powering legs versus driving digestive processes leaves the abdominal muscles in distress. So, don't drink sweet beverages before running; focus instead on hydration with water, which you'll need to support running anyway.
Remedy Number 2 - Exhale When Your Left Foot strikes the Ground
What? The theory behind this method is that stitches are caused by spasms in the ligaments that support internal organs, particularly the liver. It is suggested that exhaling as the right foot strikes the ground creates larger forces on the liver while the diaphragm is rising for exhalation. Those forces repeated during a run lead to spasms in the ligaments supporting the liver. This is a very interesting idea. If you're suffering from stitches, pay attention to when your are exhaling. Perhaps refining your breathing pattern can cure this ill.
Remedy Number 3 - Breathe Deeply
One of the easiest remedies to try is breathing deeply, down into the abdomen. The theory behind this solution is that ETAP is caused by inadequate oxygen. When you're running, getting adequate breath is key to success. If you habitually breath only into your chest, you might be limiting the amount of oxygen you can inhale. Practice breathing down into your abdomen. You will get more oxygen on each breath which certainly can't hurt your running performance.
Remedy Number 4 - Don't Eat Too Soon Before Running
As with Remedy Number 1, this remedy is based on the hypothesis that stitches are caused by issues revolving around the ability to manage stomach & intestine contents while driving the intense energy-demand of running. If you're going to eat before running, consume a small meal of complex carbohydrates far enough in advance of the run that the meal will pass out of the stomach before you run. Proteins and fats take much more time to digest and can cause digestive stress if they are still in your system during a run.
Remedy Number 5 - Hydrate Hydrate Hydrate
If you've read many of my articles, you know I take hydration very seriously. Except in very rare circumstances, you cannot drink too much water. Since cramping can be caused by dehydration and since hydration aids all of your body processes, you should be drinking water on every one of your runs. Although you might think you don't need water on your short runs, I believe every run is an opportunity to practice hydration. So take a bottle of water and drink every 10-15 minutes while running.
Remedy Number 6 - Warm-Up and Stretch Before Running
Warming up and stretching before running gives your muscles some warning of the activity that is coming soon. Taking care of your body this way before a run will leave your muscles softer and better able to handle the rigors of running.
Remedy Number 7 - Train Smart
There are many reasons to run and as many ways to train. You must - however - give your body time to recover after challenging training. Neglecting to give your body adequate recovery time will lead you inevitably to injury and failure. Training requires periods of challenging yourself alternated with periods of rest and recovery. It is during rest that the body heals itself and becomes stronger. So train smart, rest sensibly and be healthy.
If you cramp during a run, slow down your pace slightly and take slower, deeper breaths. This should help to relieve the stitches by providing oxygen to the muscles that are cramping. If you're still suffering, you may need to walk, sip water and do some stretches.
So here you have a number of strategies you can use to prevent and relieve stitches. Hopefully, your runs are stitch-free and healthy.