4 Ways to Prevent the Dreaded Side Stitch

How to avoid getting this common pain in your side
By Jenny Hadfield, Runner's World

For those who exercise regularly, we don't usually let a little pain or weather stop us. We workout through sleet and snow, heat and haze, with blisters and black toenails, headaches and knee aches. But a side stitch? That sharp, stabbing pain that hits below the ribs can stop us in our tracks. Although the exact cause of side stitches has yet to be proven, theories abound. Sports-medicine physician Jordan Metzl, M.D., coauthor of The Athlete's Book of Home Remedies, says the most likely cause is a diaphragm spasm. The diaphragm, a sheet of muscle that extends across the bottom of the rib cage, plays an important role in breathing. Just like your leg muscles, your diaphragm can fatigue and cramp when put under too much stress. That's why side stitches tend to strike beginner runners or those stepping up pace or distance. The good news is that there are a variety of effective strategies--ones that I put to the test with the runners I coach--that can help prevent this common problem.

PLUS: Exercises That Help Prevent Injuries

SHORE UP YOUR CORE
Performing just 10 minutes of core-strengthening exercises, like planks and donkey kicks, three times a week (or practicing yoga or Pilates on a regular basis) can strengthen weak diaphragm muscles, making them more resilient to fatigue and less likely to cramp.

Bonus: A stronger core will also help you run more efficiently and reduce your overall vulnerability to injury.

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FUEL WISELY
What and when you eat before exercise may contribute to side stitches. If your body is still digesting food, there will be less blood flowing to the diaphragm, which can induce spasms. Foods that are high in fat and fiber take longer to digest, and so should be avoided one to two hours before you run. Studies have also found that fruit juices and beverages that are high in sugar can contribute to stitches. So consider keeping a log of the foods and drinks you consume pre-workout and when you experience a stitch so you can recognize triggers.

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WARM UP
Going from standing to a full workout may save you time on the watch, but it can create irregular, rapid-fire breathing patterns, which can leave you bending over in pain. Invest in two to three minutes of brisk walking, and then gradually work into an easy running effort before launching into your planned workout pace.

DID YOU KNOW? How a Harder Warm-Up Can Boost Workout Results

INCREASE YOUR BREATH
If breathing is too shallow, it doesn't provide adequate oxygen to working muscles, including the diaphragm. Inhaling and exhaling fully and deeply can help reduce the occurrence of side stitches. Research shows that breathing "faster"--as in, inhale for two steps, exhale for one step--increases the depth of breath. Watch our video demo to learn the Breathing Tips Everyone Should Know.