Almost every runner has experienced the infamous side stitch: just when you hit your stride and boom, a slow cramp strikes your midsection and quickly turns into a sharp pain. Studies suggest side stitches impact nearly two-thirds of all runners at one point or another. They occur as a result of the act of running itself, which leads to increased pressure on your abdomen and intensified breathing patterns. Learn how to cope with a side stitch during your run, and strategically plan ahead to avoid them entirely.
What is a side stitch?
“A side stitch is really just a tight, spasmed oblique muscle,” explains Rui Li, president and CEO of New York Personal Training. “We tend to stay seated in the same position for long periods of time, usually with very poor posture. So, eventually some muscles get really tight, particularly those in our trunk. When we get up and start running, we suddenly put stress on those core muscles, but they’re still stuck in place from the poor posture.”
It can also be related to tight hip flexors, according to Dr. Len Lopez, a nutrition and fitness expert based in Texas. “When you look at where the psoas and iliacus muscles (hip flexors) attach, you see they also attach on the inferior aspect of your diaphragm,” he says. “As you run, your diaphragm starts pulling more forcefully up and down as you inhale and exhale.”
Above all, a side stitch indicates that your body is under stress. Running coach Kyle Kranz says, “In general, I see people get side stitches for two reasons: Either they started a run at too high of an effort without warming up into it, or they have too much in their stomachs.”
Should I keep running if I get a side stitch?
It depends. Kranz says even though they may be uncomfortable, side stitches are harmless. So, you can certainly slow down, wait a little bit, and then continue on your run. Li agrees, noting that side stitches often go away as your body continues to warm up.
However, if the pain continues, experts agree on calling it quits and giving your body a break. You can also transition your run into a walk, practice deep breathing until the pain disappears, and then slowly bring your pace and heart rate back up.
Can I prevent side stitches?
Your diaphragm functions as a wide swath of muscle across the bottom of your rib cage. Just like any other muscle in your body, it can fatigue when overloaded. That’s why beginner runners or individuals working on distance or pace tend to be most often affected. Still, there are a number of strategies you can employ to reduce your risk.
First, a solid warm-up can help get your heart rate, lungs, and blood flow moving at a manageable speed—versus going from zero to 100 in two seconds flat. “Before any activity, it’s important to perform movement preparation routines,” Li says. “Foam rolling should be the first choice because you need mobility in order to accomplish strenuous physical tasks, and you can prevent side stitches with some foam rolling on your obliques and abdominals before running.”
Additionally, core strength, breathwork, and the timing of your meals before a workout all play a part. Weak diaphragm muscles are more prone to cramping, so a strong core allows you to run efficiently, reduce your risk of injury, and minimize the likelihood of side stitches. Breathe deep, full breaths during a run to give your body the oxygen it needs to perform.
Make sure you’re allowing for enough rest time in between high-intensity running intervals if you’re training for speed. If you’re a newer runner, prioritize short breaks during your runs to help your body get used to running and breathing properly. Finally, pay attention to how soon you exercise after a meal. Try to avoid eating or drinking anything heavy at least 60 to 90 minutes before your workout.