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Many regular runners have likely experienced this: during exercise, especially while running, a sudden sharp pain occurs in the lower abdomen on the left or right side, accompanied by changes in breathing rate. This pain is known as acute chest rib pain, commonly referred to as a side stitch.

Many people alleviate the pain by slowing down or stopping to adjust. However, for those participating in running events, time is precious, and a side stitch can affect their performance, which can be frustrating.

Side stitches during running are common but not unavoidable. Today, I'll explain the causes of side stitches and how to handle them when they occur~

What is a side stitch?

A side stitch is also known as acute chest rib pain.During a side stitch, the respiratory muscles spasm, triggering receptors in the muscles and causing pain. The main respiratory muscles are the intercostal muscles and the diaphragm. When the intercostal muscles spasm, pain occurs on both sides of the chest. When the diaphragm spasms, pain occurs below the ribs on either side.

If you start intense activity without adequate warm-up, your muscles can become tense. The internal organs, being less active, can't immediately meet the muscles' demand for nutrients and oxygen, making the respiratory muscles prone to spasms.

Additionally, incorrect breathing methods during increased oxygen demand can cause shallow breathing and muscle tension, leading to spasms. Lack of regular exercise, cold weather, and low sodium levels from excessive sweating can also cause side stitches.

What causes side stitches?

1. Inadequate warm-up before running

If a runner hasn't exercised for a long time or hasn't warmed up properly, their body and organs aren't fully prepared for the activity. As exercise intensity increases, muscle fatigue can lead to spasms and side stitches.

2. Irregular breathing rhythm

If your breathing rhythm is unstable, too shallow, or too fast while running, it can fatigue the respiratory muscles. Frequent contraction and relaxation can cause spasms. Rapid, shallow breathing increases chest pressure, hindering blood return from the inferior vena cava and hepatic veins, causing liver and spleen congestion.

3. Impact of exhalation method

Most people exhale when stepping with their left foot, but some exhale when stepping with their right foot. The liver, located below the right side of the chest, moves downward when the right foot steps out, while the diaphragm moves up, causing ligament stretching and diaphragm spasms, leading to side stitches. Exhaling with the left foot reduces this risk.

4. Exercising immediately after eating

Side stitches are also related to the type, amount, and timing of food intake before running.Running after eating too much or without enough digestion time can strain the stomach and intestines, causing dull pain and spasms. Consuming high-sugar and high-osmolarity drinks before or during running can also cause side stitches.

5. Stimulation from visceral diseases

Visceral diseases can also cause exercise-induced abdominal pain. Conditions like hepatitis, bile duct infections, stomach and duodenal ulcers, and chronic appendicitis can cause congestion and swelling in affected areas. Running can further irritate these sensitive areas, causing pain.

How to handle side stitches while running?

First, assess the severity of your pain. If you feel slight discomfort or mild soreness on both sides of your waist and abdomen, the side stitch isn't severe.

1. Slow down your running speed

If the side stitch isn't too severe, you don't need to stop running immediately. Just slow down to a jog or walk. Adjust your breathing speed and depth to alleviate the pain. Generally, mild side stitch symptoms will gradually disappear after 500-600 meters.

2. Adjust landing force

When adjusting with a slow jog, if the left side under the ribs hurts, apply more force when landing on your right foot to lift your body forward, and lightly touch the ground with your left foot. If the right side hurts, do the opposite. In short, try to land more on the non-painful side.

3. Increase breathing depth

Breathing rhythm is crucial while running. Control your breathing frequency appropriately. When you experience a side stitch,switch from shallow to deep breathing. Exhale slowly and deeply, pushing the air out forcefully. This allows more air intake, meeting the oxygen demand during exercise, relaxing the respiratory muscles, and alleviating pain.

4. Press the painful area

If the side stitch pain is noticeable, place your hand on the painful area of your abdomen and press it rhythmically with your fingers according to your breathing rate until the symptoms ease or disappear. Be careful not to press too hard, as it may worsen the side stitch.

5. Hold your breath and tap the painful area

If the above methods don't relieve the pain, take a deep breath and hold it for about 30 seconds, then tap the painful area on both sides of the chest or under the ribs. Repeat slow, deep breaths a few times to relax the respiratory muscles and relieve spasms.

Summary

As a regular runner, you should strengthen your core muscles, especially the abdominal muscles. Regular deep breathing exercises can improve your respiratory system's function.To prevent side stitches, take preventive measures before running.Alwaysdo a thorough warm-up before running. This helps the respiratory muscles gradually adapt to the faster contraction rate, preventing spasms.