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How to Stop or Prevent a Side Stitch

Strategies to Reduce Exercise Related Transient Abdominal Pain when Running

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A human rib cage as portrayed in Gray’s Anatomy

It must be a very small number of runners who haven’t experienced a side stitch or two. It’s not limited to running; athletes participating in other activities share our pain. For example, those in aerobics classes, cross-country skiing just to name a couple.

The good news it that it’s not technically a running injury like . Nevertheless, it may still take you out of the game for several minutes. More good news? When you understand what brings it on, you’re halfway to stopping it or preventing it altogether.

You might have heard it called a side crampie or a side ache, but your doctor would label it ETAP (Exercise related Transient Abdominal Pain). Transient doesn’t mean she thinks you’re a homeless person or a vagrant; it just means that it’s temporary.

So What Causes Side Stitches?

This is the mystery question. Theories abound but it’s accepted that ETAP is a medical condition which happens when the ligaments which run from your diaphragm to your your liver and other internal organs stretch. Picture this: your thoracic diaphragm is essentially a group of muscles situated at the lower part of your rib cage (see illustration above).

The purpose of your thoracic diaphragm is to tighten and loosen to change the shape and proportions of your thoracic cavity. This allows your lungs to enlarge when you inhale. And you know how much more and how deeply you inhale when running. Clever, isn’t it?

It is also interesting to note that the spasms that accompany side stitches tend to happen when your right foot strikes and you’re exhaling. Coincidentally, your liver is located on right right side.

Prevent Side Stitches Before They Occur

Runners that fall victim to these aches report anecdotally that they have them less often as their fitness level increases along with their weekly mileage. Logically, this means that as the body gets used to the stress it learns to deal with it. Here’s some strategies to follow that may help: `

Ways to Stop the Pain

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