What causes a stitch and how can you prevent them?

Whether they strike in training or in races, stitches can be a real nuisance. Nick Beer looks at possible causes, and how to defeat them

How to beat a runners stitch

What is a stitch?

At some point during your years of athletic development, you may have experienced a sharp, stabbing, mild cramping sensation that manifests into a dull ache or persistent pull on the side of the abdomen. This uncomfortable feeling is an Exercise-related Transient Abdominal Pain (ETAP), or commonly known as a ‘stitch.’

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The frequency of stitches varies amongst different sports. However, sports that require the torso to be held in an extended postural position for a prolonged period of time and involve repetitive movements of the trunk are more susceptible to stitches. Running is the most provocative, closely followed by swimming, but cycling has a low incidence due to the flexed torso position and relatively little movement.

What causes a stitch?

Although stitches are very common, at present there’s no clear evidence to suggest the exact cause or how best to treat them. Early theories suggested a lack of blood to the diaphragm or the rattling of the abdominal ligaments when we rotate, but this has now been disproved. Thankfully, there are several anecdotal approaches to easing a stitch…

How can you treat a stitch, and should you run through a stitch?

Firstly, for immediate relief, slow down, take a series of deep breaths, flex the body forward and begin to stretch the affected area.

For longer-term solutions, nutritional techniques and strength and conditioning strategies could be beneficial to employ in your training programme.

Nutrition: Ensure you’re hydrated before you start your run; limit the number of sugary drinks consumed before and during the run to avoid gastrointestinal issues; and try not to eat a big meal less than 2hrs before your run. It’s essential to allow your digestive system to perform its job uninterrupted.

Strength and conditioning: As you become fitter and used to running consistently, this may help decrease the risk of contracting a stitch as your body will be more adapted to the physiological demands. And do exercises that focus on improving the range of movement in the torso and encourage spinal alignment. This may help to enhance breathing mechanics and prevent excessive rotation when running. Exercises that target the deep abdominal muscles, such as the transverse abdominus, may help support the abdominal organs. Also, exercises tailored towards developing dynamic trunk stability to improve the efficiency of the body to absorb rotational forces.

Experimenting with different approaches will help you understand what works for your own body, and could prevent future, unwelcome, side abdominal pains.

(Image: Jonny Gawler)

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Have you found an effective cure for stitches? Let us know in the comments below!